What causes vomiting, gas, increase in appetite and persistent cough?

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Posted on Tue, 24 Feb 2015 in Digestion and Bowels
Question: Hi,

I am XXXX, 29 year old 5, 11 heights working in IT industry. I am little workaholic, that doesn’t mean that I am not taking care of my health. Ill daily go to office by walk (1.5 KM), have food at regular time (may be 1 hour delay but never skips) sleep at least 6 to 7hours (rest of the time I’ll spend in office including some time weekend) this was my life for more than 4 years after I started to work). I don’t have any bad habit, no smoking, drinking etc.

Till 2014 my health was fine, on XXXXXXX 1’st 2014 I felt little weakness, I thought it may be normal. (I was under the medication for my hair loss in beard for that I was taking Decdan 0.5 mg (Dexamethasone) and it was almost more than 20 days; my hair is re-growing in beard in the same place.) On next day morning I felt Pulling sensation in my Pam and foot (It’s not Numbness or Tickling. It’s a kind of feeling if you hold silkworms in your hand when they move the feeling you get. And this sensation is there only at my Pam & Feet). I went to doctors and doctor told me it may be due to weakness, within 3 days then sensation is increased and I am feeling more weakness, not able to walk, Fainting sensation etc.

I went back to doctor once again and then he suggested me ‘Nuroxind-LC’ (Mecobalamin / Methylcobalamin) for one month. As I started taking the tablet Pulling sensation is reduced, but within 2 to 3 days I started feeling Stomach burning, Heart Burning, High hart beet. Once again I went back to doctor and he told me it is due to gastric and suggested me take ‘Pan-D 40mg’ (Pantoprazole + Domperidone) along with ‘Nuroxind-LC’. I took both the tablet for one month (entire January). During this time period I stopped taking Decdan and never taken after that.

During the period of taking the tablet Nuroxind-LC’ & Pan-D 40mg I noticed that sweating is increased (even though I work in AC my pam and feet are sweating), and instead of feeling hungry I am getting small pain inside the stomach. So whenever I get that pain I need to eat if otherwise the pain will start increasing slowly and my hands and legs will start shaking. I have high beat of if I walk even small distance and I can feel the same. As suggested I stopped taking the medicine after one month. I was recovering slowly and side effect (sweating /pain/heart beat) also reduced. I was fine after next 20 days. I also noticed that if I eat more I had strange feeling like my head is becoming light, eyes are becoming blank( like fainting sensation just for 1 or 2 sec, but I never fainted) and after lunch some time my eyes are burning and small amount tears also came some time.

In the February middle week I had dinner at night, during the dinner I felt the same fainting (my head is becoming light, eyes are becoming blank) sensation. From the next day morning I was unable to eat, so I took Pan-D once again but it is not helped. I went back to doctor once again and he suggested Endoscopy. After endoscopy he told that in may have hiatus hernia (During Endoscopy he asked me to cough) and suggested me operation but told me he is not sure whether Gastric will stop and also asked me to take other doctor suggestion before going to Operation. Then I went to super specialty Hospital, there once again doctor suggested to do endoscopy (Rep: Endoscopy & Biopsy_ Feb 2014) and doctor told me that operation is not needed and also declined that I am having hiatus hernia that required operation. He suggested me Rabekind-plus (Rabeprazole + Levosulpiride) tablet for next 6 week.

After two week one day morning I wake up and had a glass of water as regular but it Vomited. I had Breakfast but nothing happened, next day also in the morning I had a glass of water and it also vomited.

So then after each time I have water in the morning it will get vomited. I went back to doctor and inform the same he asked me to continue the same tablet for next 4 weeks. Some time I tried not to have water in morning and have Breakfast but if I do that way entire day I’ll have Vomiting sensation., so I though it’s good to have morning vomit than having the sensation throughout the day. Eventually one again pulling sensation in pam and feet started and I started taking once again ‘Nuroxind-LC’. Doctors gave me some Vomiting tablet but my morning vomit is not stopped along with water now some yellow thing also stared to come in Vomit. One day Vomiting is increased and I admitted to hospital. During the Hospitalization doctor told me to stop taking ‘Nuroxind-LC’ as he has given Injection (B12 Vitamin). Even after discharging from the Hospital my morning vomit is not stopped, I tried with many vomiting tablet but it is not stopped.

After taking B12 Vitamin now pulling sensation was stopped. I thought it may be due to Lack on Vitamin B12. After continuously taking Rabekind-plus for 3 month I changed the doctor and went to my family friend doctor. They conducted different Blood test (Rep: Cortisol _ Apr 2014, Electrolyte_ Apr 2014 & Thyroid) and suggested me to take sucralfate suspension (5ml at night). Amazingly my morning Vomit is stopped. As suggested I took it for 20 days and stopped. After I stopped next day I had Stomach burning and within two day’s once again morning vomit is started. I called the doctor and he suggested me to continue the sucralfate suspension.

