[18F] With sharp, cramping abdominal pain, nausea, and headaches

Patient Description

An 18-year-old female presents with sharp, cramping pain under the ribs, primarily on the center and left side, persisting for three days. The pain is rated at 8/10 in severity and is somewhat alleviated by laying in the fetal position. The patient also reports nausea and an inability to eat large meals, along with headaches severe enough to impede work. The headaches are not new to the patient. There is no recent history of injuries, physical activities, or dietary changes that could have triggered the pain. The patient has been experiencing significant stress due to college. Medications include a stool softener, Miralax, Wellbutrin, and Prozac, with no recent changes in dosage. There is no recent travel history or family history of gastrointestinal issues reported. No known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—sharp, cramping pain under the ribs on the center and left side, nausea, and headaches—here are some possible explanations:

  1. Gastritis or Peptic Ulcer Disease: This condition involves inflammation of the stomach lining, which can cause sharp pain and nausea. Stress and certain medications can exacerbate these symptoms. Treatment typically involves medications to reduce stomach acid and lifestyle changes.

  2. Gastroesophageal Reflux Disease (GERD): This occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). It can cause pain in the upper abdomen and nausea. Treatment often includes dietary changes and medications to reduce acid production.

  3. Pancreatitis: Inflammation of the pancreas can cause sharp abdominal pain that radiates to the back, along with nausea. This condition requires medical evaluation and treatment, which may include hospitalization.

  4. Migraine or Tension Headaches: Given your history of headaches, these could be contributing to your nausea and sensitivity to light. Treatment may involve medications to relieve headache symptoms and lifestyle modifications to reduce triggers.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take to manage your symptoms:

  1. Dietary Adjustments: Try eating smaller, more frequent meals and avoid foods that are spicy, acidic, or high in fat, as they can exacerbate stomach issues.

  2. Hydration: Ensure you stay hydrated, especially if you're experiencing nausea. Sipping on clear fluids like water or herbal tea can be soothing.

  3. Stress Management: Since stress can worsen gastrointestinal symptoms, consider stress-reduction techniques such as deep breathing exercises, meditation, or gentle yoga.

  4. Symptom Tracking: Use the MDandMe app to journal your symptoms, track any patterns, and share this information with your healthcare provider. This can help in identifying triggers and assessing the effectiveness of any interventions.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Vomiting that prevents you from keeping down fluids
  • Blood in your stool or vomit
  • Unexplained weight loss
  • Fever or chills

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare professional for a comprehensive evaluation and appropriate treatment.

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26 d ago


People Also Ask


What are the common causes of sharp, cramping pain under the ribs?

Sharp, cramping pain under the ribs can be caused by conditions such as gastritis, peptic ulcer disease, gastroesophageal reflux disease (GERD), or pancreatitis. It's important to consult a healthcare provider for an accurate diagnosis.


How can stress affect gastrointestinal health?

Stress can exacerbate gastrointestinal issues by increasing stomach acid production and affecting gut motility, potentially leading to conditions like gastritis or GERD. Managing stress through relaxation techniques can help alleviate these symptoms.


What lifestyle changes can help manage symptoms of gastritis or GERD?

Lifestyle changes to manage gastritis or GERD include eating smaller, more frequent meals, avoiding spicy, acidic, or fatty foods, staying hydrated, and reducing stress. Medications to reduce stomach acid may also be recommended by a healthcare provider.


When should someone seek medical attention for abdominal pain?

Medical attention should be sought for abdominal pain if it is severe or worsening, accompanied by vomiting that prevents fluid intake, blood in stool or vomit, unexplained weight loss, or if there is a fever or chills.

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