BMJ  2006;332:1496 (24 June), doi:10.1136/bmj.332.7556.1496

Practice

Interactive case report

A 22 year old man with persistent regurgitation and vomiting: case progression

¹ Oesophageal Laboratory, St Thomas' Hospital, London SE1 7EH, ² Department of Gastroenterology, St Thomas' Hospital, London SE1 7EH

The first 150 words of the full text of this article appear below.

Last week (BMJ 2006;332:) we presented the case of Mr Neville, a 22 year old student with persistent severe epigastric pain and regurgitation and vomiting after meals. Investigation suggested gastro-oesophageal reflux disease, but treatment with acid suppression and prokinetics was only partially effective and he was readmitted to hospital with persistent symptoms and weight loss.

His persistent reflux symptoms were treated aggressively with oral esomeprazole 40 mg twice daily and later with intravenous pantoprazole. This reduced his epigastric pain and heartburn but not the regurgitation and vomiting. He did not tolerate conventional antiemetics, developing a dystonic reaction with prochlorperazine and mental agitation with metoclopramide and cyclizine. Regular ondansetron reduced the sensation of nausea but did not prevent postprandial regurgitation and vomiting. Small bowel follow-through; upper and lower gastrointestinal endoscopy (to exclude obstruction and inflammatory bowel disease); cranial, abdominal, and pelvic computed tomography (to exclude pancreatic . . . [Full text of this article]

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A 22 year old man with persistent regurgitation and vomiting: case outcome

Mark Fox, Alasdair Young, Roy Anggiansah, Angela Anggiansah, and Jeremy Sanderson
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This article has been cited by other articles:

• Fox, M., Young, A., Anggiansah, R., Anggiansah, A., Sanderson, J. (2006). A 22 year old man with persistent regurgitation and vomiting: case outcome.. BMJ 333: 133-133 [Full text]  

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