Gagging (I think?) all the time
November 7, 2013 8:19 AM Subscribe
Since the end of august-- when I had a bout of extremely high anxiety that got me vomiting a bunch of times during panic attacks-- I have been gagging throughout the day.
I call it gagging, but I am not sure if that's right-- basically, it feels like I am about to throw up, and I dry heave, and do the gag reflex thing, but most of the time I don't actually throw anything up. This happens sometimes after I've had a normal sized meal, but more often when my stomach is empty. My stomach doesn't usually hurt or anything. I think my appetite is not as good as before and I think I've lost some weight because my clothes are too big, but I am not completely sure (things have been a whirlwind since June).
Is this bad? Is gagging the right word to describe this? I know you are not my doctors, but I don't have health insurance at the moment, so I am trying to get a sense of how badly I need to see a doctor.
IANAD. I have, however, had some throat problems and several endoscopies, so I've been through this particular mill.
I mean technically one would recommend an endoscopy to rule out esophageal cancer or esophageal strictures, but it sounds a bit like you've done something to irritate the nerves in your throat with the throwing up and the anxiety, and they're just not getting better because you keep re-irritating them via gagging. Or possibly you've got some kind of polyp irritating your throat as a result of the previous vomiting/irritation. Or possibly you're having "silent" acid reflux, which can actually produce gagging sometimes.
Do you have a history of smoking or significant alcohol use? Are you over forty? If not, it's a lot less likely that you'd have anything grave.
Can you swallow easily - liquids? dry solids? gummy solids? normal-sized bites?
As to what to do, I would try some OTC Prilosec to see if it's acid reflux (plus take the usual acid reflux advice - cut drastically down on caffeine, chocolate, etc; don't eat right before bedtime; eat more smaller meals). I might also try some relaxation exercises (whatever works for you - visualization, vigorous physical exercise, etc). And maybe some throat-coat type tea or throat lozenges.
If those things don't help, I'd suggest a doctor's visit - but a free or cheap clinic will at least be able to look at the back of your throat for obvious problems.
My money is on silent reflux, actually, now that I think about it - stress, vomiting, irritation all exacerbated by continuing reflux.
posted by Frowner at 8:37 AM on November 7, 2013 [3 favorites]
I mean technically one would recommend an endoscopy to rule out esophageal cancer or esophageal strictures, but it sounds a bit like you've done something to irritate the nerves in your throat with the throwing up and the anxiety, and they're just not getting better because you keep re-irritating them via gagging. Or possibly you've got some kind of polyp irritating your throat as a result of the previous vomiting/irritation. Or possibly you're having "silent" acid reflux, which can actually produce gagging sometimes.
Do you have a history of smoking or significant alcohol use? Are you over forty? If not, it's a lot less likely that you'd have anything grave.
Can you swallow easily - liquids? dry solids? gummy solids? normal-sized bites?
As to what to do, I would try some OTC Prilosec to see if it's acid reflux (plus take the usual acid reflux advice - cut drastically down on caffeine, chocolate, etc; don't eat right before bedtime; eat more smaller meals). I might also try some relaxation exercises (whatever works for you - visualization, vigorous physical exercise, etc). And maybe some throat-coat type tea or throat lozenges.
If those things don't help, I'd suggest a doctor's visit - but a free or cheap clinic will at least be able to look at the back of your throat for obvious problems.
My money is on silent reflux, actually, now that I think about it - stress, vomiting, irritation all exacerbated by continuing reflux.
posted by Frowner at 8:37 AM on November 7, 2013 [3 favorites]
IANAD, IANYD, OMGBBQ, etc.: what you're doing is retching, not gagging.
While it would probably be a good idea to see a doc, for the time being, it cannot HURT (and might help) to take a two-week course of generic Prilosec. I've had a few weird, severe GI issues in my day, and all of 'em have resolved with a few weeks of consistent Prilosec use. If it's a small, weird issue, it'll cut down on your acid production and give your system some time to heal; if it's a bigger, more serious issue, odds are good that it'll do NOTHING (in other words, you don't need to worry about Prilosec "masking" the symptoms of something awful).
