[21F] With multiple symptoms including back pain, headaches, and nausea

Patient Description

A 21-year-old female presents with a range of symptoms including back pain, light headaches, swollen ankles, frequent urination, nausea after eating, and constant recurring stomach pain. The back pain is located in the upper back towards the side and feels like being pushed, worsening at night and relieved by laying down. The patient has experienced light headaches triggered by loud noises, located at the back of the head, and described as an aching sensation, ongoing for months. Nausea occurs after eating even a small amount of food, accompanied by heartburn-like symptoms for days, and has been present for a few months. The abdominal pain is severe, cramp-like, sometimes stabbing, primarily in the lower left abdomen and by the ribs on the left side, rated as an 8 out of 10 in severity. The patient also reports frequent urination and mild swelling of the left ankle on and off for a few days over the past two weeks, with no changes in color or temperature of the legs and no personal or family history of blood clots. Additionally, the patient has experienced some changes in vision and sensitivity to light, along with recent weight gain. The patient's medical history includes having an ovarian cyst, with no known allergies and no current medications.

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Arora's Assessment

What might be happening

Based on the symptoms you have described, here are some possible conditions that might be affecting you:

  • Gastroesophageal Reflux Disease (GERD): This condition can cause heartburn and nausea after eating. It occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus).

    • Treatment typically involves lifestyle changes such as avoiding certain foods, eating smaller meals, and not lying down after eating. Over-the-counter antacids or prescribed medications may also help.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like stomach pain, cramping, and changes in bowel habits. Stress and certain foods can trigger symptoms.

    • Treatment often involves dietary changes, stress management, and medications to relieve symptoms.
  • Urinary Tract Infection (UTI): Frequent urination can be a sign of a UTI, which is an infection in any part of your urinary system.

    • Treatment usually involves antibiotics prescribed by a doctor.
  • Ovarian Cyst: Given your history of ovarian cysts, it's possible that a cyst could be causing your lower abdominal pain.

    • Treatment varies depending on the size and type of the cyst, but it can include watchful waiting, medications, or surgery.
  • Peripheral Edema: Swelling in the ankles can be due to fluid retention, which can be caused by various factors including prolonged standing, certain medications, or more serious conditions like heart or kidney problems.

    • Treatment depends on the underlying cause but may include lifestyle changes, medications, or other interventions.
  • Tension Headaches: These are common and can be triggered by stress, poor posture, or muscle tension.

    • Treatment often includes over-the-counter pain relievers, stress management techniques, and lifestyle changes.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Dietary Changes: Avoid foods that trigger heartburn and nausea, such as spicy or fatty foods, caffeine, and alcohol. Eat smaller, more frequent meals.
  2. Hydration: Drink plenty of water to stay hydrated, especially if you're experiencing frequent urination.
  3. Rest and Elevation: Elevate your legs when sitting or lying down to help reduce ankle swelling.
  4. Over-the-Counter Medications: Consider using antacids for heartburn and pain relievers for headaches, but consult with a healthcare provider before starting any new medication.
  5. Monitor Symptoms: Keep a symptom diary to track what triggers your symptoms and any patterns you notice. This information can be helpful for your doctor.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or urine
  • High fever or chills
  • Sudden, severe headache or vision changes
  • Significant or rapid swelling in your ankles or legs
  • Difficulty breathing or chest pain

Remember, while this information can help you understand your symptoms better, it is not a substitute for professional medical advice. Please consult a healthcare provider for a comprehensive evaluation and appropriate treatment.

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6 mo ago


People Also Ask


What could be causing my frequent urination and how is it treated?

Frequent urination can be caused by a urinary tract infection (UTI), which is an infection in any part of your urinary system. Treatment usually involves antibiotics prescribed by a doctor. It's important to stay hydrated and consult a healthcare provider for a proper diagnosis.


Why do I experience nausea and heartburn after eating, and what can I do about it?

Nausea and heartburn after eating could be symptoms of Gastroesophageal Reflux Disease (GERD), where stomach acid flows back into the esophagus. Treatment includes lifestyle changes like avoiding trigger foods, eating smaller meals, and not lying down after eating. Over-the-counter antacids or prescribed medications may also help.


What might be the reason for my swollen ankles and how can I reduce the swelling?

Swollen ankles, or peripheral edema, can be due to fluid retention from various causes such as prolonged standing or certain medications. To reduce swelling, elevate your legs when sitting or lying down, and consult a healthcare provider to determine the underlying cause and appropriate treatment.


How can I manage my recurring headaches and what might be causing them?

Recurring headaches, especially tension headaches, can be triggered by stress, poor posture, or muscle tension. Management includes over-the-counter pain relievers, stress management techniques, and lifestyle changes. Identifying and avoiding triggers can also help reduce the frequency and severity of headaches.

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