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Medical Forum / General / General / February 2004Coffee Grounds in Vomit
I have a question. To the point, how much coffee grounds-like substance is cause for concern, i.e., when should I consider this serious? I got up feeling kind of bloaty, but took my usual Prilosec, then ate my Zone nutrition bar. A few hours later I felt pretty yucky, and tried a hot shower, but I was sick shortly after. I was thinking I poisoned myself eating my own cooking. :) Dinner last night was home baked chicken nuggets and broccoli. I don't have all of the symptoms of salmonella; no diarrhea or anything, just throwing up every couple of hours. I haven't eaten anything since the Zone bar, but have been sipping Diet 7-up. A couple of episodes ago there were a couple of dark specs. The next episode, about 6 or 7, and the next maybe 10 to 15 specs of "coffee grounds" along with a little bile. Between episodes I sort of feel fine, but there are all of these "see a doctor if you vomit blood" messages all over the and I don't have insurance. How much of this would indicate it's a concern? I'm not unwilling to see a doctor and pay for it, but if I don't have to... Dana > A couple of episodes ago there were a couple of dark specs. The next > episode, about 6 or 7, and the next maybe 10 to 15 specs of "coffee > grounds" along with a little bile. Between episodes I sort of feel > fine, but there are all of these "see a doctor if you vomit blood" > messages all over the and I don't have insurance. How much of this > would indicate it's a concern? Well, vomiting blood is *never* normal. You might just have some mild gastritis, which may well resolve on its own; or, you might be developing an ulcer. Definitely keep taking the Prilosec every morning for the next eight weeks (it works best if taken on an empty stomach, and then eat something a half-hour or so later), as the acid suppression will help heal any irritation. In addition, I recommend abstaining from cigarettes, alcohol, aspirin, NSAIDs (Motrin, Advil, Aleve, etc.), and acidic foods (tomato juice/sauce, orange juice, grapefruit juice, etc.) until things are back to normal (actually, I'd strongly recommend giving up the smokes altogether, if you smoke). Watch out for changes in the appearance of your bowel movements (e.g., dark black, tarry stools), which could indicate slow but steady GI blood loss, possibly of a serious nature. Iron supplements or Pepto-Bismol can mimic this, so beware. If you see this, or if you continue to vomit blood (the coffee-ground appearance is what blood looks like after it's been worked over by your stomach's digestive processes), you really should see a doctor, insurance or no insurance. >Well, vomiting blood is *never* normal. That depends on your definition of "normal." You could easily argue that vomiting itself, bloody or not, is never "normal." However, I don't get too excited about Mallory-Weiss tears, a benign cause of hematemesis in otherwise healthy people. When I see a six-year-old who has been barfing and retching all night who has a few streaks of blood in her vomit the next morning, I usually consider that normal. PF >> Well, vomiting blood is *never* normal. > > That depends on your definition of "normal." What you appear to be trying to draw a distinction between is "serious" and "not serious." A child who vomits a small amount of blood after repeated violent episodes of emesis probably has a mucosal tear, as you suggested, which is generally not serious and will heal spontaneously. However, *no* amount of GI bleeding should be considered "normal." : I have a question. To the point, how much coffee grounds-like : substance is cause for concern, i.e., when should I consider this : serious? : I got up feeling kind of bloaty, but took my usual Prilosec, then ate : my Zone nutrition bar. A few hours later I felt pretty yucky, and [quoted text clipped - 4 lines] : of hours. I haven't eaten anything since the Zone bar, but have been : sipping Diet 7-up. : A couple of episodes ago there were a couple of dark specs. The next : episode, about 6 or 7, and the next maybe 10 to 15 specs of "coffee [quoted text clipped - 3 lines] : would indicate it's a concern? I'm not unwilling to see a doctor and : pay for it, but if I don't have to... Blood is a bad sign. What color is your "bile"? If it were me, i'd spend the $100 (or whatever) and see my doctor. Emma >I have a question. To the point, how much coffee grounds-like >substance is cause for concern, i.e., when should I consider this [quoted text clipped - 16 lines] >would indicate it's a concern? I'm not unwilling to see a doctor and >pay for it, but if I don't have to... As usual, anonymous strangers are asked for medical advice on the Usenet by someone who doesn't even tell us her age let alone anything about her medical history. How "anon" can dispense such detailed medical advice as he did without knowing whether or not this is a 75-year-old alcoholic who has esophageal varices and takes Prilosec because of a history of perforated ulcers, or a 21-year-old with some just some bothersome but benign heartburn, is beyond me. PF > How "anon" can dispense such detailed medical advice as he did without > knowing whether or not this is a 75-year-old alcoholic who has > esophageal varices and takes Prilosec because of a history of > perforated ulcers, or a 21-year-old with some just some bothersome but > benign heartburn, is beyond me. You work with the information you have, that's all, although I'll grant that it wouldn't hurt to ask more questions.  SignatureTranspose hotmail and mxsmanic in my e-mail address to reach me directly. >> How "anon" can dispense such detailed medical advice as he did without >> knowing whether or not this is a 75-year-old alcoholic who has [quoted text clipped - 4 lines] > You work with the information you have, that's all, although I'll grant > that it wouldn't hurt to ask more questions. I'm not here to take the place of anyone's doctor, but I'm happy to try to give a reasonable answer to a reasonable question. I'm not going to get into an extended Q&A in a newsgroup. If I answer a question at all, I'm usually only going to reply once to any given posting, based on what I'm given to work with. If somebody doesn't give me much to go on, they won't get much of an answer. In most cases, they'll get "see your doctor." The Internet is a wonderful thing, but it's no substitute for a face-to-face clinical encounter. > How "anon" can dispense such detailed medical advice as he did without > knowing whether or not this is a 75-year-old alcoholic who has > esophageal varices and takes Prilosec because of a history of > perforated ulcers, or a 21-year-old with some just some bothersome but > benign heartburn, is beyond me. Oh, please...tthe "advice" I gave was pretty general. Did I say anything inaccurate? Feel free to correct me if I did. Do you have anything to add? Since you didn't, I'll have to assume not. Prilosec is available over the counter nowadays, in case you weren't aware. Physicians need to recognize the fact that many patients, like Dana, will attempt to self-treat their upper GI symptoms prior to seeking medical care. The important thing for patients to recognize is when it's time to ask for help. That's exactly what I advised, and the advice would not differ whether Dana is a sixteen-year-old or a sixty-year old. As for dispensing advice, you appear to be a physician...what are *you* doing here? Maybe you're just here to argue with other physicians. anon <anon@anon.com> wrote in sci.med: >> How "anon" can dispense such detailed medical advice as he did >> without knowing whether or not this is a 75-year-old alcoholic [quoted text clipped - 17 lines] > *you* doing here? Maybe you're just here to argue with other > physicians. Thanks to one and all for the responses. Usenet never changes no matter the group, does it. ;) To those who poopoo anyone giving suggestions, I think to go into anymore depth would actually qualify as practicing medicine. That would be a bit more dangerous than simply saying a lot or a little is totally bad and hye thee to the ER, which is all I really wanted to know. I agree "normal" is in the eye of the beholder given medical histories. Needless to say I survived the night and actually did not have anymore episodes... yet. For the record, I'm a 40 year old female in good health. I take the Prilosec OTC because I am having frequent heartburn. I've been taking it for about 4 months with the blessing of a bonfide doctor. I do not smoke, drink only maybe a glass of wine once a month, and other than being slightly overweight (5'3", 160#), got a class one medical clearance from the Department of State when I was pursuing a different career. Thanks again for responding. Dana |
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