Hi — I hear you. This sounds exhausting and scary, especially after months of normal tests. Let me be direct.
Possible hidden causes (even with normal endoscopy & scans):
· Gastroparesis (delayed stomach emptying) — needs gastric emptying study, not seen on endoscopy. · Rapid gastric dumping (uncommon in your case but possible) · Functional vomiting syndrome (brain-gut dysregulation, no structural findings) · Cannabinoid hyperemesis (even if you don’t use now, past use can trigger) · Neurological (Chiari malformation, increased intracranial pressure — MRI brain needed) · Autoimmune (e.g., gastritis with negative biopsy, or cyclic vomiting syndrome)
What you still need:
· Gastric emptying study (4-hour solid phase) · Brain MRI (not just abdomen scans) · Trial of antiemetics: ondansetron + aprepitant or low-dose amitriptyline (for functional vomiting) · Feeding tube temporary if weight loss severe — don’t wait
You are not crazy. Normal tests ≠ no disease. Push for a neurogastroenterology or motility specialist.
— Dr. Nikhil Chauhan
Hello, thank you for explaining your situation. I understand how distressing and exhausting this must be. Your pattern strongly suggests a functional disorder rather than a structural problem. The most likely condition in your case is functional vomiting / rumination syndrome. This is a condition where: Food comes back up very soon after eating, There is no blockage or ulcer, It is related to involuntary muscle patterns and gut–brain interaction, not a visible disease. It is often misunderstood as “normal vomiting,” but it behaves differently: Happens almost immediately after eating, Not associated with typical nausea in many cases, Investigations usually come normal. Why this happens- Stress or subconscious gut–brain reflex changes, Altered stomach muscle coordination Sometimes triggered after an initial illness or event. This is a real medical condition, not “just psychological,” even though stress can worsen it. Here is my advise-
1. Targeted treatment (different from usual vomiting treatment)- This condition improves with specific techniques, not routine medicines: Diaphragmatic breathing exercises (key treatment), Done immediately after meals to prevent regurgitation. Eating small, frequent meals. Eating slowly and staying upright after meals.
2. Follow up with a gastroenterologist familiar with functional GI disorders. A behavioral therapy approach (CBT-based) is often very effective.
3. Some patients benefit from: Medications that improve gut motility or reduce reflex vomiting. Low-dose medicines for gut–brain axis regulation (These are prescribed based on evaluation).
Since you have: Weight loss & Severe impact on daily functioning, You should actively pursue treatment, not ignore this condition.
Even though this has been going on for months, this condition is: Diagnosable, Treatable, And many patients improve significantly once the correct approach is started. When all tests are normal but symptoms persist like this, the focus should shift to functional disorders and targeted therapy, not repeated investigations.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, D.Fam.Medicine
Hello Thank you for sharing these details. Vomiting everything you eat or drink for 3–6 months, with all tests (including endoscopy and scans) coming back normal, and no pregnancy or drug use, is very challenging and understandably distressing.
This pattern—persistent vomiting with normal investigations—can sometimes be due to a condition called functional vomiting or psychogenic vomiting (sometimes related to a disorder called rumination syndrome or cyclic vomiting syndrome), especially if all physical causes have been ruled out. However, it’s important to be absolutely sure that rare physical causes (like motility disorders, subtle neurological issues, or metabolic problems) have been considered.
A few questions to help clarify: - Do you ever vomit when you’re asleep, or only when awake and after eating/drinking? - Is the vomiting effortless (food just comes up) or is it forceful with retching? - Are you losing weight, feeling weak, or having any other symptoms like headaches, vision changes, or abdominal pain? - Have you noticed any triggers (stress, anxiety, certain foods, or situations)?
If you’d like, you can upload the endoscopy video for review. I’ll do my best to help interpret it.
You’ve already seen multiple specialists, which is excellent. If not already done, a gastrointestinal motility study (to check how your stomach empties) and a neurological evaluation (to rule out rare brain or nerve causes) might be helpful.
Let me know about the questions above, and feel free to upload your endoscopy video. I’m here to help you through this.
Thank you
thank you and to answer your questions: no i dont vomit while sleeping, only after eating sometimes it s effortless sometimes forceful yes i lost a looot ofd wieght, and energy food is the trigger
Thanks for clarifying. Vomiting only after eating, especially when it’s sometimes effortless and sometimes forceful, along with significant weight and energy loss, is concerning—especially since food is the clear trigger.
