Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Gastric Pain, Acute Vomiting And Rotten Egg Burps?
Question: My daughter who is 38 has been having severe problems with gastric pain, vomiting, at first symptoms of what seemed like pancreatitis, also had highly abnormal renal function. She went to an ER but was released, this has happened repeatedly and I am not sure why as they have not gotten to the bottom of the problem. This weekend she felt very sick and started to burp and the burps had a foul sulfuric odor. The burping was frequent and the burps prolonged (5 seconds) and then she started vomiting with much intensity. She went to the ER and they did tests and found only leukocytosis, kept her for a day, and then released her again. She is very ill and cannot get an answer.
Brief Answer:
need to see a gastroenterologist
Detailed Answer:
HI, thanks for using healthcare magic
I agree that a diagnosis is needed.
In the initial presentation, if she was vomiting a lot, this would have led to electrolyte abnormalities and acute renal impairment.
It would be best for her to try to see a gastroenterologist, this is a doctor that specializes in conditions of the gastrointestinal tract.Her general doctor can refer her or she can find one in her local hospital or using healthgrades.com.
An assessment by one of these specialist which would include a complete history as well as thorough examination of her abdomen, is important.
A complete blood count would have identified the leukocytosis but she needs imaging as well such as a barium meal or endoscopy.
In addition to further imaging, she may need additional bloods depending of what was already done.
Till she can see a gastroenterologist, she may want to consider starting on a PPI (proton pump inhibitor) such as nexium, prilosec, prevacid etc
Even though her symptoms may not be due to severe GERD, these medications would help reduce the burping/vomiting though they can sometimes take 5 to 7 days to have an effect
I hope this helps, feel free to ask any other questions
need to see a gastroenterologist
Detailed Answer:
HI, thanks for using healthcare magic
I agree that a diagnosis is needed.
In the initial presentation, if she was vomiting a lot, this would have led to electrolyte abnormalities and acute renal impairment.
It would be best for her to try to see a gastroenterologist, this is a doctor that specializes in conditions of the gastrointestinal tract.Her general doctor can refer her or she can find one in her local hospital or using healthgrades.com.
An assessment by one of these specialist which would include a complete history as well as thorough examination of her abdomen, is important.
A complete blood count would have identified the leukocytosis but she needs imaging as well such as a barium meal or endoscopy.
In addition to further imaging, she may need additional bloods depending of what was already done.
Till she can see a gastroenterologist, she may want to consider starting on a PPI (proton pump inhibitor) such as nexium, prilosec, prevacid etc
Even though her symptoms may not be due to severe GERD, these medications would help reduce the burping/vomiting though they can sometimes take 5 to 7 days to have an effect
I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am a clinical psychologist who has taught and directed curricula at a medical school for 25 years, so I did a little workup on my own after writing to you.
The initial problems that they thought was pancreatitis started around the first of April. This was following a bout of pneumonia.
The most recent sulfuric burping and vomiting started this past Friday
Pain: URQ, hurts when breathes or bend over to tie shoes; pain is aching and constant and "under my right rib cage"; painful to touch area and it radiates backward.
Blood pressure normal
"Very" anemic when tests were done in April - nothing done for that yet
Current gastric distention - quite severe she says
no trouble swallowing; no reflux
No other infections; no tooth problems
No fever
After burping vomiting episode on Friday, she went to ER and they put her on IV saline and gave her benadryl and Reglan - sent home with promethazine
They did not do imaging as they said they already did them back in April.
(from what I read, imaging should be done to rule out complications of acute cholecystitis in the differential - that a more serious condition can progress quickly - So it would seem that would need to be done again.)
At latest ER visit, lipase, kidney, other liver panel normal
Late Sat night she developed severe diarrhea, "dark-chocolate-pudding color" stool that continued all day Sun.
No new medications (takes some antidepressants)
Symptoms "maybe a bit worse" at night
She was last weighed about 1 month ago and had lost 35 lbs since Apr 4 - so a 35 lb weight loss in a month.
Never had anything like this current episode in the past; never had other earlier symptoms in the past either.
She does not ever use alcohol or illicit drugs and typically eats a healthy diet.
She now has no diarrhea today but is starting to feel burpy and like vomiting again. She had eaten a banana, some cooked carrots and gatoraide yesterday and she felt sick after eating)
What do you think she could eat/drink between now and her doc aptmt tomorrow? Do you still think she should take a PPI - is there anything more fast acting that could give her some relief for the next day?
To me this sounds gallbladder-related, but I won't be armchair doc either. I worry that it has gotten serious though and wonder if it is safe to wait until tomorrow for further care - thoughts?
