Q: I am 39 years old. I vomit throughout the day (10-12 times) after every 3-4 weeks. I also have a severe headache prior to vomiting. The vomit is very bitter and sour. The doctor in Saudi Arabia have done the stool test and diagnosed helico bacter pylori. I am also suffering form gastro-oesophageal reflux disease. The doctor prescribed omeprazole and some antacids. How can persistent vomiting be treated?

A:GERD and H pylori gastritis maybe associated with vomitings but headache is not a feature of these. 1. continue antacids 2. take small frequent meals 3. avoid carbonated/caffeine drinks 4. avoid remaining empty stomach 5. keep head end elevated by 30 degree at bedtime 6. atleast 30-45 minutes gap between meals and lying down 7. avoid spicy/fried food 8. see a neurologist to rule out a migraine variant as a cause of headache and associated vomiting.