Also, Gaviscon: tastes like cake batter, soothes like the dickens. Love that stuff.
posted by julthumbscrew at 8:44 AM on November 7, 2013 [1 favorite]
While it would probably be a good idea to see a doc, for the time being, it cannot HURT (and might help) to take a two-week course of generic Prilosec. I've had a few weird, severe GI issues in my day, and all of 'em have resolved with a few weeks of consistent Prilosec use. If it's a small, weird issue, it'll cut down on your acid production and give your system some time to heal; if it's a bigger, more serious issue, odds are good that it'll do NOTHING (in other words, you don't need to worry about Prilosec "masking" the symptoms of something awful).
Also, Gaviscon: tastes like cake batter, soothes like the dickens. Love that stuff.
posted by julthumbscrew at 8:44 AM on November 7, 2013 [1 favorite]
Does the retching happen when you're thinking something? Does a random thought float past your head and then you retch? I'd pay attention to that, if you suspect it's not directly physical.
posted by St. Peepsburg at 8:47 AM on November 7, 2013
posted by St. Peepsburg at 8:47 AM on November 7, 2013
I once dry swallowed a pill which caught on my throat and made me MISERABLE for a day or two. It was very upsetting to me, and now sometimes when I swallow a pill, if my throat is a little dry or if I prop myself up on pillows to read right after, the pill will catch on my throat a little as it goes down and I will PANIC and get the exact same feeling as when I actually did injure my throat.
I think this might be what happening to you. You are remembering the anxiety and the gagging, and when you think it might be happening again, it ramps up in your brain until you feel like you're gagging again.
I would also like to know what helps here so I am favoriting this, but the answer to your question is: it's probably not bad, and you aren't dying, most likely.
posted by chainsofreedom at 9:19 AM on November 7, 2013
I think this might be what happening to you. You are remembering the anxiety and the gagging, and when you think it might be happening again, it ramps up in your brain until you feel like you're gagging again.
I would also like to know what helps here so I am favoriting this, but the answer to your question is: it's probably not bad, and you aren't dying, most likely.
posted by chainsofreedom at 9:19 AM on November 7, 2013
You should definitely be pursuing this with doctors. When you do, you should have a strategy for making sure they don't immediately dismiss it as an after-effect of your panic attacks.
That said, it is entirely possible that it is related to your panic attacks. First, plenty of people who don't have panic attacks are made nauseous by exposure to or the thought of vomiting. Second, vomiting is itself a strong traumatic stimulus which is likely to condition a response. Third, panic attacks are a strong traumatic stimulus that condition a response. Fourth our guts themselves can have a profound impact on our emotional state. Also, retching can push acid out of the stomach, iritating your esophagus and throat, which, can also feed into things.
You should try approaching the problem on multiple fronts (cognative behavioral therapy, psych meds, prolosec) in order to dial things back. That, and make sure there isn't something else wrong.
posted by Good Brain at 9:33 AM on November 7, 2013 [1 favorite]
That said, it is entirely possible that it is related to your panic attacks. First, plenty of people who don't have panic attacks are made nauseous by exposure to or the thought of vomiting. Second, vomiting is itself a strong traumatic stimulus which is likely to condition a response. Third, panic attacks are a strong traumatic stimulus that condition a response. Fourth our guts themselves can have a profound impact on our emotional state. Also, retching can push acid out of the stomach, iritating your esophagus and throat, which, can also feed into things.
You should try approaching the problem on multiple fronts (cognative behavioral therapy, psych meds, prolosec) in order to dial things back. That, and make sure there isn't something else wrong.
posted by Good Brain at 9:33 AM on November 7, 2013 [1 favorite]
I'm aware of wrist bands that apply pressure onto the inside of your wrist with a little nub. Allegedly, this can help.
posted by blue t-shirt at 9:55 AM on November 7, 2013
posted by blue t-shirt at 9:55 AM on November 7, 2013
Response by poster: thanks for the comments so far, and julthumbscrew for "retching"- super helpful.
To clarify- I haven't been having panic attacks since early September, but the retching continues. As far as I know it's not connected to any particular thoughts, although I work a very stressful job so I am pretty much always a little stressed out.
I am 29 female, 5'2"/115 (well, that was the last time I weighed myself, which was a while ago). No history of smoking or heavy drinking or drugs, although I do drink quite a bit of coffee and tea. I am generally in good health.
