[21F] Experiencing a range of symptoms including cramps and headaches

Patient Description

A 21-year-old female presents with a variety of symptoms that have been occurring over the past few weeks. She reports cramping in the lower stomach that is severe, with pain every 20 minutes, and distinct from her menstrual cramps. Additionally, she experiences sharp back pain that worsens with sitting up and requires a pillow for support. She has had headaches for a year, which have recently worsened to a throbbing, aching, and sharp pain on the sides of her head. Dizziness with blurry vision and a sensation of being close to passing out has been present for two weeks. She also reports moderate fever, knee pain with a severity of 9 out of 10, and swelling in her feet, particularly after a vein popped out on the top of her left foot. She has been vomiting and unable to keep food down. She has a history of depression, anxiety, and a gastric sleeve procedure performed last year. She is currently on Wellbutrin 200 mg twice daily, Vitamin D 1.25 mg weekly, and Omeprazole 10 mg as needed. She is sexually active, on birth control, and unsure if she is pregnant, with her last period occurring three weeks ago, which was atypical in duration and color.

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Arora's Assessment

What might be happening

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

  • Pregnancy: Given your age, sex, and symptoms, one possibility is that you could be pregnant. Symptoms such as nausea, vomiting, fatigue, and lower abdominal cramping can occur in early pregnancy. Some women also experience changes in their menstrual cycle, such as a lighter or shorter period. The only way to confirm this is with a pregnancy test.

  • Gastroenteritis: This is an inflammation of the stomach and intestines, usually due to a viral or bacterial infection. It can cause nausea, vomiting, abdominal cramping, and diarrhea. It can also cause a low-grade fever and general malaise or fatigue.

  • Anxiety or Stress: Anxiety or stress can cause a wide range of physical symptoms, including headaches, dizziness, and gastrointestinal symptoms like nausea and vomiting. It can also cause muscle tension, which could contribute to your back and knee pain.

  • Anemia: This is a condition in which your blood doesn't have enough healthy red blood cells to carry adequate oxygen to your tissues. It can cause fatigue, dizziness, and headaches. It can also cause paleness and shortness of breath.

What you can do

  1. Take a home pregnancy test: If there's a chance you could be pregnant, taking a home pregnancy test could help clarify the situation. These tests are generally accurate and available over-the-counter at most pharmacies.

  2. Rest and hydrate: If you have gastroenteritis, rest and hydration are the mainstays of treatment. Try to drink plenty of fluids, even if you can only manage small sips at a time.

  3. Seek medical attention: Given the range and severity of your symptoms, it would be a good idea to see a healthcare provider. They can perform a physical examination, ask more detailed questions about your symptoms, and order any necessary tests.

What you should look out for

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

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Fainting or loss of consciousness
  • Shortness of breath or difficulty breathing
  • A fever over 100.4°F (38°C)

Please 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, testing, and care.

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10 mo ago

People Also Ask


What are the common symptoms of early pregnancy?

Common symptoms of early pregnancy include nausea, vomiting, fatigue, breast tenderness, frequent urination, and changes in the menstrual cycle, such as a lighter or shorter period.


How can anxiety or stress manifest physically?

Anxiety or stress can cause a variety of physical symptoms, including headaches, dizziness, nausea, vomiting, muscle tension, and gastrointestinal issues. It can also lead to increased heart rate and sweating.


What are the signs and symptoms of anemia?

Signs and symptoms of anemia include fatigue, dizziness, headaches, paleness, shortness of breath, and sometimes cold hands and feet. Severe anemia can cause chest pain and fainting.


What should I do if I suspect I have gastroenteritis?

If you suspect you have gastroenteritis, it's important to rest and stay hydrated. Drink plenty of fluids, even if only in small sips, and avoid solid foods until you feel better. If symptoms persist or worsen, seek medical attention.


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