Frequent Vomiting Following Mild Traumatic Brain Injury: A 22-Year-Old's Struggle
A 22-year-old male, measuring 5 feet 11 inches tall and weighing 140 pounds, grapples with a troubling medical issue. His current prescriptions include 75mg of Sertraline and 20mg of Omeprazole in his daily regimen. This saga began three years ago when he endured a severe concussion from a mountain climbing incident, resulting in what is termed as a mild traumatic brain injury (TBI). Post-accident, he endured numerous challenges, but gradually, many dissipated, leaving him with a few persistent symptoms—predominantly migraines, mood fluctuations, and the most distressing one: daily vomiting bouts that occur several times throughout the day. This recurrent vomiting began shortly after his primary recovery phase from the concussion and has since become a consistent part of his life. His episodes usually commence each morning, often starting with bile, due to his stomach being empty. Throughout the day, he experiences additional nauseous moments, which typically result in further vomiting, sometimes linked to meals, but rarely exceeding 2-3 occurrences in a day. Despite this, he often produces small amounts of vomit, typically comprised of previously consumed food. In search of answers, he underwent an upper endoscopy, revealing only mild inflammation, and a gastric emptying study, which returned normal results. He remains puzzled, as there do not appear to be clear food triggers, unless he consumes a large amount or highly unhealthy foods, both of which are uncommon for him. His body gives him little warning; instead of extreme abdominal discomfort, he experiences a sudden urge to gag, often just once or twice before the vomiting ensues. His gastroenterologist suggested that with the normal gastric emptying results, he should return to a neurologist for further evaluation. He previously visited a neurology clinic, but his experience was frustrating; the neurologist dismissed his concerns, attributing them primarily to anxiety, a notion he finds hard to accept. Despite identifying as someone who can be anxious, he does not believe this mental state is the root cause of his vomiting, particularly as it occurs even in calm situations. This ongoing issue is starting to affect his work performance as an EMT while he pursues nursing studies—having to suddenly excuse himself to vomit is both alarming and embarrassing. He utilized a TBI clinic for support, but they have not offered much insight into this specific problem. Although they have provided assistance in other aspects of his recovery, he feels they lack clarity on the vomiting. He has experimented with various techniques aimed at alleviating anxiety, yet they have proven ineffective, given he often experiences these episodes when he is not particularly anxious. As he contemplates potential next steps, he wonders whether finding a different neurologist would be advisable or if there are alternative options available to him. The ongoing nature of his symptoms deeply concerns him, particularly the toll daily vomiting is taking on his body and its impact on weight gain. Since his injury, he has struggled to regain lost weight, as consuming larger meals tends to trigger further vomiting.
Answers (1)
7/24/2025, 10:31:07 PM
OpenHealth AI
Frequent vomiting following a mild traumatic brain injury (TBI) can be distressing and disruptive to daily life. Your symptoms warrant thorough exploration and understanding, especially since they've persisted for years. It’s essential to prioritize your comfort and enhance your quality of life.
Explanation
Vomiting can occur due to various reasons following a TBI, and it's crucial to distinguish between physiological causes (such as issues with the stomach or gastrointestinal tract) and neurological or psychological factors. Since your gastroenterologist has ruled out significant gastrointestinal abnormalities and indicated normal gastric emptying, it may suggest that your vomiting could be related more to neurological responses, vestibular issues, or persistent effects from the TBI rather than digestive causes.
Your feelings of anxiety could be complicating factors, but it's essential to recognize that vomiting can occur independently from high-anxiety states. The connection is complex when it comes to brain injuries and symptoms.
Next Steps
-
Follow Up with a Neurologist: It’s advisable to seek a second opinion from another neurologist who has experience with post-TBI patients. Clearly communicate your vomiting symptoms and how they impact your daily life and work. A specialist may suggest further assessments, including imaging studies or tests for vestibular function, to evaluate if your inner ear (which helps with balance and coordination) is affected.
-
Explore Medication Adjustments: Discuss your current medications (Sertraline and Omeprazole) with a healthcare professional to see if adjustments could help. Sometimes, reviewing medication interactions or side effects might reveal a contributor to your symptoms.
-
Dietary Management: Keep a food diary to document what you eat and correlate it with vomiting episodes to identify any potential triggers you may have overlooked, even if they are subtle.
-
Hydration and Small Meals: Try to stay hydrated and eat smaller, more frequent meals instead of large portions, as smaller meals may help reduce vomiting episodes.
-
Seek Support for Stress Management: Even though you mentioned that anxiety techniques have not helped, consider exploring other approaches such as cognitive-behavioral therapy (CBT), which may offer a structured way to address both anxiety and coping mechanisms for your vomiting.
-
Monitor Symptoms: Keep a log of your vomiting episodes, including when they occur and any associated factors (time of day, stress levels, recent activities). This can provide useful information to share with healthcare providers.
Your situation is obviously challenging and can impact your physical and emotional well-being, particularly as you balance work and studies. Take these steps one at a time, and remember that seeking a health professional who understands your unique situation is vital in finding a resolution.
