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Bringing up bile at 2am

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I've had stomach problems and pains (epigastric region) for such a long time now. I went to a GP and they ran some tests (didn't find anything wrong other than low iron), I was put on Omaprozle (we don't even know if I have a stomach ulcer but I am taking it anyway). I have been following a lactose free diet and avoiding most gluten.

In the past 3 weeks I have had 6 incidents were I have severe pain in the upper abdomen and wake up around 2am vomiting up bile (I think it's bile, barely any food at all). Yesterday I did have 3 glasses of champange but that was between the hours of 12pm - 2pm. I rarely drink these days but it seems even if I have one alcaholic beverage I am up early in the morning in extreme pain and vomiting! Taking panadol for the pain does not help at all actually it makes me seriously nauseous.

During the day I have a lot of bowel movements, more than 3 usually. Is that unusual? I also have a constant ache in my upper abdomen.

I am meant to go back to my GP to book in a endoscopy (which could be a long waiting list). I haven't had the time to go back and see her yet. From my symptoms, anyone have any idea?
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replied March 28th, 2011
Hello, and thank you for your medical question on e Health Forum.

From the available history, the symptoms of severe epigastic chest pain, nausea, vomiting could be due to indigestion as well could be due to a number of disorders including hepatitis, gall stone disease, Gastro Esophageal Reflux disease or Peptic ulcer disease.

For the mean time you can try the tips suggested below.

1. Change and develop good dietary habits including, eating several small meals daily.

2. Diet should include fresh fruits, fiber rich foods.
Avoid spicy foods, fats and fried foods.
Also avoid coffee, tea, alcohol, colas, and smoking.
Avoid processed foods (Junk foods from refined carbohydrates),
Eat freshly cooked food from whole grains.

3. Adopt proper posture.

4. Don't eat for at least three hours before you go to bed. If you have symptoms at night, try raising the head of your bed six to ten inches.

5. Maintaining adequate hydration.

6. Adopting a sitting upright posture for 1 hr post meals will help in relieving the symptoms.

7. Avoid foods to which you are intolerant.

8. In addition, using activated charcoal (For stomach gas), OTC antacids (tums, mylanta, maalox) and Omeprazole (acid reducer) will also help the symptoms.

Presence of hepatitis or gall stones could probably be diagnosed by blood testing for liver functions as well as sonogram of the liver. Treatment would be via diet and lifestyle modification, weight reduction, physical exercise, and medications. Surgery may be necessary in severe cases of gallstones causing intolerable and recurrent symptoms.

GERD (Gastro Esophageal Reflux disease) is due to laxity of the lower end of the food pipe with regurgitation of the contents of the stomach. OTC antacids (Tums, Mylanta) or omeprazole (acid reducing medications) will help to improve your symptoms.

Peptic ulcer disease, where in erosion of the gastric or duodenal mucosa can cause severe and sometimes intolerable pain. Pain is usually caused by the ulcer but it may be aggravated by the stomach acid when it comes into contact with the ulcerated area. The management here is similar to above already mentioned. In addition tests to detect H-Pylori infection in the stomach or a Upper GI endoscopy may be helpful

I hope you find this helpful in making your health care decisions.

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