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bile / vomiting
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sahba
medicine forum beginner


Joined: 22 May 2005
Posts: 5

PostPosted: Wed Oct 19, 2005 12:22 am    Post subject: bile / vomiting Reply with quote

A lady who is a friend of mine is in the hospital to treat an ulcer in
her foot. She is over 80 years old, has diabetes, blood circulation
problems, a weak heart, and renal failure (for which she is treated
with dyalisis).

since being in the hospital, her overall condition appears to have
worsened, one of the main problems being that she cannot ingest
practically any food (or liquids) for she will soon after vomit. she
also easily vomits after coughing or shifting position, or even
spontaneously, without any apparent stimulus. she now vomits, on
average, 4 times a day. because of this, she is rapidly losing her
energies, and becoming rather unhappy about life.

her vomit is greenish: bile.

the country she is in has a poor health system, unfortunately. reacting
to this condition, the medical staff said "vomiting bile is normal, but
we will perform an endoscopy".

firstly: vomiting doesn't feel to be normal, in whatever situation it
may be.
secondly: with the endoscopy, they found out that the esophagus has
some wounds, and decided to prescribe her something to fix that.
however, my sensation is that wounds on the esophagus can't possibly be
the cause for bile to be vomited.

worried with the healthcare she is receiving, i ask for help from
experts/people from other places in the world. ask any doctor friends
you may have! i can give you a detailed list of her medication, or
answer any other medical question you may want to ask.

i thank you in advance.
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Sbharris[atsign]ix.netcom
medicine forum Guru


Joined: 28 Apr 2005
Posts: 1218

PostPosted: Wed Oct 19, 2005 3:21 am    Post subject: Re: bile / vomiting Reply with quote

sahba wrote:
Quote:
A lady who is a friend of mine is in the hospital to treat an ulcer in
her foot. She is over 80 years old, has diabetes, blood circulation
problems, a weak heart, and renal failure (for which she is treated
with dyalisis).

since being in the hospital, her overall condition appears to have
worsened, one of the main problems being that she cannot ingest
practically any food (or liquids) for she will soon after vomit. she
also easily vomits after coughing or shifting position, or even
spontaneously, without any apparent stimulus. she now vomits, on
average, 4 times a day. because of this, she is rapidly losing her
energies, and becoming rather unhappy about life.

her vomit is greenish: bile.

the country she is in has a poor health system, unfortunately. reacting
to this condition, the medical staff said "vomiting bile is normal, but
we will perform an endoscopy".


COMMENT:

We can't diagnose over the internet.

In general, vomiting is very, very common in renal failure, even on
dialysis-- it's a general sign that things aren't going well. It's also
a very common symptom in chronic diabetes from gastroparesis (a
digestive system that isn't working due to nerve damage.) Here you have
an elderly woman (old age slows the digestive system also) with both
other conditions. And a chronic infection besides.

Medicines to stimulate the GI tract in diabetic gastroparesis may or
may not be helpful in these patients. More attention can be paid to
getting the electrolytes in better balance. There are general drugs for
nausea which can be tried. In all things, pay attention to her comfort
first, because you won't be able to prolong her life much no matter
what you do, but you certainly may make the end of it less peaceful if
you insist on more and more tests and treatments.

In all of this, do fail to keep in mind the larger picture. The medical
complex you describe would be serious enough, with a fairly limited
life expectancy, even in a 40 year-old woman. This is an 80 year-old
woman. In this situation the question is usually not whether you win or
lose, but how you lose.

SBH
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sahba
medicine forum beginner


Joined: 22 May 2005
Posts: 5

PostPosted: Wed Oct 19, 2005 11:33 am    Post subject: Re: bile / vomiting Reply with quote

thank you for your reply. I add that she is taking metoclopramide
(sp?), aka Reglan, for nausea.

I am aware of the scenarios that you depicted in your reply, and i
realize an e-diagnosis is at best difficult. However, the incompetent
healthcare system which is treating her has made me decide to give it a
shot. Additionally, considering it may be, say, gastroparesis,

why did the vomiting SUDDENLY increase in frequency (exponentially)
after she was taken to the hospital?
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Sbharris[atsign]ix.netcom
medicine forum Guru


Joined: 28 Apr 2005
Posts: 1218

PostPosted: Wed Oct 19, 2005 6:30 pm    Post subject: Re: bile / vomiting Reply with quote

sahba wrote:
Quote:
thank you for your reply. I add that she is taking metoclopramide
(sp?), aka Reglan, for nausea.

I am aware of the scenarios that you depicted in your reply, and i
realize an e-diagnosis is at best difficult. However, the incompetent
healthcare system which is treating her has made me decide to give it a
shot. Additionally, considering it may be, say, gastroparesis,

why did the vomiting SUDDENLY increase in frequency (exponentially)
after she was taken to the hospital?


COMMENT:
The two most likely explanations are 1) that it's for the same reason
she went into the hospital in the first place (infection), or 2) that
it's some reaction to some new hospital treatment. The antibiotic,
perhaps, or more frequent or different kinds of dialyses. If she had
absolutlely NONE before she went into the hospital, then some side
effect of treatment seems most likely. Find out what they're doing
that's new.

S.
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sahba
medicine forum beginner


Joined: 22 May 2005
Posts: 5

PostPosted: Wed Oct 19, 2005 11:04 pm    Post subject: Re: bile / vomiting Reply with quote

she did vomit around once every 10 days, recently. aside from
medication (just about everything is new), the major thing that is new
is the fact that she lies down for most of the time. 99% of the time.

but, if it were a reaction to medication, shouldn't she vomit what she
eats EVERYTIME? because i noticed she sometimes vomits spontaneously,
or due to coughing, or other movements, but not always does she vomit
after eating - and the times she does, i get a feeling it's provoked by
her psychological fear of vomiting, rather than by the eating itself!!

thanks again for help.
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Nog
medicine forum beginner


Joined: 29 Apr 2005
Posts: 6

PostPosted: Fri May 26, 2006 5:51 pm    Post subject: Re: bile / vomiting Reply with quote

sahba wrote:

Quote:
A lady who is a friend of mine is in the hospital to treat an ulcer in
her foot. She is over 80 years old, has diabetes, blood circulation
problems, a weak heart, and renal failure (for which she is treated
with dyalisis).

since being in the hospital, her overall condition appears to have
worsened, one of the main problems being that she cannot ingest
practically any food (or liquids) for she will soon after vomit. she
also easily vomits after coughing or shifting position, or even
spontaneously, without any apparent stimulus. she now vomits, on
average, 4 times a day. because of this, she is rapidly losing her
energies, and becoming rather unhappy about life.

her vomit is greenish: bile.

the country she is in has a poor health system, unfortunately. reacting
to this condition, the medical staff said "vomiting bile is normal, but
we will perform an endoscopy".

firstly: vomiting doesn't feel to be normal, in whatever situation it
may be.
secondly: with the endoscopy, they found out that the esophagus has
some wounds, and decided to prescribe her something to fix that.
however, my sensation is that wounds on the esophagus can't possibly be
the cause for bile to be vomited.

worried with the healthcare she is receiving, i ask for help from
experts/people from other places in the world. ask any doctor friends
you may have! i can give you a detailed list of her medication, or
answer any other medical question you may want to ask.

i thank you in advance.

One you vomit green bile it's pretty much over.
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