Thank you very much for your assistance Dr. Gibson XXXXXXX
She sees her primary care doc tomorrow
Just FYI, her primary doc has been on vacation and she lost her insurance, but starting XXXXXXX 1, she is enrolled in a different plan.
The initial problems that they thought was pancreatitis started around the first of April. This was following a bout of pneumonia.
The most recent sulfuric burping and vomiting started this past Friday
Pain: URQ, hurts when breathes or bend over to tie shoes; pain is aching and constant and "under my right rib cage"; painful to touch area and it radiates backward.
Blood pressure normal
"Very" anemic when tests were done in April - nothing done for that yet
Current gastric distention - quite severe she says
no trouble swallowing; no reflux
No other infections; no tooth problems
No fever
After burping vomiting episode on Friday, she went to ER and they put her on IV saline and gave her benadryl and Reglan - sent home with promethazine
They did not do imaging as they said they already did them back in April.
(from what I read, imaging should be done to rule out complications of acute cholecystitis in the differential - that a more serious condition can progress quickly - So it would seem that would need to be done again.)
At latest ER visit, lipase, kidney, other liver panel normal
Late Sat night she developed severe diarrhea, "dark-chocolate-pudding color" stool that continued all day Sun.
No new medications (takes some antidepressants)
Symptoms "maybe a bit worse" at night
She was last weighed about 1 month ago and had lost 35 lbs since Apr 4 - so a 35 lb weight loss in a month.
Never had anything like this current episode in the past; never had other earlier symptoms in the past either.
She does not ever use alcohol or illicit drugs and typically eats a healthy diet.
She now has no diarrhea today but is starting to feel burpy and like vomiting again. She had eaten a banana, some cooked carrots and gatoraide yesterday and she felt sick after eating)
What do you think she could eat/drink between now and her doc aptmt tomorrow? Do you still think she should take a PPI - is there anything more fast acting that could give her some relief for the next day?
To me this sounds gallbladder-related, but I won't be armchair doc either. I worry that it has gotten serious though and wonder if it is safe to wait until tomorrow for further care - thoughts?
Thank you very much for your assistance Dr. Gibson XXXXXXX
She sees her primary care doc tomorrow
Just FYI, her primary doc has been on vacation and she lost her insurance, but starting XXXXXXX 1, she is enrolled in a different plan.
Brief Answer:
anemia needs further follow up
Detailed Answer:
HI
Re: anemia, with a history of severe anemia, this should be evaluated further to determine the cause. The complete blood count would determine if it is likely iron deficiency or related to another cause by looking at the mcv value.
Additional investigations to find the cause of the anemia would depend somewhat on that value
Treatment for anemia is important because the blood flow to the different organs is affected and leads to compensatory mechanisms
Imaging should repeated but particularly to look inside the GI tract with ba studies or endoscopy.
An ultrasound may be helpful as well.
She should use only bland foods for now -no spicy, no acidic, no fatty foods
The PPI were suggested because they may help reduce the acid production which may be affecting the burping/bloating/vomiting . Because they reduce acid and have no effect on they acid already present, they may not have an immediate effect.
She can try combining one of the PPI with over the counter meds such as tums etc for now till she sees her doctor in the am
I hope that her visit to the her doctor is productive.
She should query the anemia and need for further imaging, a stool analysis, because of the color changes , may also be needed
Please feel free to ask anything else
anemia needs further follow up
Detailed Answer:
HI
Re: anemia, with a history of severe anemia, this should be evaluated further to determine the cause. The complete blood count would determine if it is likely iron deficiency or related to another cause by looking at the mcv value.
Additional investigations to find the cause of the anemia would depend somewhat on that value
Treatment for anemia is important because the blood flow to the different organs is affected and leads to compensatory mechanisms
Imaging should repeated but particularly to look inside the GI tract with ba studies or endoscopy.
An ultrasound may be helpful as well.
She should use only bland foods for now -no spicy, no acidic, no fatty foods
The PPI were suggested because they may help reduce the acid production which may be affecting the burping/bloating/vomiting . Because they reduce acid and have no effect on they acid already present, they may not have an immediate effect.
She can try combining one of the PPI with over the counter meds such as tums etc for now till she sees her doctor in the am
I hope that her visit to the her doctor is productive.
She should query the anemia and need for further imaging, a stool analysis, because of the color changes , may also be needed
Please feel free to ask anything else
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your rapid response. I will let her know Dr.
Brief Answer:
no problem
Detailed Answer:
wishing her all the best
If there are any other queries, can let me know
no problem
Detailed Answer:
wishing her all the best
If there are any other queries, can let me know
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
