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What Causes Vomiting, Flatulence, Stomach Cramps, Burning Sensation In The Chest?

Posted on Wed, 10 Jun 2015

Question: So my 55yo wife just completed a half marathon in her best time, and six hours later vomited (she never vomits) and later finds great discomfort around bottom side of R rib cage and cannot take a deep breath without much discomfort as in a deep muscle pull. Feels better when she sits up. She is far from home right now and texted me this info. I said ice and advil and call me in the morning. She says its a deeper pain. So I said wait before she runs 13 miles again, but what should she watch for? Seek medical help if vomiting continues (it hasn't after the first unloading nor is she nauseous now) or...? Thank you.

Answered by Dr. Divya Kuttikrishnan (2 hours later)

Brief Answer:
Could be acidity/ gastritis

Detailed Answer:
Hi XXXX,

Thanks for writing in.

Does your wife have any symptoms of gastritis /acid reflux often; like excess, belching, flatulence, stomach cramps, burning sensation in the chest or abdomen, blood in the vomitus/black stools? If she has the above mentioned symptoms, it would be a good idea to visit the gastroenterologist to rule out acid reflux/ gastric ulcer etc.

However, if it just happened once on the day of the marathon, then it could be a one time thing due to stress, improper food intake, too little/too heavy meals, low sodium in the blood due to dehydration, increased acid production the stomach while running, etc.

After consulting with the treating physician, it might be helpful to take a tablet of pantoprazole which will neutralise the acidity. Take ORS/ tender coconut water for rehydration at regular intervals. Light diet of bread toast/apple etc might help. Let her rest/ sleep well.

AVOID Advil , Ibuprofen , Diclofenac etc as they further worsen gastric symptoms.

Hope this information was helpful to you.

Do get back to me for further clarifications.

Hope your wife feels better soon.

Regards,
Dr. Divya Kuttikrishnan

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Divya Kuttikrishnan (2 hours later)

She has not had those symtoms and has not had post-race issues in the past. So the low sodium, etc., might be the issue. Of course I failed to mention her decade long diagnosis of gastroparesis, so naturally that would be the focus so some narrow balance of food/water intake might have tipped the scales—though in numerous races this is the only time nausea with vomiting occurred. As stated, I accept the dehydration possibility, and the notion to not take NSAID. The singular symptom of pain under lower R rib following the vomiting associated with sizeable inhaling discomfort is not likely associated with muscle pull but more likely stomach related you think, even though breathing pain is reduced when in a sitting position. Deep-breathing remains painful beneath lower right rib. Thanks. s

Answered by Dr. Divya Kuttikrishnan (36 minutes later)

Brief Answer:
Better to visit a physician if pain persists...

Detailed Answer:
Hi..

I feel it is related to the stomach more than any other causes including dehydration and low sodium. When I said stomach condition, it also includes gall bladder pathology.

Therefore if the pain persists even after taking an antacid/ pantoprazole, it is advisable to see a physician nearby. An ultrasound scan and other tests are entailed.

Regards

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Above answer was peer-reviewed by : Dr. Prasad