But now after re-started taking sucralfate suspension my morning Vomit continued. Within few days pulling sensation is started once again (exactly after one and half month after taking B12 vitamin Injection). I once again visited my doctor and he suggested me to go for B12 Vitamin blood test (Rep: Vitamin B12 & Phosphorous_ Jun 2014). It’s strange that I have normal level B12, then my doctor conducted D3 Vitamin test and found that it was little low. I started taking D3 Vitamin supplements once in a week for 6 weeks. Along with D3 Vitamin supplement he gave me Pantocid DSR 40mg (pantoprazole + domperidone) for Gastric. First week it was good but second week even though I am taking D3 the pulling sensation increased. I started taking Nuroxind-LC’ along with D3 supplements. (The one thing I noted throughout this 6 month is each time I take Nuroxind-LC’ I have stomach burning; if I don’t take then I don’t have stomach burning.)

After a month my pulling sensation is stopped and it’s never repeated (from last 5 month to till today) but my morning Vomit (Gastric) continued. This time I wanted to change the medicine and started taking Ayurvedic when there is more Gastric I take Pantocid DSR 40mg (pantoprazole + domperidone). It continued Ayurvedic next 2 more months, during the time of taking Ayurvedic medicine my morning Vomit is stopped. Occasionally (once in Two weeks or three weeks) I had morning Vomit, but my Gastric continued (Feeling too hungry at every two hour and whenever I feel hungry I feel vomiting sensation also, excess gas in stomach)

I went back to Doctor (new) once again this time and doctor suggested me to go for endoscopy (rep: Endoscopy_ Oct 2014) once again. After endoscopy suggested me to take Sompraz 40mg (Esomeprazole), when my Gastric was not reduced suggested me to take Famocid 40mg (Famotidine) along with Sompraz 40mg. After 6 weeks of both the medicine still my Gastric is not reduced. This time doctor suggested me to go for PH test. During the medication time period only I went for PH test (Rep: PH test_ Nov 2014). During the time of PH test I noticed that PH meter is showing PH 2.2 in in the early morning when I woke up. Doctor told me that acid in my stomach is too much and suggested me Famocid 40mg twice a day. He suggested that I have GRED(Reflux) and if it is not reduced then I may need to go for Operation. When I asked what the reason for PH meter showing 2.2 at early morning, I not got any response.

From last one and half month I am experiencing a strange feeling under the right side below the chest. I feel like something (like a hard gas balloon) hard is there & when I touch part is Hard some time. During this period from last 6 month I am getting back pain occasionally and the pain is exactly back of my stomach (Behind below Lever). I informed the same to doctor and they suggested it may be due to Gastric.

During this entire period I changed my life style. I work only 9 hours a day, do not drink Tea(I was usually drinking Tea twice a day before). Not eating Spicy food and Non Veg food. Now a day’s I eat more Vegetable which are alkaline in Nature. Despite this change from last one year there was no significant effect on my Gastric

Recently I visited another doctor and before visiting him I had done one more round of D3 vitamin and Gastrin(Rep: ) blood test. After explaining everything he told me that my stomach become too sensitive that is the reason I am having the trouble. He told me that as I am not having Stomach pain, burning sensation, Heart burning it may not be Acid reflux and asked me to wait before going for operation. He gave me Librax 5mg (chlordiazepoxide 2mg and clidinium 2.5mg) and explained all the side effect it may cause. Now along with Sompraz 20mg I am taking Librax 5mg. I have been under this medication from last 15 days and I am feeling much better.

Note: When PH & Gastrin test was conducted I was under medication of Famocid 40mg) & Sompraz 40mg, and not taken medicine just before 24 hr.



Medication taken for Gastric till date.

Pan-D : one month (January)

‘Rabekind-plus’ – 3 month (Mid of Feb to Mid-May)

sucralfate suspension(5ml at night) - Mid May till July

‘Pantocid DSR 40mg’ – along with Ayurvedic Medicine occasionally(one or two in a week - XXXXXXX to Oct)

Sompraz 40mg & Famocid 40mg - From Oct 2014 to XXXXXXX 2015

Sompraz 20mg & Librax 5mg – From XXXXXXX 15 till date



Symptoms that are there occasionally.

Heart Burning: Only when I take Nuroxind-LC tablet

Back Pain: Nearly 4 times I got back pain, every time the back pain will last for one to two week. The back pain is exactly backside of the stomach(Liver)



Symptoms That are there throughout & present

Vomit: I had only Morning vomit that also if I drink water in the morning. I never vomited after eating food. Eating food will make me comfortable. Not had morning vomit from last 4 months as I was still taking medicine, not sure whether it will repeat if I stop taking the same.

