What is the cause and treatment vomiting blood with pain and fatigue?

Brief Answer: upper GI endoscopy may be done Detailed Answer: Hello, Yes, I agree that a part of your daughter's disease is somatic. However, there must be a physical issue as well. This I say because she is throwing up lots of red blood and it is worsening. I see that much testing has been done. Has a upper Gastrointestinal endoscopy been done? If not, you must get this done for your daughter. Due to constant binging and purging, she must have caused a tear in the oesophagus or stomach. There can be ulcers in the stomach and oesophagus. It could be chronic gastritis or gastroesophageal reflux disease (GERD). Another possibility is oesophageal varices. An upper GI endoscopy can rule out all of these conditions. You must ensure that she does not consume alcohol and cigarettes, if she does (sorry, if I have offended). She must consume bland diet and avoid all the spicy and high fatty food. Give her cold milk and yoghurt that can soothen the stomach. Also, give her over the counter available antacid like Capsule omeprazole 20mg daily on empty stomach for a minimum of 6 weeks. It would be ideal to consult a surgical gastroenterologist for the same. This is the outline of what I think is happening in your daughter. I would be pleased to discuss further on this. Regards,