The patient is a 16-year-old high school student who is examined "without gastrointestinal problems. Vomiting occurs due to nausea. This has been going on since about 3 and a half years." This story is complex and complicated. When the patient turned about 12 years old she began to have nausea and vomiting, which began about 4 days before her menstrual period. Her periods were regular until about 6 months ago. Due to premenstrual vomiting she took Tigan, Elixir and Donnatal. This was tried for about 3 months and didn't help. She was then tried on low doses of birth control pills on a regular basis. This also didn't help much and so she switched to Torecan and Pepcid. Apparently over the last 6 months her menstrual cycle has become more irregular. Additionally, he had vomiting almost every day. He says he vomits "phlegm" and sometimes vomits yellow bile that tastes bitter. She says she always feels full and doesn't want to eat. He hasn't lost weight. He also vomits if he eats spicy food. This also causes a heartburn with which s...