[18F] Experiencing severe nausea, vomiting, and fatigue

Patient Description

An 18-year-old female has been experiencing severe nausea and vomiting, which occur soon after eating and even after consuming water, for several months. These symptoms have significantly impacted her ability to eat, leading to a loss of appetite, rapid weight loss, and constant bloating. Additionally, she reports extreme fatigue, requiring multiple naps a day and difficulty sleeping at night despite taking Benadryl. Headaches described as throbbing with an intensity of 4 out of 10 and a sore throat that worsens at night have also been reported. The patient has been diagnosed with PCOS and gluten sensitivity as of May 2023. Current medications include Modafinil, Lamotrigine, Prozac, and Zofran, prescribed for bipolar disorder, depression, and nausea and fatigue, respectively. Despite these treatments, her symptoms of nausea and fatigue have not improved. No allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible conditions:

  • Gastroparesis: This is a condition where the stomach takes too long to empty its contents. It's often caused by damage to the nerves controlling the stomach muscles. Symptoms can include nausea, vomiting, feeling full quickly when eating, bloating, and weight loss. Gastroparesis is often found in people with diabetes, but it can also be associated with other conditions.

    • Treatment usually involves dietary changes and medications to help the stomach empty more quickly. In some cases, more invasive treatments may be necessary.
  • 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, causing symptoms like heartburn, chest pain, difficulty swallowing, regurgitation of food or sour liquid, sensation of a lump in your throat, and disrupted sleep.

    • Treatment typically starts with over-the-counter medications that control acid. If you don't experience relief within a few weeks, your doctor might recommend prescription medication or surgery.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. Other symptoms can include loss of memory or concentration, sore throat, enlarged lymph nodes in your neck or armpits, unexplained muscle or joint pain, headaches, and unrefreshing sleep.

    • There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for chronic fatigue syndrome focuses on symptom relief.
  • Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs. Other symptoms can include weight gain, fatigue, unwanted hair growth, infertility, and acne or oily skin.

    • Treatment focuses on managing individual symptoms, such as infertility, hirsutism, acne or obesity.

Please note that these are only possibilities and not a definitive diagnosis. You should seek care from a healthcare professional to receive a formal diagnosis and treatment.

What you can do

  1. Try to keep a food diary to track what you eat and how it affects your symptoms. This could help identify any food triggers.
  2. Stay hydrated and eat small, frequent meals instead of three large meals a day.
  3. Try to maintain a regular sleep schedule and practice good sleep hygiene.
  4. Regular physical activity can help manage symptoms of fatigue and improve sleep.
  5. Seek support from friends, family, or a professional counselor or support group.

What you should look out for

You should seek immediate medical attention if:

  • Your symptoms worsen or you develop new symptoms
  • You have severe abdominal pain
  • You are unable to keep down liquids or medications
  • You have blood in your vomit or stool
  • You have a fever over 100.4°F (38°C)

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional for an accurate diagnosis.

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8 mo ago


People Also Ask


What is gastroparesis and how is it treated?

Gastroparesis is a condition where the stomach takes too long to empty its contents, often due to nerve damage. Symptoms include nausea, vomiting, bloating, and weight loss. Treatment typically involves dietary changes, medications to help the stomach empty more quickly, and in some cases, more invasive treatments.


How can gluten sensitivity affect my symptoms and what dietary changes should I consider?

Gluten sensitivity can cause symptoms like bloating, nausea, and fatigue. To manage these symptoms, it's important to follow a gluten-free diet, avoiding foods that contain wheat, barley, and rye. Consulting with a dietitian can help in planning a balanced gluten-free diet.


What are the common symptoms of Chronic Fatigue Syndrome (CFS) and how is it managed?

Chronic Fatigue Syndrome (CFS) is characterized by extreme fatigue that doesn't improve with rest and worsens with activity. Other symptoms include sore throat, headaches, and unrefreshing sleep. Management focuses on symptom relief, including lifestyle changes, cognitive behavioral therapy, and medications to manage specific symptoms.


How does PCOS contribute to fatigue and what are the treatment options?

PCOS can contribute to fatigue due to hormonal imbalances and associated symptoms like weight gain and sleep disturbances. Treatment options include lifestyle changes, medications to regulate menstrual cycles and manage symptoms like acne and hair growth, and in some cases, fertility treatments.

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