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Every time i eat i feel sick at the top of my stomach only the top where the stomach connects and i have puked from it i have learn to hold it down. Even drink does it and now sometimes i get this heat burning all over my abdomen then i get sick but sometimes it’s before i get sick. Can someone help me? Thank you. Also its when I’m in the middle of eating sometimes sooner then that! It’s been going on a few months now maybe longer i always ignored it but now it’s gotten 10x worse. I also have this strange bruise like thing on my left ribcage it doesn’t hurt and it was going away but it came back and i have also been feeling very lightheaded.

It appears as if you are having gastrointestinal issues which requires professional evaluation by either your primary care physician or a gastroenterologist. With your symptoms three possible diagnoses come to mind: gastroesophageal reflux, hiatal hernia, esophageal dysmotility/dysfunction, or gallstones.

Gastroesophageal reflux disease (GERD) is also known as acid reflux. Patients suffer from constant reflux of stomach acid into the esophagus and often report symptoms of heartburn, sour taste at the back of the mouth, difficulty swallowing, excessive phlegm, or excessive salivation. Symptoms are often exacerbated by reclining or at night when sleeping. Treatment often includes medication that reducing acid production in the stomach thereby decreasing the amount refluxed.

A hiatal hernia is a result of a portion of the stomach prolapsing up through the diaphragm into the chest cavity. Hiatal hernias cause patients to experience much of the same symptoms as GERD and may even contribute to GERD. In addition, patients may report feeling full prematurely. Most hiatal hernias do not require treatment. However, surgery may be indicated in severe cases or if there are serious anatomic deformities resulting in inability to feed.

Esophageal dysmotility/dysfunction is a broad spectrum of diseases that range from achalasia to autonomic dysfunction to diverticulae. In short, the esophagus is unable to paralyzed (partially or completely) or there is a blind pouch in the esophagus and food becomes stuck leading the patient to feel as if something is stuck in their chest. Treatments range from pharmacotherapy to surgery depending on the cause.

Lastly, your burning and abdominal discomfort with eating may be related to gallstones (cholelithiasis) which produces painful colic in the right upper quadrant of the abdomen. Eating causes your gall bladder to contract and if there are stones present, it may cause a transient blockage of the gall bladder’s sphincter. The treatment is often with surgery to remove the gall bladder.

In short, you should be evaluated by either your primary care physician or a gastroenterologist. A physical exam is necessary to create a working differential diagnosis. Tests such as pH monitoring, barium swallows, endoscopies, and right upper quandrant ultrasounds are especially helpful in diagnosing your condition.

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