[21F] Experiencing nausea, bloating, and increased thirst

Patient Description

A 21-year-old female presents with intermittent nausea of severe intensity, rated 8 out of 10, which started approximately 2 weeks ago and may be associated with periods of stress. She also reports a sensation of a lump in her throat, bloating, and excessive thirst despite adequate water intake, which has been ongoing for about 2 months. The patient has a history of anemia diagnosed at age 12 and is currently taking azithromycin for a cold, with a dosage of 500 mg once daily for four days. No known allergies, no other medications reported, and no family history of gastrointestinal diseases provided.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing symptoms like heartburn and the sensation of a lump in your throat.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Stress or Anxiety: Stress can affect the body in many ways, including causing stomach discomfort and feelings of nausea. You mentioned that your nausea might occur during periods of stress, which could suggest this as a possible cause.

    • Treatment usually involves stress management techniques, such as relaxation exercises, meditation, and counseling. Medication may also be prescribed in some cases.
  • Dehydration: You mentioned feeling very thirsty, even though you're drinking a lot of water. This could be a sign of dehydration, which can also cause feelings of nausea and bloating.

    • Treatment involves rehydrating the body by drinking plenty of fluids and avoiding activities that cause excessive sweating.
  • Side effects from Azithromycin: Nausea and bloating are common side effects of many medications, including azithromycin. Since you've been taking this medication for a cold, it's possible that it's contributing to your symptoms.

    • Treatment usually involves managing the symptoms until the medication has been fully metabolized by the body. If the symptoms persist or worsen, you should contact your doctor.

What you can do

  1. Try to manage your stress levels. This could involve relaxation exercises, meditation, or talking to a counselor or psychologist.
  2. Stay hydrated. Drink plenty of fluids and avoid activities that cause excessive sweating.
  3. Monitor your symptoms. If they persist or worsen, you should contact your doctor.
  4. If you believe your symptoms might be a side effect of azithromycin, you should contact your doctor. They might be able to recommend a different medication or provide tips for managing the side effects.

What you should look out for

  • If your symptoms persist or worsen, you should contact your doctor.
  • If you experience severe abdominal pain, vomiting, or blood in your stool, you should seek medical attention immediately.
  • If you develop a fever, chills, or a severe headache, you should seek medical attention immediately.

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

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9 mo ago


People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, and the sensation of a lump in the throat. Some people may also experience chest pain, especially when lying down at night.


How can stress or anxiety contribute to physical symptoms like nausea?

Stress and anxiety can lead to physical symptoms such as nausea, stomach discomfort, headaches, and muscle tension. This is because stress triggers the body's 'fight or flight' response, which can affect the digestive system and other bodily functions.


What are the signs of dehydration even if I'm drinking a lot of water?

Signs of dehydration, even with adequate water intake, can include persistent thirst, dry mouth, fatigue, dizziness, and dark-colored urine. It may indicate that the body is not absorbing water properly or losing fluids too quickly.


What are the common side effects of taking azithromycin?

Common side effects of azithromycin include nausea, vomiting, diarrhea, stomach pain, and bloating. If these symptoms are severe or persistent, it's important to consult a healthcare provider.

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