[20F] Experiencing gastrointestinal symptoms and sleep disturbances

Patient Description

A 20-year-old female has been experiencing nausea, diarrhea, vomiting, restlessness, and insomnia for approximately 2 weeks. The patient reports vomiting that occurs after burping, approximately twice a week, with an orange-yellow, chunky appearance and a sour, bitter taste. Diarrhea has been occurring daily, every two to three hours, and has transitioned from solid to watery or liquid over the past 4 days. The patient has also noticed blood in the stool. Sleep disturbances include difficulty falling and staying asleep, with periods of being awake for 12 to 24 hours followed by long sleep durations of 6 to 14 hours. Additional symptoms include abdominal pain, fatigue, dry mouth, muscle aches, headaches, and joint pain. The patient has a medical history of fibromyalgia, chronic fatigue, headaches, and hepatitis A, diagnosed approximately 4 years ago. Currently, the patient is taking 75mg of Zoloft for anxiety, which was started 3 weeks ago. There is a reported history of adverse reactions to various medications, but specifics are not provided. The patient denies any recent travel, use of recreational drugs, alcohol, or unprescribed medications, and is unsure about a family history of gastrointestinal or autoimmune diseases.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Gastroenteritis: This is an inflammation of the stomach and intestines that can cause symptoms such as diarrhea, vomiting, and abdominal pain. It's usually caused by a viral or bacterial infection. Dehydration is a common complication.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. If symptoms persist or worsen, a doctor may prescribe medication.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms such as cramping, abdominal pain, bloating, gas, diarrhea, and constipation.

    • Treatment typically involves long-term management of diet, lifestyle changes, and stress. In some cases, medication or counseling might be recommended.
  • Anxiety: Chronic anxiety can cause physical symptoms such as restlessness, insomnia, and gastrointestinal problems. Since you're taking Zoloft for anxiety, it's possible that your symptoms could be related.

    • Treatment usually involves a combination of psychotherapy (talk therapy), behavioral therapy, and medication.
  • Side effects from Zoloft: Zoloft can cause side effects such as nausea, diarrhea, and sleep problems in some people.

    • If you think your medication might be causing your symptoms, it's important to talk to your doctor. Don't stop taking your medication without consulting your doctor first.

Please remember that these are possible explanations and not a definitive diagnosis. It's important to consult with a healthcare professional for an accurate diagnosis and treatment.

What you can do

  1. Stay hydrated: Drink plenty of fluids to replace those lost through diarrhea and vomiting. Water, broth, or oral rehydration solutions are good choices.
  2. Rest: Your body needs energy to fight off the virus or manage symptoms. Getting enough sleep can help.
  3. Eat small, light meals: If you can keep food down, stick to bland foods like rice, bananas, and toast.
  4. Monitor your symptoms: Keep track of any changes in your symptoms. If they get worse, seek medical attention immediately.

What you should look out for

Seek immediate medical help if you:

  • See blood in your vomit
  • Have severe abdominal or rectal pain
  • Have symptoms of severe dehydration, such as extreme thirst, very dry mouth, skin, and mucous membranes, little or no urination, severe weakness, dizziness, or lightheadedness
  • Have a fever over 102°F (38.9°C)
  • Can't keep down food for more than 2 days
  • Are vomiting for more than two days or vomiting blood

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

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What are the common causes of nausea, diarrhea, and vomiting?

Common causes of nausea, diarrhea, and vomiting include viral or bacterial infections (such as gastroenteritis), food poisoning, stress, anxiety, and side effects from medications. It's important to identify the underlying cause to determine the appropriate treatment.


Can Zoloft cause gastrointestinal issues like nausea and diarrhea?

Yes, Zoloft (sertraline) can cause gastrointestinal side effects in some people, including nausea, diarrhea, and upset stomach. If you suspect your medication is causing these symptoms, consult your doctor before making any changes to your medication regimen.


What are the symptoms of gastroenteritis and how is it treated?

Gastroenteritis is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms include diarrhea, vomiting, abdominal pain, and sometimes fever. Treatment typically involves rest, hydration, and over-the-counter medications to manage symptoms. Severe cases may require medical attention.


How can anxiety affect sleep and gastrointestinal health?

Anxiety can lead to physical symptoms such as restlessness, insomnia, and gastrointestinal issues like nausea and diarrhea. Stress and anxiety can disrupt sleep patterns, leading to difficulty falling or staying asleep. Managing anxiety through therapy, lifestyle changes, and medication can help alleviate these symptoms.


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