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Ways to treat fear of vomiting, EMETOPHOBIA.

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I am a female. I am almost 44 years old. Since my childhood, I fear vomiting and I have emetophobia. However, I did not vomit since about eight years. On the last day of September 2014, I had diarrhea (loose stool , but only 2 times and I vomited twice) after 2 hours of eating and I felt anxious. The next week I had a pus discharge from my navel and I took 3 antibiotic intramuscular injection (oframax) and I also took a spray antibiotic . I lost my appetite because I was anxious and afraid to vomit because of the antibiotic. The surgeon told me that it was just an inflammation and there is no need for worrying. The next week, one of my relatives died (sick with cancer for only 3 months) and this added to my sadness and worries. I remembered everything (My mother died in September 2013 and my father died in August 2006 and I am living alone with my sister. My mother vomited before she died and my father vomited in his last days because of renal failure). I thought I would be Ok after I finish my therapy, but this did not happen. I lost my appetite for food and I am always feeling anxious and worried about my health. I lost about 10 kiograms in 4 months. I can not sleep because I am afraid of vomiting. I always wake up in the night afraid of vomting and once I feel afraid I go to the bathroom making loose stool. The doctor told me that I have IBS and prescribed Librax and motillium for me. I made a cbc analysis which was ok (anaemia that was later treated). I also made an Xray on the abdomen only and urine and stool analysis which were ok). The terrible thinking of vomiting which I cannot prevent makes me really sick. Two weeks ago, I had a flu which continued for about two weeks and raised my temperature for two days and this of course increased my worries and all of a sudden I felt panic. I had diarrhea, felt nauseous, shaking and trembling, my mouth was dry and this lasted for several hours until I went asleep (but I did not vomit) and this of course added to my sickness. When I have the panic attack I feel I am passing away. I know that a large part of my sickness is psychological and because of my emotions and fear, which I can not prevent especially with sunset and night. The menstruation also increases my IBS symptoms and my panic attacks because it makes me feel nauseous. I do not know what to do when I have the panic attack. My stomach does not endure pills at that time and I can only take oral suspensions. At the time of the attack I need something which soothes me with rapid effect before the matter worsens and before I vomit. I need something that makes me fall asleep and stop thinking as thinking worsens my symptoms. I feel very anxious now and I can not sleep without paracetamol or aspocid. I also feel my head throbbing on the left side from time to time. I do not know what to do to prevent my panic of vomiting. Will I die because of vomiting and feeling nausea? I can not enjoy my life and I am really depressed. Do the hormones have any role in the anxiety I am feeling? What is wrong with me?


Category: Psychiatrist

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Category: Sexologist
Dr. Srikanth Reddy is online now

Expert:  Dr. Srikanth Reddy replied 4 Days.

Hello
Thanks for your query at DoctorSpring.com.
I have gone through your question in detail and I can understand what you are going through.
The condition that you are having is basically panic attacks along with specific phobia i.e. phobia of vomiting. This is a disorder of anxiety and occurs cause of imbalance of certain neurotransmitters in the brain. especially serotonin, noradrenaline, and dopamine to some extent. Yes, you are right that hormonal changes also play a role in the anxiety disorders. And nobody dies of anxiety,
Medicines are the best options to take care of these symptoms. Paroxetine is the most popular medicine and my drug of choice. I generally prescribe my patients 12.5 mg per day at night which takes care of anxiety symptoms. Also certain medicines like propranolol and clonazepam can be given as required when there is a panic episode or expected situation where panic attack can appear.
Also there is an option of cognitive behavioural therapy (CBT). This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness. This will reduce the panic attacks frequency. For the phobia the more appropriate psychotherapy is graded exposure and systematic desensitization. This is taken up by a clinical psychologist.
Do meet your doctor and discuss the mentioned medicines and also seek for a clinical psychologist referral.
Hope this helps,
In case, if you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy MD


Patient replied :

I am so terrified because I have been complaining in the last four months from, IBS, nausea and fear of vomiting (since last time I vomited at the end of September 2014), pulsating head, great anxiety, insomnia, loss of weight and appetite, and panic attacks especially during menstruation and fever (beginning with a slight fear with any bowel movement then diarrhea, nausea, trembling, sense of cold hands and dry mouth. The doctor told me that these panic attacks are psychological and because of my fears and neurotransmitters and I began partly to partly improve, but when I made the last test hormone and saw the results that indicate that I have problems with the thyroid gland, I began to feel more anxious and the panic attacks continuous medications that my stomach can not endure. I want someone to help me calm down. Are these results very bad and indicate something serious (given that my TSH was normal in June 2014)? Do these medicines affect the results? I take colospasmin, librax and sometimes liquid motillium and aspocid. I also take feroglobin syrup (one spoon twice or thrice times per week) and seven seas syrup (one spoon per week) and theragran stress (one capsule every five days, but I already stopped it three weeks ago) because I am lacking appetite and can not eat well?
The late hormone test analysis I made on 15/2/2015 showed the following results:
Free T3 2.62 pg/ml normal range (1.7-3.7)
Free T4 1.66 ng/dl normal range (0.70-1.48)
TSH 0.24 Uiu/ml normal range (0.35-4.50)
I am also attaching other tests I made. Thanks a lot



Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
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