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Having vomiting. Lost weight. Blood test showed high levels of cortisol. Having frequent hiccups. Help?

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Practicing since : 1962
Answered : 693 Questions
My wife has been throwing up all foods and liquids for 4 months now. She has lost about 47 pounds so far. We have done all the blood tests the doctors ordered, the only thing they found was that she had high levels of cortisol. In the 9th month of pregnancy she used to have hiccups when she started eating her meal and then it would disappear after the meal; the hiccups disappeared after deliver. 1 and a half months after delivery, she had the hiccups again. Then at about 2 and a half months post delivery she started to have a pain and difficulty swallowing solid foods but could swallow liquids. At the third month post delivery the pain disappeared and she began to throw up anything that gets into her stomach and she has been like that since then. She now weighs 74 pounds and she is till losing weight because nothing stays in her stomach even liquids. Can you please help because we have seen so many doctors but with no definite answer. I am enclosing all her lab test results in the compressed file.
Posted Sat, 13 Jul 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 25 hours later
Hello ,XXXXX,
Thank you for contacting XXXXXXX with your concerns about your dear wife's
health issues. Especially since she is not able to keep anything down ,
she is not getting any neutrients and hence the significant weight loss.
I am in a way relieved that all her blood tests came back O.K. You also
say that her endoscopic examination was also normal.
During her pregnancy, she had hiccups. This is just related to hiatus hernia
that is from the pressure on the diaphragm from the baby and enlarged
uterus. This happens in many women but is temporary. Rarely the hernia
can persist even after the delivery. Your doctor would have been able to
tell if she had this at the time of endoscopy.
You mention that you had sent an attachment of her reports. I don't see it.
Please check with the moderator.
I am a little concerned about the high cortisol levels. This points to some
endocrine problems , something with the adrenal glands.
High cortisol levels are associated with Adrenal tumors, severe stress, Overactive
thyroid, pituitary tumors, medications such as oral contraceptives can all
cause elevated levels.
Hope your doctors have ruled out all of these.
If no anatomical or other causes are not found , she may have to be treated
symptomatically or even hospitalized and observed .
I would like to see her complete blood profile.
Remember Anorexia and Bulemia can be hidden as well.
I wish her the very best.
Above answer was peer-reviewed by
Follow-up: Having vomiting. Lost weight. Blood test showed high levels of cortisol. Having frequent hiccups. Help? 5 hours later
I am attaching her blood tests in separate files. I hope thye get through this time.
Here is file 1 XXXXXXX

Here is file 2

Here is the rest of the fiels
Answered by Dr. Charles S Narasi 13 hours later
Hello, XXXXX,
Thank you for sending all the test results.
Surprisingly , with all the vomiting etc. all
her blood work seems to be in normal range.
Except for a slightly low potassium level (Expected)
her protein levels, liver tests, her hemoglobin and
hematocrit, CRP, ESR , kidney tests are all normal.
Urine shows a little red cells and white cells which
may be due to contamination or presence of periods
or could be a slight infection (Urinary Tract). I also
see a second Cortisol level came back normal .
All this to me indicates that your wife might be under
a lot of stress and she might be fighting to cope with that.
But , there are some tests that I did not see.
Thyroid blood tests . If she has not had a CT-Scan of the
head , or an MRI , it may be worth doing it to rule out
some of the conditions that I mentioned before.
Perhaps a joint visit to a psychologist may be helpful.
She does not appear to be in a state of malnutrition looking
at all her blood work.
I wish you both the very best.
Above answer was peer-reviewed by
Follow-up: Having vomiting. Lost weight. Blood test showed high levels of cortisol. Having frequent hiccups. Help? 3 hours later
Since all of her blood work is normal. How can we get her back on foods, are there any suggestions that we can follow to get her to eat normally; I mean do we need to put her on a certain food regimen?
Can you please advise, because the doctors here are not telling us what to do with regard to providing her with nutrients. Are there any foods that she needs to start with, and does she need to eat in small portions and how often?
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXX,

The best way is , if she likes certain foods or drinks start
with small quantity. Even if she has to eat every two hours ,
small amounts of easily digestible foods with calories are better.
For example , if she likes ice cream of certain flavor start her to
take that. There are also milk shakes or protein drinks which she
can have 2-3 ozs. three or four times a day. If she likes fruits ,
ripe bananas, grapes , apples , pineapple , papaya in small portions
are good. Also , I would recommend a good super B-Complex vitamin
along with Vitamin-C 1000 mg. once a day .This should improve
her appetite and also help the immune system.
It is better to have her eat very frequent smaller meals.
Avoid very fatty , greasy or fried foods.
You can consult with a dietician or a nutritionist for proper advice.
I really want to wish her the very best and hope she returns to
normal eating habits in time.
Above answer was peer-reviewed by
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