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What Do Persistent Vomiting And Dehydration Indicate?
Posted on
Fri, 6 Jan 2017
Fri, 6 Jan 2017
Answered on
Mon, 30 Jan 2017
Last reviewed on
Question : Almost every morning I vomit bile, which has been ongoing since I was a kid. Almost everything upsets my stomach, but occasionally the smell of my BMs beyond off, like burnt hair or smells like a baby's blowout. I drink a lot of water but always feel dehydrated. Sometimes it's like the water is going right through me. I've also been experiencing pain under my right ribs that's sharp and burns. That pain doesn't last long and comes & goes but it is excruciating for a moment. I also have had significant pain behind my right shoulder blade and have had that for the last 15 years (I'm 32). It's a dull ach and could be unrelated, but worth mentioning. Could these just be additional symptoms of fibromyalgia, or something else like an infection or pancreas/gallbladder issues? What should I be adding a Dr to look for?
(Additional Info: diagnosed with fibromyalgia in 2012, misdiagnosed with celiac 2014, diagnosed with gluten intolerance and not celiac in 2015. My PCP is in a different state than me, and I strongly try not to see another Dr or NP unless I really need to.)
(Additional Info: diagnosed with fibromyalgia in 2012, misdiagnosed with celiac 2014, diagnosed with gluten intolerance and not celiac in 2015. My PCP is in a different state than me, and I strongly try not to see another Dr or NP unless I really need to.)
Brief Answer:
Here are a few investigations that you should try: USG and UGIE
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Here are a few points I would like to comment on based on the information you have provided ma'am:
+ Bilious vomiting does indicate an issue with the gastrointestinal tract (GIT). If the vomitus is bilious, then the issue lies around or below the duodenum. Issues like stenosis, constrictions, pressure from adjacent organs, tumors, etc; should be considered and investigated for as they are all likely causes for bilious vomiting
+ The pain around your ribs and the shoulder blade could quite possibly be associated with your fibromyalgia, but to be on the safer side I would recommend:
1. Ultrasound of your abdomen and pelvis
2. Upper gastrointestinal endoscopy to look for possible ulcers, etc; that could be causing pain in the region
+ Celiac disease would explain the right side rib pain, but as it was ruled out, we could take some time and look into other conditions that present in a similar manner (listed below).
+The gluten intolerance would explain the pain around the right ribs and right shoulder, but this should occur only on contact with gluten (ingestion of gluten i.e.); if gluten was not taken, then other such conditions should be ruled out which are part of the differential diagnosis for gluten intolerance (e.g. irritable bowel syndrome, Crohn's Disease, lactose intolerance, diverticulosis, hiatus hernia, etc.)
+ Of course, other conditions need to be ruled out, along with your suspicion of gall bladder issues, pancreatic issues, infections, etc; these would all be ruled out with the help of an ultrasound of the abdomen and pelvis (simple, easy and non-invasive investigation)
I hope you find my response helpful. Please do not hesitate to write to me for any further clarifications or information, I am always here to help.
Best wishes.
Here are a few investigations that you should try: USG and UGIE
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Here are a few points I would like to comment on based on the information you have provided ma'am:
+ Bilious vomiting does indicate an issue with the gastrointestinal tract (GIT). If the vomitus is bilious, then the issue lies around or below the duodenum. Issues like stenosis, constrictions, pressure from adjacent organs, tumors, etc; should be considered and investigated for as they are all likely causes for bilious vomiting
+ The pain around your ribs and the shoulder blade could quite possibly be associated with your fibromyalgia, but to be on the safer side I would recommend:
1. Ultrasound of your abdomen and pelvis
2. Upper gastrointestinal endoscopy to look for possible ulcers, etc; that could be causing pain in the region
+ Celiac disease would explain the right side rib pain, but as it was ruled out, we could take some time and look into other conditions that present in a similar manner (listed below).
+The gluten intolerance would explain the pain around the right ribs and right shoulder, but this should occur only on contact with gluten (ingestion of gluten i.e.); if gluten was not taken, then other such conditions should be ruled out which are part of the differential diagnosis for gluten intolerance (e.g. irritable bowel syndrome, Crohn's Disease, lactose intolerance, diverticulosis, hiatus hernia, etc.)
+ Of course, other conditions need to be ruled out, along with your suspicion of gall bladder issues, pancreatic issues, infections, etc; these would all be ruled out with the help of an ultrasound of the abdomen and pelvis (simple, easy and non-invasive investigation)
I hope you find my response helpful. Please do not hesitate to write to me for any further clarifications or information, I am always here to help.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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