Dr Flo, I have a three-year-old daughter who has been vomiting often. She only vomits at night. Before vomiting, she complains of stomach-ache, but after vomiting she is fine. Sometimes she gets a cough and fever, which again happens at night and in the morning she is fine. I took her to a doctor and he said that the vomiting is caused by sugar and that I should reduce her sugar intake. Please shed light on this. Mama B
Dear Mama B,
Your daughter may have cyclic vomiting syndrome (CVS). This is a condition where there are repeated attacks of nausea, vomiting and exhaustion for no apparent reason. The child may also have abdominal pain, headache, drooling or spitting, gagging or retching, thirst, low grade fever, diarrhoea, and not wanting to talk. It starts suddenly, lasts for several days in a month (but not daily), it happens at around the same time and the person seems fine after that.
The exact cause is not known, but it may be triggered by migraines, anxiety, genetic or hormonal problems, respiratory infection, certain foods (chocolate, caffeine, cheese, MSG), physical exhaustion, over-eating, fasting or eating just before sleeping.
The symptoms may also be due to gastroesophageal reflux, where food in the stomach comes back up the food pipe. It may also be due to ketotic hypoglycaemia, where hunger and low blood glucose in the middle of the night triggers vomiting. It may also be due to an infection, hyperacidity, or a problem with food movement through the digestive tract. It would be advisable for your daughter to be seen by a paediatric gastroenterologist for thorough examination and tests to be done. There is medication given to prevent the attacks and medication that is given once the symptoms have started to control the vomiting, migraines and reduce acid production.
I am 35 years old. I’ve had lower back pains for nearly two years now. I have had two MRI scans done. The pain is normally worse, and is sometimes accompanied by pin prick pain in the lower limbs after driving for a short distance. I have been on physiotherapy (TENs) Cox B and Mysopaz. Recently I developed general body aches and the only finding after tests was elevated calcium levels. The kidney, liver, full blood ESR, CRP, vitamin D levels and parathyroid levels were normal. I still have aches and burning pains on the feet. Kindly help. Jack
The longstanding back pain, pinprick and burning pain in the feet points to radicular pain, which develops when a nerve is compressed or inflamed.
According to your MRI report, you also have tears and bulging of the discs (the cushions found in between the bones of the spine) which may be contributing to nerve compression and pain.
In such cases, the pain is usually chronic, because the damage has probably happened slowly over time and is irreversible. In severe cases, surgery may be done to relieve pressure from the bulging discs.
Management involves medication, warm compresses, massage, lumbar support and physiotherapy. This is longterm treatment, and the pain may never go away completely. Avoid working while bending or lifting heavy things and maintain good posture.
Dr Flo, I am 32 years old. After running or doing heavy lifting and stopping suddenly, I feel dizzy. Please advise me. Eric
During exercise or physical exertion, the muscles use up a lot of oxygen and energy, and the body temperature rises, so you sweat to cool down. This can lead to lack of adequate oxygen supply to the brain, low blood sugar, dehydration or low blood pressure, all of which can cause dizziness. The autonomic (involuntary) nerve system that helps to balance all these may also have a problem, causing dizziness.
To manage it, learn how to breathe enough during and after exercise, take adequate water before and during exercise, eat whole grain and/or protein about an hour before exercise, and take a snack afterwards.
Try not to do too much too fast. Listen to your body, monitor your heart rate, and build up the exercise slowly over time. Warm up before exercise and cool down afterwards for about five minutes each. When you are feeling dizzy, sit with your head between your legs to increase blood flow to the brain.
If these measure do not help, visit a neurologist and a cardiologist to check for any other underlying issues.
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