Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Gagging and Throwing Up | | | QUESTION | | | Dear Dr. Needlman,
My three-year-old daughter soon to be four gags a lot. I do mean a lot. Sometimes she ends up throwing up but rarely. The least bit of smell of anything starts her to gag, she gags when she even goes to the bathroom and pees and almost throws up every time, even if she walks into a room and smells food cooking that sometimes makes her gag or throw up but if she's been in the room while it's cooking she ok. I've asked her doctor and he said maybe she's just got a weak stomach, but I'm really worried it be something else or leading to something else when she's older. She's been doing this for about a year. If you have any advice, I would appreciate it.— Worried Mom in OH | | | ANSWER |
April 25, 2001 | | | Dear Worried Mom,
The symptom you describe--frequent gagging in a nearly four-year-old girl--is not common. I think you are right to want answers, especially since it has been going on for a year. Without seeing you and your daughter in person, I can't be specific about your case. But here are some general thoughts that might help you put the problem into perspective and get the help you need.
Frequent gagging and occasional vomiting can be caused by many different sorts of underlying problems: medical, developmental, psychological, or behavioral.
Poor weight gain, difficulty swallowing or eating, coughing, or pain suggest a possible medical problem. For example, many children who spit up frequently end up having gastroesophageal reflux (GER). GER is when stomach acid comes back up the esophagus. When the acid gets up to the top of the esophagus it can trigger gagging. There are several different ways that doctors can test for GER, and it can be treated effectively. Other less common medical problems also can cause gagging.
Children with severe developmental delays (or mental retardation) are prone to having gagging problems. Specialized training can often help them to get better. Psychological problems also can cause gagging. Usually, the child has experienced severe stress or has great difficulties in her relationships with parents and other family members.
Sometimes a child has simply picked up a habit of gagging, and the gagging has become a reflex response to certain unpleasant smells or other stimuli. This can happen in an otherwise healthy child who starts gagging because of a minor medical illness and then somehow learns to associate the gagging response with stimuli that normally don't cause gagging (such as kitchen odors). The habit can persist and feed on itself, even when the original cause of the gagging has gone away.
Some of the problems that can cause gagging need to be treated medically; in other cases, psychological or behavioral approaches will be most helpful. Often, it's best to use both medical and behavioral treatments.
If your child is gaining weight poorly, or showing signs of developmental or psychological difficulties in addition to the gagging, she needs a thorough assessment urgently. In any case, the sooner your daughter gets help, the better. — by Robert Needlman, M.D., F.A.A.P. |
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