[18F] Experiencing chronic stomach pain, headaches, and recent chest pressure

Patient Description

An 18-year-old female presents with a two-year history of chronic stomach pain, rated 5-7/10 in severity, located near the belly button and associated with nausea and reduced morning appetite. The patient also reports episodic headaches that migrate across different areas of the head and can last up to two weeks. Recently, she has experienced chest pressure described as a non-painful sensation of something sitting on the chest, which is unaffected by changes in position or breathing. The patient has increased thirst leading to frequent urination, a history of fainting due to dehydration approximately a year ago, and uses over-the-counter allergy medication and a daily probiotic (BioGaia). Additionally, she reports soft stools with color changes and flatulence with an unusual egg smell, without a confirmed gastrointestinal diagnosis. There is a family history of celiac disease. The patient has a past diagnosis of anxiety and depression but is not on any related medication. No known drug allergies.

Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.
Gastroenteritis: This condition causes inflammation in the stomach and intestines, which can lead to symptoms like abdominal pain and diarrhea. It's usually caused by a viral or bacterial infection.
Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest pain.
Celiac Disease: Given your family history of celiac disease, this could be a possibility. Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley, and rye. Over time, this reaction damages your small intestine's lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.

What you can do

Keep a symptom diary: Note down what you eat and drink, the types of physical activities you engage in, and how you feel afterwards. This can help identify triggers or patterns to your symptoms.
Stay hydrated: Drink plenty of fluids to avoid dehydration, especially if you're experiencing diarrhea.
Eat smaller, more frequent meals: This can help manage your symptoms.
Try dietary changes: Limit foods that seem to worsen your symptoms. If you haven't already, you might try a gluten-free diet given your family history of celiac disease.
Exercise regularly: Regular physical activity can help reduce anxiety and improve bowel movements.
Seek medical attention: It's important to consult with a healthcare provider for a proper diagnosis and treatment plan. They may recommend certain tests or procedures based on your symptoms and family history.

What you should look out for

Seek immediate medical attention if you experience:

Severe abdominal pain
Blood in your stool
Unexplained weight loss
Chest pain that spreads to your jaw, left arm, or back
Shortness of breath
A severe headache unlike any you've had before

Please remember that this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines