[21M] With persistent vomiting, weight loss, and abdominal pain

Patient Description

A 21-year-old male has been experiencing persistent vomiting multiple times per day for the past month, which occurs during and after meals and is not triggered by any specific foods. The patient reports significant fatigue and an unintended weight loss of about 15 pounds. He describes a sharp pain in the upper abdomen that radiates into the back and lasts for 2-3 minutes, which is not alleviated by any measures and is worse when sitting down. Additionally, he has had loose, almost black stools 4-5 times a day for the past two days. The patient's recent blood tests indicate high neutrophils, monocytes, and white blood cell count. No fever or chills are present, and there is no history of recent travel, known allergies, pre-existing conditions, or medication use.

Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

Gastroenteritis: This is an inflammation of the digestive tract, often caused by a virus, bacteria, or parasites. It can cause symptoms like vomiting, diarrhea, abdominal pain, and sometimes fever.
- Treatment usually involves rest, hydration, and over-the-counter medications to help manage symptoms.
Gastric Ulcer: This is a sore that develops on the lining of the stomach, upper small intestine or esophagus. It can cause symptoms like vomiting, weight loss, and abdominal pain.
- Treatment usually involves medications to reduce stomach acid and protect the stomach lining.
Gastrointestinal Bleeding: This can be caused by a variety of conditions, including gastric ulcers, gastritis, or esophageal varices. The dark, almost black stool you described could be melena, which is a sign of bleeding in the upper gastrointestinal tract.
- Treatment depends on the cause of the bleeding, but may include medications, endoscopy, or surgery.
Pancreatitis: This is an inflammation of the pancreas, which can cause symptoms like vomiting, weight loss, and abdominal pain that radiates to the back.
- Treatment usually involves hospitalization, pain management, and treating the underlying cause.

Please note, these are just possibilities and not a definitive diagnosis. You should seek immediate medical attention to get a proper diagnosis and treatment.

What you can do

Seek immediate medical attention. Your symptoms are serious and require a healthcare professional's evaluation.
Try to stay hydrated. Dehydration can occur with vomiting and diarrhea.
Avoid eating solid food until vomiting stops. Then try small amounts of mild, bland foods such as rice or crackers.

What you should look out for

You should seek immediate medical attention if you:

Notice blood in your vomit or stool
Experience severe abdominal pain
Have a high fever
Become dehydrated (symptoms of dehydration include extreme thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness)
Your symptoms continue to worsen

Remember, I'm an AI and this advice is based on the information you gave me. It's always important to consult with a healthcare professional for accurate information.

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines