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I vomit acid almost every day. I feel like it is associated…

Customer Question
I vomit acid almost...

I vomit acid almost every day. I feel like it is associated with emotional stress. Over the last 4 years I have been on a number of PPI's none worked. In fact made it all worse.

Doctor's Assistant: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?

I am underweight because of loss of appetite. Chronic fatigue. No energy. Overall weakness. Nauseous everyone I eat.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have developed anxiety and have bouts of depression due to this

Doctor's Assistant: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?

4 years. I am 26 years old Probably anxiety and stress

Submitted: 9 months ago.Category: Health
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Answered in 9 minutes by:
9/27/2017
Health Professional: Dr. Muneeb Ali, Doctor (MD/DO) replied 9 months ago
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor (MD/DO)
Category: Health
Satisfied Customers: 9,665
Experience: MBBS, MD, ECFMG certified. 11 year experience in dealing with cases related to all fields of medicine
Verified

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Can i ask have you undergone an endoscopy? A stomach emptying study/motility test? Screening for h.pyroli? What about a CT scan of the abdomen?

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Customer reply replied 9 months ago
I have had 3 endoscopys in the last 3 years. The last one showed a hiatal hernia of 2 cms. I was in lansoprazole and ranitinde for a year and a half and they did not help in fact made it worse. 4 years ago I had h pylori which cleared up after taking antibiotics. From then on I have severe acid reflux. Vomiting it regularly in the mornings
Health Professional: Dr. Muneeb Ali, Doctor (MD/DO) replied 9 months ago

Have they tried correcting the hiatal hernia via surgery to see if that is causing worsening of your symptoms. Actually usually a small hiatal hernia would not cause siuch severe symptoms in most cases however if you are not responding to the medications then this is a possibility to considered. Secondly, if the vomiting is worsening and this is occurring at such a young age then they should also consider zollinger ellison syndrome which is a condition in which there is a benign tumor of the pancreas which can lead to increase production of gastrin which in turn causes marked increase in acid production leading to symptoms like yours. It would be diagnosed with serum gastrin levels and also a CT scan of the abdomen with contrast. This would be then treated with surgery.

ANother cause which should be looked into is that you could have a stomach motility disorder which is causing inability of the stomach contents to move forward in a timely fashion. This would need a gastric emptying study or motility test to be diagnosed and if this is the case then it should be managed with the help of simple motility agents like erythromycin or metoclopramide. Once those are started it would be effective in controlling the problem.

Lastly you should also be started on STRONGER PPI's such as rabeprazole, pantoprazole if they have not been tried, ranitidine is not a very good drug in your case. If these dont work then your doctor can try dexilant which is the strongest of these drugs and patients who dont respond to other drugs do respond to these drugs.

You should also be screened for MEN syndrome or multiple endocrine neoplasia (in which there are benign tumors in multiple glands of the body) , these are BENIGN tumors but they do cause fatigue etc.

Also sorry for the late response but i was offline

Do you have any more questions?

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Health Professional: Dr. Muneeb Ali, Doctor (MD/DO) replied 8 months ago

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

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