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Suffering from upset stomach. Feeling vomiting and weak. What can be done?

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General & Family Physician
Practicing since : 2009
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i've been suffering over the last 2 weeks of a mildly upset stomach off and on, only in the mornings. it happens about 15 - 20 minutes after i've been up and it feels as if i need to gag / throw up. there is never any vomit, blood etc but i do feel a bit weak. after i gag / cough i begin to feel better. coffee seems to make it worse. by late morning im fine and usually feel no symptoms similar til the next morning.

ive also noticed this feeling in cold weather, particularly if i catch some wind in the face.

i've recently had a good amount of blood work done, thyroid checked, full physical etc. tthis was mainly due to suffering heat exhaustion event which occurred in early april. all my tests thus far have shown nothing.

actually suffered from a panic attack about 2 weeks after my heat exhaustion, due to fatigue / light headed which kept occurring. this was especially true while walking.

i visited an ENT and did a full scale test on balance (VNG), they found no central problems or inner ear issues.

any thoughts or recommendations on this?? do i need to get an MRI?

my doctor thinks it is all anxiety related.

i also notice my feet sweating a bit but dont believe its a major issue. please let me know. thank you

Posted Wed, 5 Jun 2013 in General Health
Answered by Dr. Shoaib Khan 10 hours later
Hello and welcome to XXXXXXX

Thank you for writing to us.

I have gone through your query and shall try my best to put forward as much information as required by you.

To start off with, it is a good thing you ruled out vertigo (is the sensation of dizziness and nausea like feeling due to change in position), which is a ear and balance/central system related problem.

The next thing we will have to look into is blood sugar. At times, especially early in the morning, which is after a long duration of fasting, many patients experience a lot of symptoms, so I advice you to get your glycemic profile checked. This will have to be ruled out.

The next thing we should look for is a gastrointestinal cause. Eg. ulcers, increased acid production in the stomach, acid reflux, hiatus hernia, etc. I have mentioned these conditions because of your observation of a general worsening in condition after the consumption of coffee. But, getting better as the day progresses.

Next we speak about postural hypotension. This is a fluctuation of blood pressure, especially with a change in position. Will have to be ruled out by measuring blood pressure in different positions

Hypertension. This condition in itself can cause early morning nausea and vomiting, due to overnight fluctuations. A Holters monitoring device can be used for 24 hours to check on fluctuations.

And lastly, the anxiety alone can also cause these symptoms. This can be ruled out when the anxiety is completely under control, but the symptoms you are experiencing are still present. But, if all of the above conditions have been ruled it, it should be an anxiety-related problem.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
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