[45F] Experiencing vomiting and heartburn during exertion

Patient Description

A 45-year-old female reports experiencing vomiting when exerting effort, occurring 2-3 times a week for the past 4 weeks. The vomiting is preceded by heartburn, rated as a 7 out of 10 in severity, and results in small pools of vomit, approximately 4-5 times per episode. The patient also experiences bloating, described as occurring behind the lungs, which is somewhat relieved by vomiting and the use of Tums. Eggs have been identified as a potential dietary trigger. The patient has tried unspecified treatments or medications, but they have not alleviated the symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when 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 and cause heartburn, which you mentioned experiencing before vomiting. GERD can also lead to nausea and vomiting, especially after exertion or eating certain trigger foods like eggs.

    • Typical treatments include lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Medications like antacids, H2 blockers, or proton pump inhibitors may also be recommended by a healthcare provider.
  • Food Intolerance or Allergy: Your symptoms could be related to an intolerance or allergy to certain foods, such as eggs. This can cause digestive symptoms like bloating, diarrhea, and vomiting.

    • Treatment involves avoiding the trigger food and possibly using medications to manage symptoms.
  • Exercise-Induced Nausea: Some people experience nausea and vomiting during or after exercise due to increased pressure on the stomach or changes in blood flow.

    • Treatment includes adjusting your exercise routine, staying hydrated, and avoiding heavy meals before physical activity.

What you can do

  1. Dietary Adjustments: Consider keeping a food diary to track what you eat and how it affects your symptoms. Avoid foods that seem to trigger your symptoms, like eggs, and try to eat smaller, more frequent meals.

  2. Lifestyle Changes: Avoid lying down immediately after eating and try to maintain an upright position for at least a couple of hours post-meal. This can help reduce heartburn and reflux symptoms.

  3. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and gain insights. This information can be valuable when discussing your symptoms with a healthcare provider.

  4. Hydration and Rest: Ensure you stay well-hydrated, especially if you're experiencing diarrhea. Resting after exertion may also help reduce symptoms.

What you should look out for

  • Seek Medical Attention: If your symptoms persist or worsen, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

  • Watch for Severe Symptoms: If you experience severe abdominal pain, blood in your vomit or stool, or significant weight loss, seek medical care promptly.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare provider for a comprehensive evaluation and personalized advice.

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19 d ago


People Also Ask


What is Gastroesophageal Reflux Disease (GERD) and how can it cause vomiting?

Gastroesophageal Reflux Disease (GERD) is a condition where stomach acid frequently flows back into the esophagus, causing irritation. This can lead to symptoms like heartburn and, in some cases, vomiting, especially after exertion or consuming trigger foods.


How can food intolerance or allergy lead to symptoms like vomiting and bloating?

Food intolerance or allergy can cause digestive symptoms such as bloating, diarrhea, and vomiting when the body reacts negatively to certain foods. Avoiding the trigger food and using medications to manage symptoms can help.


What is exercise-induced nausea and how can it be managed?

Exercise-induced nausea occurs when physical activity increases pressure on the stomach or alters blood flow, leading to nausea and vomiting. Managing it involves adjusting exercise routines, staying hydrated, and avoiding heavy meals before exercising.


What lifestyle changes can help reduce symptoms of heartburn and vomiting?

Lifestyle changes to reduce heartburn and vomiting include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, and maintaining an upright position for a couple of hours post-meal.

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