[20F] Experiencing syncope, nausea, and abdominal pain

Patient Description

A 20-year-old female has been experiencing episodes of syncope for about 6 years, with varying frequency from multiple times a week to months with little to no symptoms. Syncope episodes are sometimes instantaneous, while other times preceded by blurry vision, dizziness, and fatigue. Triggers are not always present but include rising from bed, bright lights, or sudden sounds. Lying down with elevated feet and hydration seems to help, as well as wearing compression socks. Nausea has been a problem for 5 years, worsening over time, and is now accompanied by morning sickness, loss of appetite, fatigue, and significant weight loss (40 pounds in a year). The severity of nausea varies from mild to severe. Lightheadedness is also severe, sometimes leading to loss of consciousness. The patient has a long-standing issue with constipation and currently experiences sharp abdominal pain below the belly button or on the left side, with a severity ranging from moderate to high. No fever is reported, but the patient experiences chills.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be considered:

  • Orthostatic Hypotension: This condition is characterized by a sudden drop in blood pressure when you stand up from a sitting or lying position, leading to dizziness and fainting. Your mention of symptoms being worse when getting out of bed could be indicative of this.

    • Treatment typically involves lifestyle changes such as standing up slowly, staying hydrated, and wearing compression stockings.
  • Gastrointestinal Disorders: Conditions such as Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) could explain your abdominal pain, constipation, and nausea. These conditions can also cause weight loss and malnutrition, which could contribute to your fainting episodes.

    • Treatment typically involves dietary changes, stress management, and sometimes medication.
  • Gastritis or Peptic Ulcer Disease: These conditions can cause abdominal pain and nausea, especially in relation to eating. They can also cause weight loss if the pain leads to reduced food intake.

    • Treatment typically involves medication to reduce stomach acid and possibly antibiotics if an infection is present.
  • Anemia or Malnutrition: These conditions could result from your reported weight loss and could contribute to your fainting episodes.

    • Treatment typically involves dietary changes and possibly supplements or medication.

Please note that these are potential explanations based on the information provided, but they are not definitive diagnoses. It's important to consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Make an appointment with a healthcare provider as soon as possible. They can perform a physical examination and order tests as needed to determine the cause of your symptoms.

  2. Keep a symptom diary. Note when your symptoms occur, what you're doing when they happen, and anything that makes them better or worse. This can help your healthcare provider in diagnosing your condition.

  3. Stay hydrated and try to maintain a balanced diet. This can help manage your symptoms and prevent malnutrition.

  4. Stand up slowly from a sitting or lying position. This can help prevent fainting episodes if you have orthostatic hypotension.

  5. Try to maintain a regular sleep schedule. This can help manage your symptoms and improve your overall health.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool or vomit
  • Severe or worsening fainting episodes
  • Rapid, unexplained weight loss
  • Fever or severe chills

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

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11 mo ago

Top picked over-the-counter products for Orthostatic Hypotension: American Heart Association Guidelines

People Also Ask


What are common causes of syncope in young adults?

Common causes of syncope in young adults include dehydration, orthostatic hypotension, vasovagal syncope, and heart-related issues. It's important to identify triggers and consult a healthcare provider for a proper diagnosis.


How can orthostatic hypotension be managed at home?

Orthostatic hypotension can be managed at home by staying well-hydrated, standing up slowly, wearing compression stockings, and increasing salt intake if advised by a doctor. It's also helpful to avoid prolonged standing and to elevate the head of the bed.


What dietary changes can help with gastrointestinal disorders like IBS or IBD?

Dietary changes for managing IBS or IBD include increasing fiber intake, avoiding trigger foods (such as dairy or gluten), eating smaller, more frequent meals, and staying hydrated. Consulting with a dietitian can provide personalized advice.


What are the signs of anemia or malnutrition that I should be aware of?

Signs of anemia or malnutrition include fatigue, pale skin, shortness of breath, dizziness, and unexplained weight loss. If you experience these symptoms, it's important to seek medical advice for proper evaluation and treatment.


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