Please, Dr. Gott, any suggestions you have would be greatly appreciated. My husband and I are desperate to help our daughter get over this. Thank you!

DEAR READER: You certainly appear to have covered many of the bases but still have not hit a home run in resolving the problem. I do not believe the stress and anxiety your daughter undergoes is related to an underlying medical condition, nor do I feel she does it for attention, but I don’t know her. Speak with her physician to be assured of her medical well-being. Vomiting can be the result of fear or emotional stress but can also represent a viral infection, milk allergy, a blocked intestine, tumor, gastritis and the reaction to specific smells or odors. These potential conditions are relatively easy to rule out with the assistance of laboratory work and X-rays. Again, because she doesn’t complain of pain, fever, diarrhea, headache and other common symptoms, my guess is that her testing will be normal. However, her pediatrician would be remiss if he or she did not consider the big picture. If her tests fail to reveal anything and she is an otherwise normal, physically healthy child, request a referral to a child therapist with whom she feels comfortable and can see regularly.

While you might give the therapist a heads-up, she should be allowed to speak freely without a parent sitting nearby coaching her. Then back off as much as possible when an 8-year-old is involved. Allow your daughter to establish a relationship with the therapist, one she feels will help her now and in the future when other issues could come to light. Everything may be stress related, but it may be difficult to understand why she only reaches her limit when in a restaurant. This should be investigated and dealt with.

You have indicated that you are on edge when dining out, expecting a repeat of her normal pattern. Whether you express it outwardly or not, I am sure she is perceptive enough to sense how you feel. And she picks up on that, no matter how well you think you are concealing your feelings.

A step you may or may not have considered is to stay away from restaurants. From my perspective, it doesn’t appear worth putting your daughter through the trauma of public embarrassment. If there are compelling reasons for eating out, perhaps you can pick a corner table away from the hub of activity. Consider allowing her to bring a friend along so they can talk and giggle to reduce the tension level. Select a “restaurant” that has outdoor tables, and weather permitting, eat out of doors. Allow her and her friend to bring a hand-held game board to divert her attention away from her surroundings.

Rule out potential medical conditions, assure her that she can speak frankly with a professional therapist and see what transpires.

To provide related information, I am sending you a copy of my Health Report “Eating Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: General anesthesia takes a person from a conscious to an unconscious state so an invasive surgical procedure can be performed. Anesthesiologists, nurse anesthetists and other trained professionals determine the amount of anesthesia to be administered, depending on the procedure to be performed. Some people remain anesthetized for a short time during a relatively simple process and are released the same day. Others, such as yours, take substantially longer and require hospitalization for several days following. While you didn’t mention what surgery was performed, four hours is extensive and could certainly be responsible for the unwanted results.

Some people are fortunate enough not to have any side effects at all. Others can be rather debilitated by them. Side effects commonly appear within a few hours and disappear while a person is still in the recovery room. They can include dehydration, nausea, headache, joint or muscle pain, or a person may feel as if he or she had too much to drink the night before. Unusual but entirely possible side effects can include nightmares, uncontrollable shaking and chills.

Be sure to check with your surgeon if you experience jaundice, weight loss, blood in your stool or have symptoms lasting two weeks or longer. He or she will want to be assured your postoperative recovery is progressing well. Otherwise, the symptoms should resolve on their own.

To provide related information, I am sending you a copy of my Health Report “Digestive Gas.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Can you give me any insight into this phenomenon?

DEAR READER: Your experience appears to be common among individuals who have had gallbladder removal surgery. In fact is it so common it has been titled postcholecystectomy syndrome. It occurs in 5-40% of all patients following gallbladder removal.

Symptoms may include persistent upper right abdomen pain, gas, bloating, nausea, upset stomach, vomiting and diarrhea. Diarrhea from this disorder can be eased by taking the medication cholestyramine.

Pain that persists should be followed up with your gastroenterologist to ensure that another condition, such as Irritable Bowel Syndrome, pancreatitis, peptic ulcers, or sludge in the bile duct are not to blame.

To give you related information, I am sending you a copy of my Health Report “Gallbladder Disease”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.