Given that all your tests (including endoscopy) were normal, but you’re still losing a lot of weight and energy, this points toward a few possibilities:
- Functional vomiting (a type of functional gastrointestinal disorder): The gut isn’t working properly, but there’s no structural problem found on tests. - Gastroparesis: Delayed stomach emptying, but this usually shows up on special tests. - Psychogenic vomiting: Vomiting triggered by stress, anxiety, or psychological factors, even if you don’t feel anxious. - Rare metabolic or motility disorders: These are less common but can sometimes be missed on routine tests.
### What to Do Next - Keep a food and symptom diary: Note what you eat, when you vomit, and how you feel emotionally and physically. - Ask your doctor about a gastric emptying study: This checks for gastroparesis. - Consider a referral to a gastroenterologist (if not already done): They can look for rare causes and help manage symptoms. - Ask about seeing a psychologist or psychiatrist: Sometimes, even if you don’t feel stressed, the body can react with symptoms like vomiting.
### Managing Symptoms - Eat small, frequent meals. - Try bland, easy-to-digest foods. - Stay hydrated—sip water or oral rehydration solutions. - Avoid lying down right after eating.
If you develop new symptoms like severe abdominal pain, blood in vomit, or can’t keep any fluids down, seek medical help immediately.
You’re not alone—this is a tough situation, but there are still options to explore.
Thank you
Hello dear See as per clinical history it seems either Rumination syndrome Gastric mobility Esophageal issues Diagnosis often requires proper evaluation and history Since majority of the tests are normal so the reason seems psychogenic However i suggest you to please get in person consultation with gastroenterologist for better clarity Kindly observe for Weightloss Dizziness Nausea Weakness Headache Fever Loose motions It will require emergency treatment with emphasis on feedback history and diaphragm working Regards
Vomiting immediately (within 2–5 minutes) after every meal for months, with normal endoscopy and scans, usually points to a functional or motility-related condition rather than a structural problem. But because there is weight loss and severe impact on daily life, this situation needs continued medical follow-up.
Most likely causes when tests are normal: One common cause is Rumination syndrome, where food comes back up soon after eating due to involuntary abdominal muscle contractions. Another possibility is Gastroparesis (sometimes missed on routine tests), or a functional vomiting disorder related to the brain–gut connection, stress, or anxiety. Less commonly, severe acid reflux, swallowing disorders, or rare neurological causes can contribute.
What to do next (practical steps): You should continue care with a gastroenterologist and specifically ask about: • A gastric emptying study (if not already done) • Evaluation for rumination syndrome (often diagnosed clinically) • Referral to a motility specialist or multidisciplinary clinic • Nutritional assessment to prevent further weight loss
There are also targeted treatments depending on the cause. For example, rumination syndrome often improves significantly with diaphragmatic breathing training and behavioral therapy, while gastroparesis may require specific medications and diet adjustments.
Seek urgent care if any of these occur: Inability to keep fluids down, signs of dehydration (very little urine, dizziness), rapid weight loss, blood in vomit, severe weakness, or fainting.
Bottom line: When vomiting happens immediately after eating and tests are normal, the most common explanations are functional conditions like rumination syndrome or a motility disorder. These are real, treatable conditions, but they often require specialized evaluation beyond standard tests.
If you’ve undergone extensive testing with normal results but continue to experience persistent vomiting right after eating, it’s understandable that you’re frustrated. One potential path that might not have been fully explored is the possibility of a functional gastrointestinal disorder, such as rumination syndrome. This condition can cause the involuntary regurgitation of food soon after eating. It differs from vomiting because it often doesn’t involve nausea and the regurgitated food may be re-chewed and ingested or spit out. Though rumination syndrome is uncommon, it sometimes goes undiagnosed due to a lack of awareness among both patients and healthcare providers. A specialized evaluation with a gastroenterologist familiar with functional gastrointestinal disturbances may be helpful. Another angle to consider is cyclic vomiting syndrome, although this often has episodes lasting for hours or days rather than being limited to immediately after meals. A gastroenterology or psychiatry team might work together to address the neural connections that control digestive movements, which sometimes play a role in these conditions. Behavioral therapy, like diaphragmatic breathing, has helped some individuals manage symptoms related to rumination. Food intolerances or allergies might also warrant another look, though less likely given the timeline and testing done. In rare instances, compounded stress or psychological factors can interact with gut motility—consider following up with specialists in neuro-gastroenterology or functional medicine departments that might offer a more holistic view of the mind-gut axis. Still, given the impact this is likely having on your health and quality of life, seek medical care with an emphasis on multidisciplinary collaboration. Ensure that ongoing monitoring of your nutritional status is part of your care plan while these concerns are being evaluated.
