Conversation: The conversation between human and AI assistant.
[|Human|] My husband has had two recent episodes of rather violent vomiting preceded by some coughing. He says the coughing relievespressure in his stomach whichhurts. He did visit his doctor after the first episode and nothing was found but a mri was recommended which has yet to be done. Any ideas? He is 71 and in generally good health but with a history of ulcers and has had stomach surgery for them with the pyloric valve removed. This happened 30 yrs ago.
[|AI|]  Hi. Thanks for your query. Considering the age of the patient of 71 and the history of vomiting and coughing which relieves the pain, I would think about Hiatus Hernia as the first cause. Get upper GI Endoscopy done before any other investigation. Additional X-ray of the chest in supine (lying down) position, barium studies for the esophagus, stomach and duodenum (history of gastric surgery notes). Coughing looks to be due to reflex due to pressure felt in the chest due to hernia. Both coughing and vomiting relieve the pressure means there is fullness which develops over time.