[22F] Experiencing persistent nausea, sore throat, and chest pain

Patient Description

A 22-year-old female presents with persistent nausea rated 8/10 in severity, starting yesterday morning and persisting throughout the day, unaffected by food intake or specific triggers. The patient also reports a sore throat and chest pain but denies any recent respiratory infections, vomiting, blood in vomit, shortness of breath, palpitations, or radiation of chest pain. The patient has a family history of gastrointestinal diseases and a personal medical history of anxiety and depression diagnosed in 2018. Current medications include fluoxetine 30 mg daily, hydroxyzine 50 mg daily and 10 mg as needed, topiramate 50 mg daily, B12 500 mg every other day, and sumatriptan 50 mg as needed for migraines. The patient has allergies to cephalexin and sertraline.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your symptoms include:

  • 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 chest pain and sore throat. Nausea is less common but can occur.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Anxiety Disorders: Given your history of anxiety, it's possible that your symptoms are related to this condition. Anxiety can cause a variety of physical symptoms, including nausea, chest pain, and a sore throat.

    • Treatment typically involves a combination of psychotherapy (talk therapy), behavioral therapy, and medication.
  • Gastritis: This is an inflammation of the stomach lining that can cause nausea and chest pain. A sore throat is less common but can occur if there is significant acid reflux.

    • Treatment typically involves taking antacids and other drugs to reduce stomach acid, avoiding hot and spicy foods, and abstaining from alcohol and nonsteroidal anti-inflammatory drugs.

Please note that these are just possible causes and not a definitive diagnosis. It's important to see a healthcare professional for a proper evaluation.

What you can do

Here are some general suggestions that may help alleviate your symptoms:

  1. Avoid foods and drinks that trigger heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Try to eat smaller meals. Avoid overeating by eating smaller meals.
  3. Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.
  5. Don't wear tight clothes or tight belts.
  6. If you smoke, stop. Smoking decreases the lower esophageal sphincter's ability to function properly.

What you should look out for

Here are some signs that you should seek medical attention immediately:

  • Severe chest pain or pressure, especially if it radiates to your arm, neck, or back
  • Vomiting blood or material that looks like coffee grounds
  • Severe, persistent, and unexplained nausea or stomach pain
  • Trouble swallowing
  • Yellow discoloration of the skin and eyes (jaundice)

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare professional for accurate information.

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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, chest pain, and a sore throat. Nausea can also occur, although it is less common.


Can anxiety cause physical symptoms like nausea and chest pain?

Yes, anxiety can cause a variety of physical symptoms, including nausea, chest pain, a sore throat, and even gastrointestinal issues. These symptoms are often a result of the body's stress response.


What lifestyle changes can help manage symptoms of gastritis?

To manage symptoms of gastritis, it is recommended to avoid hot and spicy foods, alcohol, and nonsteroidal anti-inflammatory drugs. Eating smaller meals, avoiding lying down after eating, and reducing stress can also help.


When should I seek medical attention for nausea and chest pain?

You should seek medical attention if you experience severe chest pain or pressure, especially if it radiates to your arm, neck, or back, vomiting blood, severe and unexplained nausea or stomach pain, trouble swallowing, or jaundice.


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