[19F] Experiencing chest burn, headaches, and abdominal discomfort

Patient Description

A 19-year-old female reports a 5-6 month history of severe chest burn, rated 8/10, that worsens with food intake and prolonged sitting, and is accompanied by frequent regurgitation and a sensation of heaviness. The chest burn is described as a hot feeling that rises from the stomach to the throat, particularly worse in the evening. She also experiences a sore, aching headache on the right side, extending from the middle of the head down to the ear and neck, rated 5/10 in intensity. Additionally, she has been feeling an overall sensation of overheating for the same duration. The patient has a history of an appendectomy and exposure to toxic mold 6 months prior, which caused heart palpitations, fevers, chills, and lethargy. No current medications or known drug allergies. She also reports occasional shortness of breath and frequent pain radiating to her arms and jaw.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This condition happens when 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 chest burn, stomach burn, and a feeling of heaviness in the chest. The fact that your symptoms are worse after eating and when lying down also points to GERD.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be necessary.
  • Migraines: These are a type of headache characterized by intense pain and a pulsating sensation, usually on one side of the head. Migraines are often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Your description of a headache on the right side of your head that extends down to your neck could be indicative of a migraine.

    • Treatment usually involves pain-relieving medications and preventive medications.
  • Ear Infections: These occur when a bacterial or viral infection affects the middle ear — the sections of your ear just behind the eardrum. Ear infections can cause pain, discomfort, and a feeling of fullness in the ear.

    • Treatment typically involves managing pain and monitoring the problem. Antibiotics might be necessary if there is an ongoing infection.

Please remember that while these conditions could explain your symptoms, it's also possible that something else is causing them. You should consult a healthcare provider for a formal diagnosis.

What you can do

Here are some steps you can take to manage your symptoms:

  1. For GERD, try lifestyle changes such as eating smaller meals, avoiding food and drinks that trigger heartburn (such as spicy or fatty foods), and not lying down or going to bed for at least a couple of hours after eating. Over-the-counter antacids may also help.

  2. For migraines, over-the-counter pain relievers may help. Resting or sleeping in a dark, quiet room can also be beneficial.

  3. For ear infections, over-the-counter pain relievers can help manage the pain. Applying a warm cloth to the affected ear may also provide some relief.

What you should look out for

You should seek immediate medical attention if:

  • Your chest pain becomes severe or is accompanied by pain spreading to your arm, jaw, or back, nausea, sweating, or shortness of breath. These could be signs of a heart attack.
  • Your headache is severe and sudden, or it's accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking. These could be signs of a serious condition, such as a stroke or meningitis.
  • Your ear pain is severe or is accompanied by a high fever, headache, or neck stiffness, or if you notice fluid (pus or blood) leaking from your ear. These could be signs of a serious ear infection.

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, diagnosis, and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, chest pain, and a sensation of a lump in the throat. Symptoms often worsen after eating or when lying down.


How can migraines be effectively managed or treated?

Migraines can be managed with over-the-counter pain relievers, prescription medications, and lifestyle changes such as maintaining a regular sleep schedule, avoiding known triggers, and managing stress. In some cases, preventive medications may be prescribed.


What are the signs that an ear infection might require medical attention?

Signs that an ear infection might require medical attention include severe pain, high fever, headache, neck stiffness, or fluid discharge from the ear. If these symptoms occur, it's important to see a healthcare provider.


What lifestyle changes can help alleviate symptoms of GERD?

Lifestyle changes that can help alleviate symptoms of GERD include eating smaller meals, avoiding foods and drinks that trigger heartburn (such as spicy or fatty foods), not lying down immediately after eating, and elevating the head of the bed. Over-the-counter antacids may also provide relief.


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