The retching happens a lot in the morning and late at night. I can usually eat a smaller meal without any problem, but every time I eat a normal portion I feel sick afterwards. I used to be able to out-eat guys twice my size. For most of my life I have a super strong GI system and pretty much never vomit, which is a little bit why I'm really confused by the retching right now.
posted by redwaterman at 10:20 AM on November 7, 2013
To clarify- I haven't been having panic attacks since early September, but the retching continues. As far as I know it's not connected to any particular thoughts, although I work a very stressful job so I am pretty much always a little stressed out.
I am 29 female, 5'2"/115 (well, that was the last time I weighed myself, which was a while ago). No history of smoking or heavy drinking or drugs, although I do drink quite a bit of coffee and tea. I am generally in good health.
The retching happens a lot in the morning and late at night. I can usually eat a smaller meal without any problem, but every time I eat a normal portion I feel sick afterwards. I used to be able to out-eat guys twice my size. For most of my life I have a super strong GI system and pretty much never vomit, which is a little bit why I'm really confused by the retching right now.
posted by redwaterman at 10:20 AM on November 7, 2013
Are you on any blood pressure meds? This might be a side effect.
posted by sixpack at 11:56 AM on November 7, 2013
posted by sixpack at 11:56 AM on November 7, 2013
I inadvertently overdosed on caffeine this past couple of months (new prescription for antihistamine medicine + extra sensitivity to caffeine). I then cut caffeine off cold turkey.
Symptom I experienced from caffeine overdose: general anxiety, occasional panic attacks and depression, restlessness (difficulty reading books or doing anything for more than ten minutes), rapid heartbeat leading to constant muscle tension, occasional nausea.
Symptoms I experienced from caffeine withdrawal: headache, increased physical jitters, severe nausea (retching) plus zero appetite. Malaise, occasional dipping into depression. Duration, almost 3 weeks, though steadily improving each day.
I am typically happy and laid-back, so the entire experience was unusual and frightening. Perhaps take a good look to see what's changed in your diet, exercise and daily routine since around September? It's astounding how much tiny little things can affect our health and mood sometimes.
posted by enlivener at 12:01 PM on November 7, 2013
Symptom I experienced from caffeine overdose: general anxiety, occasional panic attacks and depression, restlessness (difficulty reading books or doing anything for more than ten minutes), rapid heartbeat leading to constant muscle tension, occasional nausea.
Symptoms I experienced from caffeine withdrawal: headache, increased physical jitters, severe nausea (retching) plus zero appetite. Malaise, occasional dipping into depression. Duration, almost 3 weeks, though steadily improving each day.
I am typically happy and laid-back, so the entire experience was unusual and frightening. Perhaps take a good look to see what's changed in your diet, exercise and daily routine since around September? It's astounding how much tiny little things can affect our health and mood sometimes.
posted by enlivener at 12:01 PM on November 7, 2013
Welcome to your thirties. I started getting more sensitive to caffeine around your age. The retching hits me when I get stressed out and/or exercise vigorously after drinking coffee. I first noticed it after wolfing down my breakfast and chasing it with a large black coffee. It also happens when I consume other heavily caffeinated substances like Red Bull or Excedrin.
I still drink coffee every day, but stick to smaller servings and consume it more slowly. I also find it helps to eat a small amount of food with my coffee or tea, preferably something with a little protein and fat in it, like a hard boiled egg or yogurt.
posted by Mendl at 12:02 PM on November 7, 2013
I still drink coffee every day, but stick to smaller servings and consume it more slowly. I also find it helps to eat a small amount of food with my coffee or tea, preferably something with a little protein and fat in it, like a hard boiled egg or yogurt.
posted by Mendl at 12:02 PM on November 7, 2013
I have a similar problem where chronic post-nasal drip stimulates my gag reflex. It's especially bad when I wake up and when I go to bed because of the mucus pooling in the back of my throat while I'm lying down.
