{"id":13254,"date":"2022-08-23T19:47:40","date_gmt":"2022-08-23T11:47:40","guid":{"rendered":"https:\/\/vstcm.com\/case-study-vomit-cum-belching-for-one-night-%e3%80%90tcm-liau%e3%80%91\/"},"modified":"2022-11-07T19:14:20","modified_gmt":"2022-11-07T11:14:20","slug":"case-study-vomit-cum-belching-for-one-night","status":"publish","type":"post","link":"https:\/\/vstcm.com\/en\/case-study-vomit-cum-belching-for-one-night\/","title":{"rendered":"Case Study &#8211; Vomit cum Belching for one night \u3010TCM Liau\u3011"},"content":{"rendered":"<p><strong><span style=\"font-size: 14pt; color: #000000;\">Patient: Mr. Lee (Male) Age 43<br \/>\nDate\uff1a<\/span><span style=\"font-size: 14pt; color: #000000;\">19 June 2022\uff0cFirst Consultation<br \/>\n<\/span><span style=\"font-size: 14pt; color: #000000;\">Main Issue: Vomit cum Belching for one night <\/span><\/strong><\/p>\n<p><img fetchpriority=\"high\" fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-13213\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/vomit.png\" alt=\"\" width=\"254\" height=\"266\" \/><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Mr. Lee\u2019s first visit is telling me his problem with a dull face and sluggish expression: \u201cTCM Doctor, now <strong>I feel my throat is having an inflammation and heat sensation. I have also a frequent belching. I vomited since last midnight 12.00am till 7:00am this morning. \u201c<\/strong><\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">After detail checking, we confirmed that he had a sore throat, frequent belching with no acid flow back in the esophagus. Yesterday night he felt stomachache but today stopped. Due to worries, if he will continue vomit for tonight, so he turns up for a consultation.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">I ask: \u201cMay you tell me the story how it happens please?\u201d<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">He answers: \u201cYesterday 11am I took my first meal as \u2018brunch\u2019. I ate curry noodles and drunk a glass of iced-milk tea.<\/span><span style=\"font-size: 14pt; color: #000000;\"><br \/>\n<img decoding=\"async\" class=\"alignnone size-full wp-image-13220\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/%E5%92%96%E5%96%B1%E9%9D%A2.png\" alt=\"\" width=\"302\" height=\"227\" \/> <img decoding=\"async\" class=\"alignnone wp-image-13222\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/%E5%A5%B6%E8%8C%B6.png\" alt=\"\" width=\"145\" height=\"227\" \/><br \/>\n<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">In the afternoon around 5pm, I met with my friends and I have a plate of Italian spaghetti and a glass of iced-lemon tea.<br \/>\n<\/span><\/p>\n<p><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\" wp-image-13216\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/%E6%84%8F%E5%A4%A7%E5%88%A9%E9%9D%A2-scaled.jpg\" alt=\"\" width=\"293\" height=\"195\" \/> <img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-13224\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/%E6%9F%A0%E6%AA%AC%E6%B0%B4.png\" alt=\"\" width=\"190\" height=\"194\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">About half an hour later, <strong>my stomach cramped and feel gastro reflux. I kept belching every minute. I feel heat sensation in the throat and stomachache.<\/strong> I went back home to take a rest. <strong>Then I started vomiting from 12am midnight until 7am this morning for the total of 5 times. The residue vomited was watery mixed with small pieces of digested food. I has also purged watery stool few times in the midnight. \u201d<\/strong><\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">I ask: \u201cSo your stool in normal day also watery?\u201d<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">He answers: \u201cI always have loose and dark brown stool, usually I have constipation, I will purge once in a three to four days.\u201d<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Taken the measurement of the blood pressure it shows BP=126\/87_mm\uff0cp=81.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">When I asked him the details, we got to know that he only take two meals per day for past 2 months. He started his first meal around 12pm and the second meal at 7pm. Besides this, he drinks a cup of green apple cider vinegar with an empty stomach.<\/span><\/p>\n<p><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13226\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/%E9%9D%92%E8%8B%B9%E6%9E%9C%E9%86%8B.png\" alt=\"\" width=\"248\" height=\"435\" \/><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Stomach diagnosis: When we press on the stomach, we feel stomach distension.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Tongue diagnosis: A deep crack in the middle and blood clots underneath the tongue.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\"><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-13229\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1.jpg\" alt=\"\" width=\"386\" height=\"396\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1.jpg 480w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1-292x300.jpg 292w\" sizes=\"auto, (max-width: 386px) 100vw, 386px\" \/> <img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-13231\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/2-1.jpg\" alt=\"\" width=\"298\" height=\"397\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/2-1.jpg 369w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/2-1-225x300.jpg 225w\" sizes=\"auto, (max-width: 298px) 100vw, 298px\" \/><br \/>\n<\/span><\/p>\n<p><span style=\"color: #800000;\"><strong><span style=\"font-size: 14pt;\">\u3010Acupuncture treatment\u3011<\/span><\/strong><\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\"><strong>Advice: Ask the patient to follow a regular meal which is three meals per day. <span style=\"text-decoration: underline;\">Emphasize him must take breakfast in the morning.<\/span><\/strong> Advise him to <span style=\"text-decoration: underline;\"><strong><span style=\"color: #800000; text-decoration: underline;\">stop<\/span> the green apple vinegar in the morning with an empty stomach.<\/strong><\/span> Stop cold or icy food, fried food and spicy food.<\/span><\/p>\n<p><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-13219\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/-2-e1661230440270.png\" alt=\"\" width=\"471\" height=\"351\" \/><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\"><strong>25-06-2022 Revisit<\/strong>\uff1a<\/span><\/p>\n<p><strong><span style=\"font-size: 14pt; color: #000000;\">Vomit has stopped. The heat sensation in the throat has mitigated.<\/span><\/strong><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\"><strong>Mr. Lee\u2019s appetite has improved much. He abides the recommendations to follow a regular meal which is three meals per day with appropriate portion. He stopped spicy and fried food.<\/strong> Only vomited on 19th and 20th of June, observed some vegetable residue. This few days the occurrence of belching has increased, he senses the stinky smell especially after taking spicy or oily food.