Related Questions
Understanding Inhibin A Levels
I recently had my inhibin A level measured and it reads 97 pg/ml. For some context, I am a 36-year-old woman, weighing 133 pounds and standing at 5 feet 2 inches tall. Additionally, I am currently menstruating and had this test done to check for potential tumor markers. Could anyone clarify if this value falls within a normal range? I've come across information suggesting that levels below 98 pg/ml are typical, while other sources indicate that a normal range can extend from 0 to 160 pg/ml. Any guidance on this matter would be greatly appreciated.
IUD Removal: Experiencing Symptoms - Should I Seek Help?
A couple of nights ago, I had an embedded IUD taken out. Following the procedure, I experienced a low-grade fever lasting about one and a half to two hours. I’m wondering if a doctor’s visit is necessary. I am a 26-year-old female, non-smoker, and don’t consume alcohol. My only health concern has been treated iron deficiency without any other known issues. I visited the emergency room two nights ago due to my IUD being lodged in my uterus. After the removal, I was discharged with no signs of infection. However, last night I developed a slight fever that reached up to 100.5°F for around thirty minutes before it dropped back down to approximately 98°F. I didn’t use any medications to lower my fever, and since then, my temperature has stabilized between 97.5°F and 98.9°F. Additionally, I felt a racing heart and some nausea last night, likely due to anxiety. I’m still experiencing nausea today. There’s light to moderate vaginal bleeding, which might be my period, but no unpleasant-smelling discharge. I also feel some intermittent pain, likely from the irritation caused by the IUD removal, though it is currently quite mild. I’m contemplating whether I should visit urgent care for these symptoms. I tend to worry about health issues, particularly regarding infections.
Concerns About Brain-Eating Amoeba
M16, weighing 183lbs Unfiltered and non-chlorinated tap water accidentally entered my nose, and I suddenly became anxious about the possibility of contracting a brain-eating amoeba. For the past three days, I haven't been able to sleep properly, consumed by the fear that I might die in my sleep. Now, after 72 hours, I haven't experienced any symptoms. Should I be worried? I need assistance.
Seeking Guidance: Positive Nitrates but Negative for Leukocytes
I am a 23-year-old female, standing at 5'2" and weighing 108 pounds. I have a mixed ethnic background of Caucasian and Hispanic and reside in the United States. My nicotine use includes vaping, but I do not consume alcohol. For about a year and a half, I've been taking Prozac at a dosage of 40 mg and have also been on a low-dose birth control pill, Northedrione 0.35 mg. Currently, I find myself somewhat lost regarding my health situation. My primary complaint involves an urgent need to urinate and occasional leakage, which has intensified over the last year. Fortunately, I don't experience burning sensations or pain while urinating; however, I do struggle with significant fatigue, often requiring more than 10 hours of sleep and feeling the need to nap frequently. I've also been encountering sudden shooting pains in my hands and numbness in my feet, along with headaches that have evolved into more severe migraines, particularly behind one eye. These headaches have become more enduring than in the past. Recently, I underwent urinalysis followed by a culture. The test results indicated a normal pH level, but showed the presence of protein, ketones, and nitrates in my urine. There were trace amounts of bilirubin and urobilinogen noted as well, but leukocytes were absent. It's worth mentioning that the urine sample was relatively small, under 30 ml. Upon further investigation through the culture, it revealed a high concentration of E. Coli, along with a small presence of mixed bacteria. What could these findings imply? I have mostly come across information concerning the presence of leukocytes combined with a lack of nitrates, rather than the other way around. It’s clear to me that I’m experiencing an infection, but I’m perplexed about the absence of leukocytes, especially given the severity of my symptoms. Apart from that, the only other abnormal lab result I received was related to my vitamin D levels, which have shown a decline upon retesting over a couple of months. I have undergone various tests for allergies, autoimmune disorders, and arthritis, including routine blood panels like a CBC, as well as thyroid and B12 assessments. My primary care physician has referred me to a urologist and has prescribed antibiotics for my condition.
Exploring Gluten Sensitivity with Autoimmune Conditions
Hey there, I’m a 22-year-old female and I’ve been managing Type 1 Diabetes (T1D) for nearly eight years now. Each year, I undergo testing for celiac disease, and while my tTG-IgA levels have consistently shown normal results, my recent tests have revealed elevated Reflexive IgA levels exceeding 400mg/dL. Following this development, my physician suggested I consider adopting a gluten-free diet to potentially address some concerning fluctuations in my blood sugar levels. I find myself puzzled, especially since my tTG-IgA results were normal. Lately, I've experienced some strange symptoms including facial rashes, unusual fatigue, and slow-healing spots on my legs and arms. Shortly after these issues began emerging, my usually stable blood sugar levels have become erratic, with unexpected spikes occurring without clear explanation. While rheumatoid arthritis has been ruled out and my thyroid function appears to be normal, I can't shake the feeling that something isn’t right—and neither can my doctor. This leads me to wonder about the reasoning behind shifting to a gluten-free diet. I am committed to trying it out, but I’m curious if there are specific questions or topics I should discuss further during my next appointment with my doctor. Appreciate any advice in advance!