[22F] Experiencing a range of symptoms including headache, GI issues, and anxiety

Patient Description

A 22-year-old female has been experiencing a variety of symptoms for an extended period. The patient reports a throbbing headache at the top of the head for over six months, rated 8/10 in severity, worsened by rapid standing, lights, and loud noises, with occasional relief in dark, cool environments. Additionally, the patient has been dealing with loose stools approximately four days a week, alongside chronic GI inflammation diagnosed recently. Anxiety has been a significant concern for over five years, exacerbated by a recent tornado event, leading to heightened fear of weather. The patient also describes a constant racing heart sensation for about a year, daily discomfort in the stomach and joints, with the stomach discomfort being a chronic ache sometimes burning, rated 7/10 in severity, and ongoing for over ten years. Notable weight gain and extreme fatigue have been reported, with an absence of menstrual periods since January. The patient has a medical history of anxiety, depression, Mobitz heart block, and chronic GI inflammation, and is currently on Spironalactone 100 mg, Prozac 20 mg, pantoprazole 20 mg, and Nadolol 10 mg, all taken once daily in the morning. No new medications have been started recently, and no side effects from the current medications have been noted.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be contributing to your symptoms:

  • Migraines: Your description of a throbbing headache, sensitivity to light and sound, and relief in a dark, cool place are common symptoms of migraines.

    • Treatment typically involves pain-relieving medications and preventive medications. Lifestyle changes such as regular sleep, meals, and exercise can also help manage migraines.
  • Irritable Bowel Syndrome with Diarrhea (IBS-D): Your chronic inflammation and frequent loose stools are consistent with this condition.

    • Treatment often involves dietary changes, medication, and addressing stress and mental health.
  • Anxiety Disorder: Your feelings of constant worry, especially about weather, and a racing heart could be signs of an anxiety disorder.

    • Treatment typically involves psychotherapy (cognitive behavioral therapy), medications, and coping strategies.
  • Chronic Fatigue Syndrome (CFS): Your extreme fatigue and joint discomfort could be signs of CFS, especially if rest doesn't help you feel more energetic.

    • Treatment often involves a combination of lifestyle changes, dietary recommendations, gentle exercise, and cognitive behavioral therapy.
  • Hypothyroidism: Your weight gain, fatigue, and changes in your menstrual cycle could be signs of an underactive thyroid.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine.

Remember, these are potential explanations for your symptoms based on the information you've provided, but only a healthcare provider can give you a definitive diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform tests to confirm a diagnosis.
  2. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider understand your condition.
  3. Try to maintain a regular sleep schedule, eat balanced meals, and engage in regular physical activity. These lifestyle changes can help manage several of your symptoms.
  4. Consider seeking support from a mental health professional to help manage your anxiety.

What you should look out for

Seek immediate medical attention if:

  • Your headaches become more severe or frequent
  • You experience sudden, severe abdominal pain
  • Your heart racing is accompanied by chest pain, shortness of breath, fainting, or severe dizziness
  • Your anxiety becomes overwhelming or leads to thoughts of self-harm or suicide

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare provider for a formal diagnosis and treatment.

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8 mo ago

People Also Ask


What are common triggers for migraines and how can they be managed?

Common triggers for migraines include stress, certain foods and drinks, hormonal changes, and sensory stimuli like bright lights or loud noises. Management often involves identifying and avoiding triggers, using pain-relief medications, and implementing lifestyle changes such as regular sleep, meals, and exercise.


How can Irritable Bowel Syndrome with Diarrhea (IBS-D) be treated or managed?

IBS-D can be managed through dietary changes like increasing fiber intake, avoiding trigger foods, and staying hydrated. Medications may include antidiarrheal drugs, antispasmodics, or low-dose antidepressants. Stress management and mental health support are also important.


What are effective strategies for managing anxiety disorders?

Effective strategies for managing anxiety disorders include cognitive behavioral therapy (CBT), medications such as SSRIs or benzodiazepines, mindfulness practices, regular physical activity, and developing coping strategies to handle anxiety-provoking situations.


What are the symptoms and treatment options for hypothyroidism?

Symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, and menstrual irregularities. Treatment typically involves daily use of synthetic thyroid hormone levothyroxine, which helps normalize hormone levels and alleviate symptoms.


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