Commentary: Patient's view

BMJ 2006; 333 doi: (Published 13 July 2006) Cite this as: BMJ 2006;333:134
  1. Kenneth Neville1,
  2. Mark Fox, specialist registrar (markfox{at}
  1. 1 Oesophageal Laboratory, St Thomas' Hospital, London SE1 7EH
  1. Correspondence to: M Fox

    As a child I remember eating well and enjoying my food, although I did get heartburn now and again. That all changed in 2001 when I started to bring up what I ate. At first this was occasional, but then my stomach settled into a new routine. On eating even small amounts I felt unpleasantly full, then I had to belch and the food came back to my mouth. I usually spat this out, but sometimes I swallowed it again. If I tried to eat larger amounts my stomach hurt and I had to vomit everything up.

    In spring 2004 I was sicking up more and more, but my stomach just felt fuller and fuller. I was admitted to hospital. At first everybody was sympathetic. However, after a while I could sense that the doctors were becoming frustrated at not reaching a diagnosis and then I felt that they began to get frustrated with me as a person. In the end I was sent home without an explanation for my problems. I got the impression that the doctors thought that I was wasting their time.

    At home I forced myself to eat, but I was keeping down only a third of my food. At Christmas I had to keep leaving the dining room so I could be sick without upsetting my mother. I put off going to hospital until the New Year because I knew nothing would happen until after the holidays. Back on the ward I had a lot of investigations. Every time the person doing the test would come to me and say, “Everything's normal”; they always wondered why I lost my smile. I was begging for something to come back positive so I could get on with my life. The doctors didn't seem to be able to agree on how to deal with me. I asked for a second opinion.

    At St Thomas' I kept on losing weight and became so weak that I could not get out of bed. Finally, I had an investigation that measured what happened in my stomach after I ate. I always wondered why nobody had done that before. I had my doubts when I was told that the problem was under my control. With the doctors' help I became aware of the process. I began to feel the tension building up in my stomach after eating and tried to keep the food down. At first it was hard to distinguish wind and food coming back up, but suddenly I got the hang of it. Once I was in control it encouraged me to continue. I still remember the excitement when I moved from “underweight” to “low normal” on the weight chart. At home I am getting stronger and have only allowed food to come back up a couple of times when I ate too much. I'm really grateful and glad because I can now get my life back.

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