Dr. Eisner Answers Your Questions Part 3
Three months ago, I woke up in the middle of the night vomiting. No warning, no heartburn, no wake up and vomit - just I'm awake and vomiting. Afterwards, I had difficulty breathing, couldn't catch my breath, and after I did I catch my breath had a sore throat and my voice was rough for a couple of days. I saw a doctor in Hong Kong (where I live) and was given three weeks worth of antacids and anti-gas meds. Since then, nothing has happened until three nights ago when I had another "attack" that went exactly like the first except I had a rattling in my chest afterwards and difficulty breathing so I went to the hospital. They admitted me for two nights and discharged me today with a prescription for an antacid named Pariet. Is this GERD, acid reflux, or something else? I do have a lot of gas but almost never experience heartburn sensations. I really need help and advice on this. I'm not getting much from my local doctors. Is vomiting a normal symptom for one of these conditions? Should I be looking for some other diagnosis? Why is this happening? I am afraid I'll wake up vomiting next time and NOT be able to catch my breath.
Nighttime vomiting without any other associated symptoms is usually a result of acid reflux disease. The most serious complication would be aspiration. That is when contents from the stomach come up the esophagus and then go down the respiratory system into the trachea and then into the lungs. While acid reflux needs to be evaluated and ruled out, so do motility disorders of the esophagus and stomach. But this is one of several possibilities, and the final diagnosis can only be established by the treating physician. If the stomach fails to empty, when one lies flat, the contents from the stomach will rise into the esophagus and occasionally out the mouth. As a protective measure, one option could be not to lie flat for 3 hours after eating, and if the problem persists, the head of the bed should be elevated with either multiple pillows or cinder blocks. Evaluation by a gastroenterologist could consist of an upper endoscopy, barium studies and possibly nuclear studies to assess emptying ability of the stomach.
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Published On: September 13, 2006