[21F] Experiencing headache, neck and shoulder pain, and persistent diarrhea

Patient Description

A 21-year-old female has been experiencing a throbbing headache that affects the back of the head, temples, and sometimes around the eyes, which worsens when lying down. The headache severity is rated at 6/10 and is partially alleviated by 200mg of ibuprofen every 12 hours. Additionally, the patient reports a dull ache in the neck and shoulders with difficulty holding the head up, also rated at 6/10 in severity. Accompanying these symptoms is persistent diarrhea with soft, tan stools and crampy left and lower abdominal pain preceding bowel movements, occurring approximately 7 times daily. The abdominal pain is rated at 6/10 in severity. The patient has been taking 2mg of loperamide every morning. There is no noted fever, chills, blood in stool, recent travel, or exposure to sick individuals. The patient has no known allergies, no pre-existing conditions, and is not on any other medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Tension Headache: This is a common type of headache characterized by a dull ache around the head, often described as a tight band around the forehead or at the back of the head. It can be associated with stress, lack of sleep, poor posture, or eye strain. The neck and shoulder pain you're experiencing could also be related to this.

    • Treatment typically involves over-the-counter pain relievers, such as the ibuprofen you're already taking, and lifestyle modifications to address potential triggers.
  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can cause diarrhea, stomach pain, and cramping. However, it usually resolves on its own within a few days.

    • Treatment involves staying hydrated and eating bland foods until your symptoms improve.
  • Irritable Bowel Syndrome (IBS): This is a chronic disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation. It's worth noting that IBS is usually a long-term condition, and your symptoms have only been present for a few days.

    • Treatment often involves long-term dietary adjustments, stress management, and sometimes medications.

Please note that these are just possibilities based on the symptoms you've described. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking ibuprofen as directed for your headache, but avoid taking more than the recommended dose.
  2. Try to identify and manage any potential triggers for your headache, such as stress or poor posture.
  3. Stay hydrated and eat bland, easy-to-digest foods like rice, bananas, and toast to help manage your diarrhea.
  4. If your symptoms persist or worsen, seek medical attention. Your healthcare provider may want to perform further tests or refer you to a specialist.

What you should look out for

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

  • Severe headache that comes on suddenly
  • Headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse
  • Chronic, progressive headache that is made worse by coughing, exertion, straining, or a sudden movement
  • Diarrhea for more than 3 days without improvement
  • Blood or mucus in your stool
  • Severe abdominal or rectal pain
  • Signs of dehydration, such as excessive thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

People Also Ask


What are common causes of tension headaches and how can they be managed?

Tension headaches are often caused by stress, poor posture, eye strain, or lack of sleep. Management includes over-the-counter pain relievers like ibuprofen, stress reduction techniques, proper posture, and regular breaks from screens.


What dietary changes can help manage symptoms of gastroenteritis?

To manage gastroenteritis, it's important to stay hydrated and consume bland foods such as rice, bananas, applesauce, and toast. Avoid dairy, caffeine, alcohol, and fatty or spicy foods until symptoms improve.


How can I differentiate between gastroenteritis and irritable bowel syndrome (IBS)?

Gastroenteritis typically presents with sudden onset diarrhea and stomach pain, often resolving within a few days. IBS is a chronic condition with recurring symptoms like abdominal pain, bloating, and changes in bowel habits. A healthcare provider can help differentiate between the two based on symptom duration and patterns.


When should I seek medical attention for persistent diarrhea?

Seek medical attention for diarrhea if it lasts more than 3 days without improvement, if there is blood or mucus in the stool, if you experience severe abdominal or rectal pain, or if you show signs of dehydration such as excessive thirst, dry mouth, or dizziness.


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