Hungry: I feel hungry every 2 hours, even after having full Meals also I feel too hungry. If I delay in eating 5 min the gas will form in the stomach and I feel Vomiting sensation. My wait Increased from 63kg to 78kg & waist size from 32inch to 37inch. Some day’s my stomach is increased in such a way that I am not bale to wear my pant.(After started taking Librax tablet i am feeling little less hungry, Vomiting senation is stoped which i was feeling during hungy)

Stomach Gas: I can feel that my stomach is expanded; the pant which I wear will suddenly become very tight. It was really embracing when I regularly release gas (minimum 10 to 20 times)in a day ( from anus).

Cough: I have light cough from last one year(it taste like sour)



Questions:

1: What was the reason due to which I had pulling sensation? even when I had enough B12 vitamins I had pulling sensation and taking once again 'Nuroxind-LC' was giving me relief.

2: Doctor recently suggested me operation in which they told they will twist the food pipe so that acid will not come up. When I asked how that will reduce my stomach acid I had not got any response. whether due to GRED(Acid reflux) more acid will be produced in stomach or due to more acid in stomach GRED will occur?

3: Does the early morning vomit is a symptom of GRED(Acid Reflux)? As I am not having any other symptoms like stomach burning & Heart burn etc.

4: I went through different test, except PH test & D3 Vitamin every other test showed normal. Do I need to go through any other test for finding the reason for Gastric.

5: How the operation will prevent my acidity? Does my symptoms are related to IBS or IBD?

As i can upload only upto 2 MB i am not able to upload all the report.
doctor
Answered by Dr. T Chandrakant 44 hours later
Brief Answer:
Need further investigations and an opinion of a Gastroenterologist

Detailed Answer:
Hi Mr XXXXXXX .
Thanks a lot for your query and an elucidate history, in a chronological manner.

Read, re-read and understood your problems. After associating all the symptoms I think you should have further tests to confirm or rule out some peculiar diseases and usually least thought of.

I would advise you the following:
-An opinion of a Gastroenterologist
-Contrast enhanced CT scan of the whole abdomen with high resolution of the stomach, duodenum, and pancreas.
-Blood tests : Serum Calcium, PTH (Parathyroid Hormone), Serum Gastrin, and the other tests as advised by the Gastroenterologist.
-Endoscopic ultrasonography of the pancreas.
-Other relevant tests...
- Barium swallow for the early morning vomiting

Now to answer your queries:
1. Reason for pulling sensation- this is not a very peculiar symptoms and can occurs due to so many reasons. Just to pin-point the cause is not possible and How Nuroxid LC helped is a again difficult to say .

2. GERD does not produce more acid; More acid in the stomach also may not produce GERD. GERD is Gastro-esophageal Reflux Disease, meaning the contents of the stomach come back (reflux) to esophagus, which does not occur in a normal person.

3. Early morning Vomit -You have early morning vomit only if you are taking water. There are many causes other than GERD. To get a proper diagnosis one need to go for further tests. Anxiety and stress are one of the most important contributory factors.

4. I have mentioned few of the most important tests that you should undergo. These are suggested after studying your very detailed and an elucidate history.
* In addition your can go for :
USG of the neck for parathyroids
MRI of the Pituitary and brain

5. I really do not know how the operation may help you as you do not have severe heart burn, too much eructations or so. Probably they might have been thinking of vagotomy and gastro-jejunostomy which is not needed after the invention of Prazoles (Pantoprazole and all others), which you have already taken.

IBS /IBD : will have associated intestinal symptoms, which you have not mentioned and I take they are not present.
Many of such disorders are related to the stress and / or anxiety, but can be labelled so only if all the relevant tests are normal.

I hope I have tried my best to help solve your problems and will be happy to study and discuss further till we can get a reasonable proper diagnosis either by confirming some or ''ruling-out'' some.

Please feel free to discuss the relevant points or if you feel there is a gap-of-communication. Please let me know about your city of residence or work... and any other points you would like to share.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 3 hours later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. T Chandrakant 16 minutes later
Brief Answer:
seen

Detailed Answer:
Only the one with Calcium, Phosphorus and B12 is new .. seen
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 55 minutes later
Look like due to space Issue the uploaded documents are not reflecting. Deleted few reports and added 'CT Scan','Electrolite' & 'Protein' report.
doctor
Answered by Dr. T Chandrakant 37 minutes later
Brief Answer:
Anxiety / Stress ?

Detailed Answer:
Great.

The reports of CT scan abdomen, Electrolytes and Proteins seen. The reports are old one, but are quite within normal limits. You may delete the previous reports and add on others.
I hope the blood sugar, urea, creatinine, liver function tests are also within normal limits.
Any other tests I have mentioned above done ?

