[27F] Experiencing early morning vomiting without other symptoms

Patient Description

A 27-year-old female has been waking up early in the morning with a tendency to vomit for the past 3-4 days. The patient reports vomiting saliva and yellow bile before consuming any food or drink. There is an associated presence of a significant amount of gas in the mornings. The patient has not identified any specific food triggers and has not observed blood in the vomit. There is no reported heartburn, abdominal pain, changes in appetite, or significant weight changes, although there has been a slight weight gain over the past year. The patient experienced a similar episode two months prior, resulting in a loss of appetite. Currently, the patient is taking Ondasetron and Gazo. There are no known drug allergies or other medications being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like heartburn, regurgitation of food or sour liquid, and in some cases, vomiting.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Gastroparesis: This is a condition that affects the stomach muscles and prevents proper stomach emptying. One of the symptoms can be vomiting undigested food—sometimes several hours after a meal.

    • Treatment typically involves dietary changes, medication, and, in severe cases, feeding tubes and surgery.
  • Peptic Ulcer: These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. Symptoms can include burning stomach pain, feeling of fullness, bloating or belching, and nausea or vomiting.

    • Treatment typically involves medications to decrease stomach acid. If an H. pylori infection is causing your peptic ulcers, you'll need to take antibiotics.

Please note that these are only possibilities and not a definitive diagnosis. You should consult with a healthcare provider for an accurate diagnosis.

What you can do

In the meantime, you can try the following to alleviate your symptoms:

  1. Avoid foods and drinks that trigger your symptoms. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Eat smaller, more frequent meals. It may help to eat five or six smaller meals each day, rather than three larger meals.
  3. Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.

What you should look out for

You should seek immediate medical attention if you:

  • Vomit blood
  • Have bloody or black tarry stools
  • Have difficulty swallowing
  • Experience severe or persistent abdominal pain
  • Have persistent nausea or vomiting
  • Experience unexplained weight loss

Remember, I'm an AI and I'm here to guide you, but I'm not a doctor. Please consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What could be causing morning vomiting of saliva and yellow bile?

Morning vomiting of saliva and yellow bile could be caused by conditions such as GERD, gastroparesis, or peptic ulcers. These conditions can lead to the regurgitation of stomach contents, including bile, especially when the stomach is empty.


How can I differentiate between GERD and gastroparesis based on symptoms?

GERD often presents with symptoms like heartburn, regurgitation, and sour taste in the mouth, while gastroparesis may involve vomiting undigested food hours after eating, bloating, and feeling full quickly. A healthcare provider can help differentiate these conditions through specific tests and evaluations.


What lifestyle changes can help alleviate symptoms of potential GERD?

To alleviate symptoms of GERD, you can avoid trigger foods and drinks, eat smaller and more frequent meals, avoid lying down after eating, and elevate the head of your bed. These changes can help reduce acid reflux and improve symptoms.


When should I seek immediate medical attention for vomiting?

You should seek immediate medical attention if you experience vomiting blood, have bloody or black tarry stools, difficulty swallowing, severe or persistent abdominal pain, persistent nausea or vomiting, or unexplained weight loss.


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