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What causes spitting of white sticky liquid and uneasiness after meals?

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Posted on Fri, 15 May 2015
Question: Hello, My mother was detected with GERD and LAX XXXXXXX around 3 years back. However the symptoms had occurred almost 10 years back. We could never understand what the exact problem was. She spits out a white sticky liquid everytime after her meals. This liquid chokes her up if she doesn't remove it. Also, she cannot digest very spicy, oily or heavy food. Hence, the salt, spice intake is also less. She is diabetic too (low diabetes). In these past 3-4 years she has lost almost 8-10 kgs. We have took many opinions and done endoscopy, capsule endoscopy, colonoscopy but the tests doesn't show any major internal problems. The haemoglobin level is always between 7-9. She feels very uneasy after meals n cannot sleep properly. She feels fine only after she vomits this liquid. She is currently on thyroid and BP Medicines. Her creatinine level has touched 3. She gets frustrated all the time because of this liquid. Please help. How can this liquid stop? Will she be able to digest food properly?
doctor
Answered by Dr. S. Samanta (24 hours later)
Brief Answer:
It would better if biopsy report was there!

Detailed Answer:
Hi! thanks for sharing your mother's health problems!

It is clear that she has chronic problem of upper gut; it could be H. pylori infection (not tested/reported), giardia , parasites, acid/peptic diseases, atrophic gastritis even tuberculosis or gall bladder problems.

No biopsy was done for her from esophagus, stomach or duodenum; whatever might be the cause!

According to my experience of nearly 3000 endoscopic biopsies, I would suspect following possibilities in her case:

1. hiatal hernia or nerve problem that makes the lower esophageal sphincter loose!

2. undetected infections like candida, viruses or H. pylori

3. hyperacidity

4. bile reflux if fat content of food is more

She needs to take medicines as prescribed and in addition avoid empty stomach more than 3 hours, take small amount of foods 6/8 times a day consisting of bland /dry items

there are few preparations in XXXXXXX medicine shops to reduce/help this regurgitation like metoclopramide/domperidone/cisapride/antacids etc.

Als let her avoid taking water just after food; take it after 30 minutes and take rest in head-up position/slow indoor walks.

regards,
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. S. Samanta (23 hours later)
Hello Doctor,

Thankyou for the reply. I would like to mention, that the biopsy of her colon was done and was found normal. I would like to know more about hiatal hernia or nerve problem and undetected infections/ H pylori. What tests can be done to find out the same? Also can you prescribe such medicines which reduce this problem like you mentioned in your answer?
The problem with small indoor walks is, that after sometime, her feet start swelling. This is supposedly because of the kidney problem. Can there be any other light exercise apart from this?
doctor
Answered by Dr. S. Samanta (17 minutes later)
Brief Answer:
A thorough review could be helpful in her case!

Detailed Answer:
Hi! colon biopsy was not required; rather esophageal/gastric biopsy were needed. Anyways, in hiatal hernia, balloon-like part of stomach enters into chest cavity and gives pressure on the esophagus...regurgitation of gastric juice/foods occur. phrenic nerves/vagus, if affected by diabetes, infection etc, may loosen lower esophageal sphincter causing GERD. Blood tests like H. pylori IgG can detect infections. Mid-abdominal fat or ascites might also cause GERD.

Give her chewable antacid tablets/dry popcorn/puffed rice etc to reduce the symptoms. If H. pylori is positive, give her HP kit under prescription. Give her famotidine/domperidone combination 1/2 hour before meals twice a day.

Frequent change of posture and placing a pillow under feet can help to reduce leg edema. Review of her medicines also necessary.

feedback most welcome!
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. S. Samanta (45 hours later)
Hello Doctor,
Thankyou for the explanation. However I have a doubt, Isn't hiatal hernia detected from endoscopy or colonoscopy? Also I would like to know if any of the tests that you suggested i.e esophageal/gastric biopsy involve the use of XXXXXXX since our consulting nephrologist has not recommended its use because of her creatinine levels. They say there is no guarantee as to when she will come to conscious after its use. Citi scans and MRI's are also not recommended as they will lead to condition of dialysis. Kindly also tell us where these tests are available, locally or at special hospitals? If any prescription is required to conduct these tests?
doctor
Answered by Dr. S. Samanta (13 minutes later)
Brief Answer:
These are very common tests but need prescription.

Detailed Answer:
Hi!
Thank you for the feedback.
No. hiatal hernia is not detected by endoscopy or colonoscopy; it is best detected by ultrasonography or sometimes upper g.i endoscopy.

esophageal/gastric biopsy are done under local anesthetic liquids and with full consciousness and does not involve the use of Anaesthesia .

Plain CT scan (without contrast) and MRI are could be done even if patient has defective kidneys.

Well, these tests are available even in small diagnostic centres, multispeciality hospitals and nursing homes; these are all very common tests. not to worry at all!

If any prescription is required to conduct these tests? YES.

Regards,
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Dr. S. Samanta

Pathologist and Microbiologist

Practicing since :2004

Answered : 1107 Questions

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What causes spitting of white sticky liquid and uneasiness after meals?

Brief Answer: It would better if biopsy report was there! Detailed Answer: Hi! thanks for sharing your mother's health problems! It is clear that she has chronic problem of upper gut; it could be H. pylori infection (not tested/reported), giardia , parasites, acid/peptic diseases, atrophic gastritis even tuberculosis or gall bladder problems. No biopsy was done for her from esophagus, stomach or duodenum; whatever might be the cause! According to my experience of nearly 3000 endoscopic biopsies, I would suspect following possibilities in her case: 1. hiatal hernia or nerve problem that makes the lower esophageal sphincter loose! 2. undetected infections like candida, viruses or H. pylori 3. hyperacidity 4. bile reflux if fat content of food is more She needs to take medicines as prescribed and in addition avoid empty stomach more than 3 hours, take small amount of foods 6/8 times a day consisting of bland /dry items there are few preparations in XXXXXXX medicine shops to reduce/help this regurgitation like metoclopramide/domperidone/cisapride/antacids etc. Als let her avoid taking water just after food; take it after 30 minutes and take rest in head-up position/slow indoor walks. regards,