What is the level of stress and anxiety and work-load you undergo ?
How many times do you take Librax ?
Start taking Probiotic, activated charcoal tablets like Flatuna or gasex thrice daily, as you are suffering from gases. Take Mucaine gel 3 tsf every 3 hours, particularly when you are empty stomach.
Take small frequent meals, meaning divide daily requirements to 4 equal part. Do not be very fastidious about what to eat and what not to- the simplest trick is to stop all the foods and the beverages which you must have witnessed to cause you any sort of trouble and take / consume everything else which is not know to cause any trouble in you.

Let us see the results of these simple ricks.

Avoid everything possible that gives you indirect or direct stress and / or anxiety.
Change is a part of life and helps in many such disorders, at least try as a treatment and see the results.

Awaiting your feedback..

Dr T Chandrakant
http://bit.ly/askdrtchandrakant
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 1 hour later
Serum Calcium, PTH (Parathyroid Hormone), Serum Gastrin, Endoscopic ultrasonography of the pancreas are yet to be done. (Gastrin level of blood is done - attached D3 &Gastrin report..

I have no stress at work or Family. Now i work only 9hr( Previously i was working 16 to 18 hr's) and sleep at least 7 to 8 hr.
I was eating the food prepared by rice as its give me comfortable other causes me little more problem. using more fruit/vegetable which are alkaline in nature. this was my diet from last 8 months...
I even tried Yoga but that was not much helpful..

Presently i take Librax 5mg at night after dinner also taking somparaz 20mg at morning 30 min before breakfast. After started taking Librax(last 15 days) the Vomiting senation which i was feeling during hungry is reduced but gas is still there

As far as i noticed my gastric went different cycle.
Cycle 1: Stomach & Heart burn. ( It was when i started taking Nuroxind-LC tablet for numbness or tinkling in hand & foot)(Jan 2014)

Cycle 2: I was not able to have food, even i was not able to eat single dosa/idle at breakfast( during this time i started loosing wait also, to keep the stamina i was eating every 1 hour. i was not able to work also. i took 3 month leave this time. i had like morning sickness where in morning i was not even able to walk etc and during evening time feeling little better. during this time only morning Vomit started)(March to May 2014)

Cycle 3: Excess gas and feeling over hungry. during this time i gained wait as i am not able to stop eating, even after having meals i was feeling hungry within next 2 hour. I i don't eat then gas will form and i was feeling vomiting sensation.

Flatuna/gasex dosage and when need to be taken...

surly ill try with Flatuna/gasex and Mucaine, please let me know if any other test or medicine i need to go through.

Thanks you.
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Flatuna / gases can be taken 3 times a day

Detailed Answer:
Thanks for your feedback. Gone through it carefully and repeatedly.
The D3 and Gastrin is also normal.

Well stress and / anxiety are perceived differently and you may be feeling alright as per the situations you were and are in.
You had to take the leave for 3 months.
Nice to know your changed routines. Working 16 to 18 hours is definitely something a usual person is incapable and you did it.
Continue the foods as we discussed.

You may please increase Librax gradually to the level that does not affect your day-to-day life and work in the most optimal dosage that suits you as well as therapeutically effective , as this is helping you. You may start taking this twice daily and increase gradually under the prescription and guidance of your Doctor (this is a prescription medicines).

Read and understood the cycles which you have really put-in well.
1. Stomach and heart burn was caused by Nuroind LC and it is good that you noticed and stopped. This is the one thing I liked about your observations.

2. Eating one hourly to keep the stamina : this is something that is not palatable by me. This might indicate your stress and / or anxiety at that time and that you had to take a leave for 3 months. Morning Vomiting started during this time only.

3. Excess gases and over hungry : again indicates something as I suspected. Gaining weight was then primarily due to over-eating. If you did not eat - gases formed - Most of the times the major cause of gases is aerophagia, meaning one swallows the air to give you flatulence (gases), Once the stomach is distended, vomiting may be just a normal reflex of the body.

Flatuna or gases can be taken 1 to 2 tablets three times a day. You may please start them now...

Just let us complete the tests which have not yet been done, get the follow-up with newer regimen as we are discussing.

Get the investigations which are still remaining to be done. And let us see the results of added medicines and altered dosages. I was wondering if you really need to take Sompraz 20; you have been taking such medicines for long time now. You may stop for few days and see the response without Sompraz. If no problem stop for sometime and restart only if you start getting the treatment.

Let us see the results and then decide....
I hope this answer helps you.

And I also hope that you do not any complaints regarding Bowel movement / urine / any other symptoms which may be related or you may feel not at all related to the present problem.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

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Practicing since :1984

Answered : 17435 Questions

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