[18F] with multiple bleeding episodes and systemic symptoms

Patient Description

An 18-year-old female presents with multiple episodes of bleeding, including blood in stool, frequent bloody noses, and blood in the eye. She also reports a throbbing headache rated 7/10 in intensity, located in the forehead, and associated with dizziness following nosebleeds. The patient has been experiencing these headaches for several days, and they have not responded to any attempted interventions. Additionally, she mentions a sore throat and stomach ache. She has been feeling more tired than usual but denies any fever, weight loss, changes in vision, fainting, or recent bruising. The blood in the stool was bright red with streaks and incorporated within the stool, and this has occurred twice in one day. There have been no previous occurrences of blood in the stool, and this is the first instance of such a severe headache. No other systemic symptoms such as vision changes or fainting were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've reported, here are a few possibilities:

  • Nosebleeds and Gastrointestinal Bleeding: Frequent nosebleeds and blood in the stool could be due to a bleeding disorder, such as von Willebrand disease or a platelet function disorder. These conditions can cause spontaneous bleeding from the nose and gastrointestinal tract.

  • Infectious Gastroenteritis: This is an infection of the gut that can cause bloody diarrhea, abdominal pain, and sometimes symptoms outside the gut such as a headache.

  • Peptic Ulcer Disease: This condition causes sores in the lining of the stomach or the first part of the small intestine (the duodenum). It can cause abdominal pain and bloody stools.

  • Migraines: These are severe headaches that can cause throbbing pain, usually on one side of the head. They can also cause light-headedness and dizziness.

Please remember that this is not a comprehensive list and these conditions can present differently in different people. It's important to seek medical attention for a proper diagnosis.

What you can do

Given the severity and frequency of your symptoms, it's important to seek medical attention as soon as possible. In the meantime, try to stay hydrated, especially if you're losing a lot of blood.

What you should look out for

Seek immediate medical attention if you:

  • Notice a large amount of blood in your stool or if the bleeding doesn't stop
  • Experience severe abdominal pain
  • Have a severe headache or a headache that doesn't go away
  • Feel faint or lose consciousness

Remember, 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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9 mo ago


People Also Ask


What could cause frequent nosebleeds and blood in the stool?

Frequent nosebleeds and blood in the stool can be caused by a bleeding disorder such as von Willebrand disease or a platelet function disorder. These conditions affect the blood's ability to clot properly, leading to spontaneous bleeding in various parts of the body.


How can I differentiate between a migraine and other types of headaches?

Migraines are typically characterized by a throbbing or pulsing pain on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. Other types of headaches, like tension headaches, usually cause a dull, aching sensation all over the head without these additional symptoms.


What are the signs of a bleeding disorder like von Willebrand disease?

Signs of a bleeding disorder like von Willebrand disease include frequent nosebleeds, easy bruising, prolonged bleeding from cuts, heavy menstrual bleeding, and blood in the stool or urine. If you suspect a bleeding disorder, it's important to consult a healthcare provider for proper testing and diagnosis.


When should I seek medical attention for gastrointestinal bleeding?

You should seek medical attention for gastrointestinal bleeding if you notice a large amount of blood in your stool, if the bleeding doesn't stop, or if you experience severe abdominal pain. Additionally, if you feel faint or lose consciousness, it's crucial to get immediate medical help.


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