Thanks for the query to H.C.M. Forum.
Since main problem is still there is esophageal ulcer with all symptoms as nausea , vomiting
and above all blood in vomiting ( fresh ).
This blood may be due to further worsen of esophageal ulcer , may be due to ,
1 Variceal bleeding. While vigorous hemorrhage may arise from any portal -system venous collaterals , bleeding is the most common from varices
in the region of the gastroesophageal junction.
Exact cause is not understand till now ,but may be due to portal hyper tension ( >12 mm Hg) . Diagnosis can be confirmed by measurement of portal hyper tension.
Try raising the head of your bed about 4 inches with blocks. It also might help to avoid eating or drinking for 2 hours before patient lie down .
To help control esophagus
ulcer one should not drink drinks with caffeine in thme or eat chocolates, or spicy food or greasy food.
As in my opinion she is taking proton pump
inhibitors , still no relief so consult a gastroenterologist
and get his opinion .
2 Esophageal ulcer may change into peptic ulcer disease
, diagnosis can be confirmed by upper G I endoscopy
In both condition it is very important to evaluate the diagnosis , so consult a gastroenterologist and get his opinion.
Good luck. Dr. HET