[18M] Experiencing nausea and abdominal pain with diarrhea

Patient Description

An 18-year-old male has been waking up with nausea and the urge to vomit for the past three days. The nausea persists before and after meals and is rated as moderate in severity. Burping provides slight but insufficient relief. Accompanying the nausea is an upper stomach pain described as a squeezing sensation, which subsides as the day progresses but reoccurs each morning. The abdominal pain is rated as mild to moderate in severity. Additionally, the patient reports having diarrhea that is soft and mud-like in consistency, occurring once in the morning with the possibility of recurring throughout the day. No specific food triggers have been identified, and there is no recent history of foreign travel. The patient denies the presence of blood in stool or vomit, severe abdominal pain, persistent vomiting, signs of dehydration, recent weight loss, or changes in appetite. There is no use of recreational drugs, alcohol, or tobacco, and no known family history of gastrointestinal diseases, although the patient mentions a genetic stomach problem in his father. The patient is not on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the U.S. The symptoms are often a low-grade fever, nausea, vomiting, and diarrhea.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be prescribed if a bacterial cause is identified.
  • Gastritis: This is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic). It's often caused by the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers or drinking too much alcohol can also contribute to gastritis.

    • Treatment typically involves taking antacids and other drugs to reduce stomach acid, which helps relieve gastritis symptoms and promotes healing.
  • Peptic Ulcer Disease: This is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum). Symptoms can include burning stomach pain, feeling of fullness, bloating or belching, intolerance to fatty foods, heartburn, and nausea.

    • Treatment typically involves medications to decrease stomach acid. If a bacteria called H. pylori is causing your peptic ulcers, you'll need to take antibiotics.
  • Gallstones: These are hardened deposits in the gallbladder that can cause abdominal pain and nausea. Gallstones are more common in women, but can occur at any age and in either sex.

    • Treatment can involve a change in diet or removal of the gallbladder, depending on the severity of the condition.
  • 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, dry cough, and the feeling of a lump in your throat.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Stronger medications and surgery are options if other treatments don't help.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to alleviate your symptoms:

  1. Stay hydrated: Drink plenty of fluids like water, broth or an over-the-counter, oral rehydration solution.
  2. Rest: Your body needs energy to fight off the virus. Getting enough sleep can help.
  3. Eat light: Try to eat when you feel up to it, but opt for light foods that are easy on your stomach like rice, crackers or bananas.
  4. Avoid certain foods: Dairy, caffeine, alcohol, nicotine, and fatty or highly seasoned foods can make your symptoms worse.
  5. Over-the-counter medication: There are over-the-counter medications that can help with symptoms of nausea and abdominal discomfort.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms persist for more than a few days
  • If you notice blood in your stool or vomit
  • If you develop a fever (temperature over 100.4°F)
  • If you have severe abdominal pain
  • If you become dehydrated — signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common causes of morning nausea and stomach pain?

Common causes of morning nausea and stomach pain include gastroenteritis, gastritis, peptic ulcer disease, and GERD. These conditions can cause inflammation or irritation in the stomach lining, leading to discomfort and nausea, especially in the morning.


How can I differentiate between gastroenteritis and gastritis?

Gastroenteritis is typically caused by an infection and presents with symptoms like nausea, vomiting, diarrhea, and sometimes fever. Gastritis, on the other hand, is inflammation of the stomach lining and may cause nausea, vomiting, and upper stomach pain without diarrhea. A healthcare provider can help differentiate between the two through medical history and tests.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD symptoms include avoiding foods and drinks that trigger reflux (such as fatty foods, caffeine, and alcohol), eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed.


When should I seek medical attention for persistent nausea and diarrhea?

You should seek medical attention if your symptoms persist for more than a few days, if you notice blood in your stool or vomit, if you develop a fever, if you experience severe abdominal pain, or if you show signs of dehydration such as excessive thirst, dry mouth, or dizziness.


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