I'm able to keep it pretty well controlled with cheap generic non-prescription medications for allergies and acid reflux so I recommend trying those.
posted by Jacqueline at 12:21 PM on November 7, 2013
I'm able to keep it pretty well controlled with cheap generic non-prescription medications for allergies and acid reflux so I recommend trying those.
posted by Jacqueline at 12:21 PM on November 7, 2013
Oh, I should add that I once had really awful throat symptoms that were purely stress related. I didn't even feel that stressed, but I literally had an unexpected crying bout and freak-out one day and immediately noticed that the Very Obvious symptoms (difficulty swallowing, horrible taste in mouth) went away. It's possible that while you don't feel stressed compared to how things were, your body is quietly stressing out. Especially if there's positive stress - you just had a question about your girlfriend, and that sounds like a classic case of "so great that it is discombobulating me".
posted by Frowner at 1:12 PM on November 7, 2013 [1 favorite]
posted by Frowner at 1:12 PM on November 7, 2013 [1 favorite]
I've had EXACTLY this same issue - gagging, combined with very low appetite - when I was dealing with severe anxiety coming out of a shitty emotionally abusive relationship some years ago. My triggers for gagging were brushing my teeth, and reading messages or emails from the dude about how unworthy I was of love. I bring this up mostly to let you know that what you described can absolutely be anxiety related with no underlying other cause. Please see a doctor if you can, both to rule out possible other causes, and to see if there is a way they could help you deal with your anxiety. In my situation, this was the point at which I started on a low dose SSRI, which helped immensely with my physical symptoms (which also included chest tightness and difficulty taking a deep breath) as well as my appetite. Generics of many common anxiety meds are really cheap (think $5 or less a month) and I think they could help you feel better very quickly. I hope you find what works to help this - it's really awful and I completely feel for you going through it.
posted by augustimagination at 3:36 PM on November 7, 2013
posted by augustimagination at 3:36 PM on November 7, 2013
I can usually eat a smaller meal without any problem, but every time I eat a normal portion I feel sick afterwards.
IANAD, but to me, this indicates a couple of specific problems to look into. This could be, like Jacqueline has experienced, a gag reflex stimulated by postnasal drip, especially after meals—which in itself can be a symptom of "silent" reflux like GERD (gastroesophageal reflux disease) or LPR (laryngopharyngeal reflux disease). It could also be a motility issue, like slow or delayed gastric emptying (gastroparesis), which would make sense in light of the fact that this problem mostly occurs after larger meals. Anxiety and depression correlate with increased symptoms of gastroparesis, and also make GERD and LPR worse. It's also possible that you could have both reflux and gastroparesis acting together.
In any case, frequent nausea/retching like this suggests the need for a visit to the doctor, 'cause we can't definitively diagnose you from afar!
posted by limeonaire at 4:14 PM on November 7, 2013
IANAD, but to me, this indicates a couple of specific problems to look into. This could be, like Jacqueline has experienced, a gag reflex stimulated by postnasal drip, especially after meals—which in itself can be a symptom of "silent" reflux like GERD (gastroesophageal reflux disease) or LPR (laryngopharyngeal reflux disease). It could also be a motility issue, like slow or delayed gastric emptying (gastroparesis), which would make sense in light of the fact that this problem mostly occurs after larger meals. Anxiety and depression correlate with increased symptoms of gastroparesis, and also make GERD and LPR worse. It's also possible that you could have both reflux and gastroparesis acting together.
In any case, frequent nausea/retching like this suggests the need for a visit to the doctor, 'cause we can't definitively diagnose you from afar!
posted by limeonaire at 4:14 PM on November 7, 2013
Does it happened after you smell something unpleasant? This experience came and went with both my GI issues and anxiety and depression. mostly the former.
posted by Jewel98 at 9:27 PM on November 7, 2013
posted by Jewel98 at 9:27 PM on November 7, 2013
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Are you saying that the gagging is completely related to panic attacks or anything mental or are you saying that it can be related.
I would say if there's any chance it could be food related then see a doc.
If it's definitely a result of panic attacks and nothing else then you still have a problem but it sounds like it's a problem that a standard doctor isn't usually much help with and something you're already familiar with. If that's the case maybe it's a less pressing problem? - and time to focus on the panic attacks.
In any case I recommend making this clearer in your comments on the question
-j
posted by jago25_98 at 8:30 AM on November 7, 2013