My doctor has been treating me over a long time for many small ulcers. These were confirmed on X-rays a year ago, which showed some old ones and some new. Lately, I have been throwing up after eating dinner. The food never seems to digest. Twenty minutes after I eat something it feels as if it is all in my throat. Once I throw up, the pain is gone. I can eat very small amounts during the day, and by dinner I am starved, but then even small amounts cause this problem. Meat especially causes me a lot of burning and a rolling feeling in my stomach. I am not actually nauseous, and I do not feel sick other than this. I have read this could be caused by old ulcer scars blocking digestion. Could this be the case? Would X-rays or other tests show for sure? What methods are used to help this?

M.P.

The symptoms you are describing suggest that you may have a gastric outlet obstruction or marked delay in emptying of your stomach. It's possible that you simply have recurrent ulcers creating intermittent severe inflammation, which in turn may cause a transient obstruction.

Stomach or duodenal ulcers, also called peptic ulcers, are most often associated with the bacterium Helicobacter pylori, which causes inflammation in the stomach (gastritis). You should have been tested for this and treated with medications if you have it. For most people, once the organism is eradicated, the ulcers are cured. If you do not have H. pylori and you are taking a nonsteroidal antiinflammatory drug (such as aspirin or ibuprofen), this could be causing a recurrent ulcer. Smoking may also predispose to ulcer recurrence, especially if H. pylori is not eradicated. Rarely, recurrent ulcers may be the result of a condition called Zollinger-Ellison syndrome, in which a tumor causes the production of large amounts of stomach acid.

The best test to find the source of your problem is probably an endoscopy, which enables the doctor to examine the inside of your stomach and duodenum with a fiberoptic scope. An upper GI series of X-rays might help, but it would not be as accurate. Please ask your doctor to refer you to a gastroenterologist for a thorough exam.