Severe Vomiting, Back Pain, and Chest Discomfort: What to Do? - Gastroenterology and Hepatology

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I'm sorry to hear about your father's health issues. It sounds like he is experiencing a complex set of symptoms that require careful evaluation and management. Given the symptoms you've described—severe vomiting, back pain, and chest discomfort—there are several important considerations and steps you can take.

Firstly, it’s crucial to understand that the gastrointestinal system is closely linked to other bodily systems, and issues in the digestive tract can manifest as pain in various areas, including the back and chest. The fact that your father has a history of gastrointestinal problems and is currently experiencing these symptoms after a change in medication suggests that he may be experiencing side effects or complications related to the new treatment.

The vomiting and back pain could potentially be related to a few different issues:
1. Gastrointestinal Obstruction: The report of fecal impaction is significant. This can lead to severe abdominal pain, vomiting, and even back pain due to the pressure and irritation it causes in the abdomen. If the obstruction is severe, it can also lead to complications such as perforation or infection, which are medical emergencies.

2. Medication Side Effects: Changes in medication can sometimes lead to gastrointestinal upset, including nausea and vomiting. If your father has been prescribed new medications, it’s important to discuss these with his healthcare provider to determine if they could be contributing to his symptoms.

3. Kidney Stones: Given your mention of your father's tendency to develop stones, it’s worth considering that kidney stones can cause referred pain to the back and chest, especially if they are causing obstruction or irritation in the urinary tract. However, this would typically be accompanied by other symptoms such as hematuria (blood in urine) or severe flank pain.

4. Musculoskeletal Issues: The back pain could also be musculoskeletal in nature, possibly exacerbated by the vomiting or a change in posture due to discomfort.
Given these possibilities, I recommend the following steps:
- Consult a Gastroenterologist: Since your father has a history of gastrointestinal issues and is currently experiencing symptoms related to his digestive system, a gastroenterologist would be the most appropriate specialist to consult. They can evaluate the fecal impaction and determine if further intervention is necessary, such as manual disimpaction or other treatments.

- Consider a Urologist: If there is a concern about kidney stones, especially given your father's history, a urologist can evaluate this possibility. They may perform imaging studies, such as an ultrasound or CT scan, to assess for stones or other urinary tract issues.

- Monitor Symptoms: Keep a close eye on your father's symptoms. If he experiences worsening pain, fever, or any signs of dehydration (such as decreased urination, dry mouth, or dizziness), seek immediate medical attention.

- Medication Review: Ensure that your father’s healthcare provider reviews all his current medications, especially after the recent change. They may need to adjust dosages or switch to alternative medications that are less likely to cause gastrointestinal distress.

In summary, your father's symptoms warrant a thorough evaluation by a gastroenterologist, and possibly a urologist, to address both the gastrointestinal concerns and the potential for kidney stones. It's important to act promptly, especially given the severity of his symptoms. Thank you for reaching out, and I hope your father finds relief soon.