[20F] Experiencing severe migraine, bloody stool, and blurred vision

Patient Description

A 20-year-old female has been experiencing a severe migraine that started at 2:30 AM, waking her from sleep, and has persisted for 2 days. The pain is sharp, primarily located in the back, top, and right side of the head, and worsens when bending down. This is her first experience with migraines. Accompanying symptoms include blurred vision, described as slight out-of-focus visuals without prior occurrences, and flashes of light in the left eye, appearing as blinking black and white. Additionally, she reports bloody stool for the last couple of days, which is unusual in its frequency and volume compared to her past occasional experiences. She also mentioned a stiff neck. The patient is currently taking iron supplements and birth control pills. There are no known pre-existing conditions, head injuries, or recent trauma reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Migraine: Migraines are a type of headache characterized by severe, throbbing pain, usually on one side of the head. They can last for hours to days and can be so severe that they interfere with your daily activities. However, migraines are usually not associated with bloody stool or blurred vision.

    • Treatment for migraines usually involves pain relievers and other medications to manage symptoms.
  • Hemorrhoids: Hemorrhoids are swollen blood vessels in the rectum or anus that can cause blood in the stool. They can be caused by straining during bowel movements, obesity, or pregnancy.

    • Treatment for hemorrhoids can include over-the-counter creams or ointments, lifestyle changes, or in severe cases, surgery.
  • Gastrointestinal bleeding: This could be a cause of the bloody stool. This condition can be caused by a variety of factors, including hemorrhoids, anal fissures, diverticulosis, peptic ulcers, and more.

    • Treatment for gastrointestinal bleeding depends on the cause and may include medications, lifestyle changes, or in severe cases, surgery.
  • Retinal detachment: The flashing lights and blurred vision could be symptoms of a retinal detachment, which is a medical emergency. The retina is the light-sensitive layer of tissue at the back of the eye, and when it detaches, it's pulled from its normal position.

    • Treatment for retinal detachment usually involves surgery to reattach the retina.

What you can do

Given the severity of your symptoms and the potential seriousness of the conditions that could be causing them, it's important that you seek medical attention immediately. Please go to the emergency department right away.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Sudden, severe headache
  • Sudden loss of vision or vision changes
  • Sudden weakness or numbness on one side of your body
  • Difficulty speaking or understanding speech
  • Severe abdominal pain
  • Blood in your stool or black, tarry stools

Please remember that this advice is based on the information you've provided and is not a substitute for professional medical advice. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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7 mo ago


People Also Ask


What are the common symptoms of a migraine and how can they be managed?

Common symptoms of a migraine include severe, throbbing pain on one side of the head, sensitivity to light and sound, nausea, and sometimes visual disturbances like auras. Management typically involves pain relievers, anti-nausea medications, and preventive treatments for frequent migraines.


What could cause blood in the stool and how is it treated?

Blood in the stool can be caused by hemorrhoids, anal fissures, gastrointestinal bleeding, or more serious conditions like diverticulosis or peptic ulcers. Treatment depends on the cause and may include medications, lifestyle changes, or surgery.


What are the signs of retinal detachment and why is it considered a medical emergency?

Signs of retinal detachment include sudden flashes of light, blurred vision, and a shadow or curtain over part of the visual field. It is a medical emergency because if not treated promptly, it can lead to permanent vision loss. Treatment usually involves surgery to reattach the retina.


Can iron supplements or birth control pills cause any of these symptoms?

Iron supplements can cause gastrointestinal issues like constipation or dark stools, but they are not typically associated with bloody stools or migraines. Birth control pills can sometimes cause headaches, but they are unlikely to cause the other symptoms described. It's important to discuss these symptoms with a healthcare provider to determine their cause.

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