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">After taking the herbs for last week, the loosen stool become firm and solid, and the bowel movement increased to daily once.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Stomach Diagnosis: When we press on the stomach, we feel stomach distension especially the left side.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Tongue diagnosis: A deep crack in the middle and blood clots underneath the tongue.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong><span style=\"font-size: 14pt; color: #000000;\">Acupuncture treatment.<\/span><\/strong><\/p>\n<p><strong><span style=\"font-size: 14pt; color: #000000;\">Diagnosis\uff1a<\/span><\/strong><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Main Issue: Vomit cum Belching for one night.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">Base on the conversation, the main root cause is due to the mixture of cooling and heaty food. He took curry noodle (heaty) and iced-milk tea (cooling). Not long after, he took dinner as Italian Spaghetti (oily) and iced-lemon tea (sour). Lemon used to dissolve oily food, when it was taken, the stomach started to have reaction, the mixture of heaty and cooling, the acid has been released to digest the food. As a conditioned reflex, it caused the acid flow back from the cardia of stomach towards the esophagus, when it rises to the throat hence causing the heat sensation and causing a frequent expelling of air, eventually the burping start. During the occurrence of burping, the food hardly been digested via acid in the stomach, the force pushing the food to rise up through the esophagus and causing a vomit. The discomfort in the intestine will cause a weakening digestion and hence the purge of bowel movement is watery stool.<\/span><\/p>\n<p><span style=\"font-size: 14pt; color: #000000;\">As for the past 2 months, the patient changed his meal pattern to 816. That is, taking food within 8 hours and fasting within the next 16 hours. Besides, he took a glass of green apple vinegar with an empty stomach. Due to the longer hours of fasting, the vinegar trigger the outer layer of the stomach membrane, and mix with the acid that released from the stomach, so when the he takes spicy food, the mixture of all these acidic food has caused the issue of vomit, belching. The medical term for this disease is called \u201cGastro esophageal reflux disease\u201d(GERD).<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong><span style=\"font-size: 14pt; color: #000000;\">Recommendation:<\/span><\/strong><\/p>\n<ul>\n<li><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\">1. Regular meal. Three meals per day. Must take breakfast as the first meal.<br \/>\n<\/span><\/span><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-13233\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1.png\" alt=\"\" width=\"291\" height=\"369\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1.png 362w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/1-1-237x300.png 237w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><\/li>\n<li><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\">2. Avoid drinking green apple vinegar with an empty stomach; you can mix with sugar like honey or brown sugar.<br \/>\n<\/span><\/span><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13235\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/2-1.png\" alt=\"\" width=\"293\" height=\"214\" \/><\/li>\n<li><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\">3. Taking heated food with warm water, avoid cold water.<br \/>\n<\/span><\/span><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13237\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/3-1.png\" alt=\"\" width=\"315\" height=\"233\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/3-1.png 315w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/3-1-300x222.png 300w\" sizes=\"auto, (max-width: 315px) 100vw, 315px\" \/><\/li>\n<li><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\">4. Menu for your meal include both cold and heaty food at a balancing portion. Neither too cool nor too heaty or too spicy.<\/span><\/span><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13239\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/4.png\" alt=\"\" width=\"496\" height=\"207\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/4.png 496w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/4-480x200.png 480w\" sizes=\"auto, (min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) 496px, 100vw\" \/><\/li>\n<li><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\"><span style=\"font-size: 14pt; color: #000000;\">5. Ensure a daily bowel movement. If you have a constipation issue, we try to make it the next day for a regular bowel movement.<br \/>\n<img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13241\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/5-1.png\" alt=\"\" width=\"207\" height=\"263\" \/><\/span><\/span><\/span><\/li>\n<li><span style=\"font-size: 14pt; color: #000000;\">6. Our daily life has numerous of stress and we learn to release the stress via regular exercise or some outing activities or execute some hobbies we loved.<br \/>\n<img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-13243\" src=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/6-1.png\" alt=\"\" width=\"348\" height=\"227\" srcset=\"https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/6-1.png 348w, https:\/\/vstcm.com\/wp-content\/uploads\/2022\/08\/6-1-300x196.png 300w\" sizes=\"auto, (max-width: 348px) 100vw, 348px\" \/><br \/>\n<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Patient: Mr. Lee (Male) Age 43 Date\uff1a19 June 2022\uff0cFirst Consultation Main Issue: Vomit cum Belching for one night Mr. Lee\u2019s first visit is telling me his problem with a dull face and sluggish expression: \u201cTCM Doctor, now I feel my throat is having an inflammation and heat sensation. I have also a frequent belching. I [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":13245,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[435,426],"tags":[570,135,467,559],"class_list":["post-13254","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-cases-sharing-en","category-doc-tcm-liau-en","tag-tcm","tag-135","tag--en"],"_links":{"self":[{"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/posts\/13254","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/comments?post=13254"}],"version-history":[{"count":2,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/posts\/13254\/revisions"}],"predecessor-version":[{"id":14261,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/posts\/13254\/revisions\/14261"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/media\/13245"}],"wp:attachment":[{"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/media?parent=13254"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/categories?post=13254"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vstcm.com\/en\/wp-json\/wp\/v2\/tags?post=13254"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}