[18F] Experiencing severe nausea, stabbing backache, and headache

Patient Description

An 18-year-old female presents with severe nausea rated 8/10 in intensity, which has persisted for weeks and is exacerbated after eating, leading to multiple episodes of vomiting. The patient also reports a stabbing backache behind the shoulder blade, rated 9/10 in severity, worsening at night, and ongoing for a couple of days without any history of injury. Additionally, she experiences migraine-like headaches with a severity of 7/10, accompanied by a foggy sensation, and sensitivity to light and sound, which have been occurring intermittently for 5 days. The patient also describes abdominal pain, predominantly in the middle of the stomach, with a severity of 8/10, and associated with constipation and occasional diarrhea. She reports chills but no numbness or vision changes. Changes in bowel habits include periods of over 24 hours without bowel movements.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastroenteritis: This condition is an inflammation of the gastrointestinal tract, typically from a viral or bacterial infection. Symptoms often include nausea, vomiting, diarrhea, and abdominal pain.

    • Treatment typically involves rest, hydration, and over-the-counter medications to alleviate symptoms.
  • Gastritis: This is inflammation of the stomach lining, which can cause nausea, vomiting, and abdominal pain. It can be caused by various factors, such as long-term use of NSAIDs, infection with Helicobacter pylori, or excessive alcohol consumption.

    • Treatment usually involves medications to reduce stomach acid and, if H. pylori is present, antibiotics.
  • Peptic Ulcer Disease: This condition is characterized by sores that develop on the lining of the stomach, upper small intestine or esophagus. The symptoms can include burning stomach pain, feeling of fullness, bloating or belching, intolerance to fatty foods, heartburn, and nausea.

    • Treatment usually involves medications to reduce stomach acid and, if H. pylori is present, antibiotics.
  • Gallstones: These are hard deposits in the gallbladder that can cause pain in the right upper abdomen, nausea, and vomiting.

    • Treatment can range from lifestyle changes to surgical removal of the gallbladder.
  • Migraines: These are a type of headache characterized by severe pain, often on one side of the head, and other symptoms such as nausea, vomiting, and sensitivity to light and sound.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks.

What you can do

  1. Seek medical attention: Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. Your doctor can provide a formal assessment and order relevant tests if necessary.

  2. Stay hydrated: Regardless of the cause, vomiting and diarrhea can lead to dehydration. Try to drink plenty of fluids, such as water, broth, or oral rehydration solutions.

  3. Rest: Rest can help your body recover from illness and can also help manage migraine symptoms.

  4. Over-the-counter medication: Over-the-counter medication can help manage symptoms of migraines and gastrointestinal upset. However, you should consult with a healthcare provider before starting any new medication.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • A high fever (over 100.4°F)
  • Signs of dehydration, such as dry mouth, feeling very thirsty, not urinating much, or feeling very dizzy when you stand up
  • Symptoms that persist or worsen over time

Remember, while this advice provides a starting point for understanding your symptoms, it's crucial to consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common causes of persistent nausea and vomiting?

Persistent nausea and vomiting can be caused by a variety of conditions, including gastroenteritis, gastritis, peptic ulcer disease, gallstones, and migraines. Other potential causes include pregnancy, food poisoning, and certain medications. It's important to consult a healthcare provider for a proper diagnosis.


How can I differentiate between a migraine and a regular headache?

Migraines are typically more severe than regular headaches and are often accompanied by additional symptoms such as nausea, vomiting, and sensitivity to light and sound. They may also cause a throbbing or pulsing sensation, usually on one side of the head. Regular headaches, such as tension headaches, are generally less intense and do not have these additional symptoms.


What are the symptoms of gallstones and how are they treated?

Gallstones can cause symptoms such as severe pain in the right upper abdomen, nausea, vomiting, and sometimes jaundice. Treatment options include lifestyle changes, medications to dissolve the stones, or surgical removal of the gallbladder, known as a cholecystectomy.


When should I seek medical attention for abdominal pain?

You should seek medical attention for abdominal pain if it is severe, persistent, or accompanied by other concerning symptoms such as blood in vomit or stool, high fever, signs of dehydration, or if the pain worsens over time. Immediate medical attention is crucial in these cases to rule out serious conditions.


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