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Vomiting after eating. Suspected for mild tonsils inflation, gastro intestinal reflux. Proper diagnosis?

Feb 2013
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Practicing since : 2002
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Hi I have a four year old daughter.

The problem is ever since her early years she vomits on very frequent occassions after a meal. This is generally due to the cold and mild phlegm that she develops. we have seen many doctors. Where some say she has a mild tonsils inflation others say it is a gastro intestinal reflux. But the problem still persists. She vomits or is nauseated almost in every meal when even with a mild bout of cold. And this cold occurs in her every 15 days. Please guide
Posted Mon, 29 Apr 2013 in Infections
Answered by Dr. E Venkata Ramana 23 minutes later

Thank you for your query on Healthcare Magic.

Usually a bout of cough causes vomiting due to pressure on vomiting center as the both cough and vomiting centers closely located in the brain.

Cold followed by ingestion of mucus will lead to irritation of gastric mucosa and in return vomiting will occur.

But the other causes of vomitings are :

1. Forceful feeding.

2. Gastro esophageal reflux.

What is her present weight?

Is there any decrease in her weight?

Kindly send this information in your next query.

If vomiting is due to post cough or gastric irritation with cold and mucus, no treatment is required for vomitings and treating cold and cough will decreases vomitings.

If the vomitings are due to forceful feeding, stop it and ask her to eat her food and don't force her while giving food.

If it is due to gastro esophageal reflux, small feeds at frequent intervals to be given. And after feed, child should be in upright position for 10 to 15 minutes.

If the reflux is severe prokinetic and antacid drugs like domperidone and ranitidine will be useful in the control of reflux.

For frequent cold, get her examined for presence of any allergic rhinitis which requires avoidance of exposure to allergen and treatment with an oral antihistamine like cetirizine or fexofenadine.

Therefore I advise you to consult a Pediatrician for the review of her detailed history, her complete physical examination and further evaluation to find out the reason.

Hope I have answered your query, if you have any clarification please let me know.

Above answer was peer-reviewed by
Follow-up: Vomiting after eating. Suspected for mild tonsils inflation, gastro intestinal reflux. Proper diagnosis? 14 minutes later
Hi thanks for yor query....

1) There is no decrease in weight gain, but there is no increase either. She has a very thin body frame too.

2) There is no forceful feeding.. Infact the child eats quite well otherwise.

3) When she gets this bout of cold, she vomits every single meal including water...

) its not cought but there is a lot of phelgm built up. And the reflux is quite severe. Have tried Emset but she vomits that also.

i want to know how do i prevent these from recurring? docs generally give cetrizine wgen the cold has already come. can i give cetrizine on a regular basis?

Also I have tried multiple pedriaticians . Have not got an answer.. What are the checks recommended apart from allergens?
Answered by Dr. E Venkata Ramana 2 hours later

Thank you for getting back.

As there is no weight loss, nothing to worry.

And I appreciate your child for having her food quite well without a struggle at meal time and this indicates secured attachment with parents and rules out forceful feeding.

So the possibility of vomitings are due to a reflux or irritation of stomach by phlegm which is swallowed.

If it is due to reflux the following measures will help to decrease the vomitings:

1.Avoiding acidic foods like tomatoes, chocolate, and mint and beverages like juices, carbonated and caffeinated drinks.

2.Head end of bed elevation and left side position during sleeping.

3.Ranitidine for mild to moderate reflux.

4.Prokinetic agents like domperidone.

If the vomitings are due to phlegm and cold, symptomatic treatment with oral antihistamines and avoidance of exposure to a particular known allergens will be useful.

Without a doctor advise please don't give cetrizine for longer duration.

To prevent recurrent attacks of cold, avoid exposure of the child to smoke, pollution, dust, plants, pets, and to people with cold and cough in general and to any known allergic substances.

Try to maintain a diary of his daily food types, activity, attacks of cold, and any exposures to various allergens and correlate them to know any particular thing is causing cold persistently and if it is there you can avoid it.

What I advise is to be in regular follow up with one Pediatrician for her complaints as it will be helpful in planning treatment for your child.

Give a balanced diet.

Encourage her to wash hands frequently with a liquid soap especially after playing and coming from out.

Hope I have answered your query, if you have any clarification please let me know.

Above answer was peer-reviewed by
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