[23F] Experiencing chronic gastrointestinal and neurological symptoms

Patient Description

A 23-year-old female presents with a complex medical history including chronic vomiting, diarrhea, migraines, fatigue, body aches, stomach aches, and hot flashes, all persisting for approximately two years. The vomiting is random and often results in the expulsion of bile, while the diarrhea occurs up to nine times daily, described as watery and clumpy. She experiences body aches that worsen when relaxing, migraines with nausea and sensitivity to light and sound, and sharp, spasm-like stomach aches that are more severe on the right side. Additionally, she has had a brain bleed five years ago, anxiety, depression, and had her gallbladder removed a year ago. She is currently taking paroxetine and buspirone for anxiety and depression and has a known adverse reaction to codeine. No recent travel history was reported, and she experiences random weight fluctuations and sometimes green stools.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a virus, bacteria, or parasites. It can lead to symptoms like diarrhea, vomiting, and stomach cramps. However, it usually resolves within a few days and doesn't typically last for years.

  • Irritable Bowel Syndrome (IBS): This is a chronic disorder affecting the large intestine. It can cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. The exact cause of IBS is not known, but several factors play a role, including muscle contractions in the intestine, nervous system abnormalities, inflammation in the intestines, severe infection, and changes in bacteria in the gut.

  • Gastroparesis: This is a condition where the stomach cannot empty itself of food in a normal fashion. It can be caused by damage to the vagus nerve, which regulates the digestive system. Symptoms include nausea and vomiting, feeling full quickly when eating, abdominal bloating, and fluctuating blood glucose levels.

  • Cyclic Vomiting Syndrome (CVS): This is a rare disorder characterized by recurrent, similar episodes of severe nausea and vomiting. An episode may last for a few hours to several days and then is followed by a period of time with no symptoms.

  • Migraines: Migraines are a type of headache characterized by severe, throbbing pain usually on one side of the head. They are often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound.

Please note that these are possibilities based on the symptoms you've reported. It's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Maintain a healthy diet: Eating a balanced diet can help manage some of your symptoms. