[23F] Experiencing nausea, headaches, and bloating

Patient Description

A 23-year-old female presents with nausea for the past four days, triggered by certain smells (poop, broccoli, fish) and overeating. The nausea is alleviated by bowel movements. She also reports headaches, increased mucus, and bloating above the belly button, all lasting for the same duration. The patient has a history of irritable bowel syndrome (IBS) and notes more frequent stools (4-5 times daily) with normal texture and color. She experiences a loss of appetite, slight abdominal pain, and sharp pains near her temple. She has chronic heartburn due to gastroesophageal reflux disease (GERD). Medical history includes severe anxiety, depressive disorder, seasonal allergic rhinitis, chronic migraine, occipital neuralgia, and esophageal stricture. She is allergic to amoxicillin. Current medications include Buspar, Zoloft, Zofran, daily allergy medicine, birth control, magnesium, omeprazole, Emgality, Tylenol, ibuprofen, and Excedrin.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Nausea and Bloating

  • Irritable Bowel Syndrome (IBS): Given your history of IBS, the increased frequency of bowel movements and bloating could be related to an IBS flare-up. IBS can cause nausea, especially when the gastrointestinal tract is more active.
  • Gastroesophageal Reflux Disease (GERD): Your chronic GERD could also contribute to nausea and bloating, especially if your symptoms are worse after eating.
  • Gastroenteritis: Although less likely given the absence of vomiting and fever, a mild gastrointestinal infection could cause nausea and increased bowel movements.

Headaches and Sharp Pains

  • Chronic Migraine: Your history of chronic migraines could explain the frequent headaches and sharp pains near your temple.
  • Occipital Neuralgia: This condition can cause sharp, shooting pains in the head and could be contributing to your symptoms.

Mucus Production

  • Seasonal Allergic Rhinitis: Your history of allergies could explain the increased mucus production, especially if you are exposed to allergens.

Unifying Diagnosis

  • Stress and Anxiety: Your severe anxiety could be exacerbating all of these symptoms. Stress can worsen IBS, GERD, and migraines, and can also lead to increased mucus production due to hyperventilation or other stress-related responses.

What you can do

Nausea and Bloating

  • Dietary Adjustments: Avoid foods that trigger your GERD and IBS symptoms. Smaller, more frequent meals may help.
  • Hydration: Drink plenty of water to stay hydrated, especially if you are having frequent bowel movements.
  • Over-the-Counter Remedies: Consider using antacids or anti-nausea medications like Zofran as needed.

Headaches and Sharp Pains

  • Medication: Continue taking your prescribed medications for migraines and occipital neuralgia. Over-the-counter pain relievers like Tylenol or Ibuprofen can also help.
  • Rest: Ensure you are getting enough rest and try to avoid known headache triggers.

Mucus Production

  • Allergy Management: Continue taking your daily allergy medication. Using a saline nasal spray can help clear mucus.
  • Environment: Try to avoid known allergens and keep your living space clean to reduce exposure.

General Tips

  • Stress Management: Practice stress-reducing techniques such as deep breathing, meditation, or yoga. Managing your anxiety can help alleviate many of your symptoms.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and get insights. This can be helpful for your healthcare provider to understand your condition better.

What you should look out for

Given the complexity of your symptoms, it's important to seek medical care if you experience any of the following:

  • Severe abdominal pain or cramping
  • Persistent vomiting
  • Significant weight loss
  • High fever or chills
  • Severe headache that doesn't respond to medication
  • Any new or worsening symptoms

Remember, while I can provide guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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4 mo ago

People Also Ask


Can IBS cause nausea and bloating?

Yes, IBS can cause nausea and bloating. During an IBS flare-up, the gastrointestinal tract can become more active, leading to these symptoms.


How does GERD contribute to nausea?

GERD can contribute to nausea because the reflux of stomach acid into the esophagus can irritate the lining, leading to discomfort and nausea, especially after eating.


What are the symptoms of occipital neuralgia?

Occipital neuralgia is characterized by sharp, shooting pains in the back of the head, neck, and behind the eyes. It can also cause sensitivity to light and scalp tenderness.


How can stress and anxiety affect physical symptoms like headaches and digestive issues?

Stress and anxiety can exacerbate physical symptoms by increasing muscle tension, altering digestion, and triggering headaches. They can worsen conditions like IBS, GERD, and migraines, leading to more pronounced symptoms.


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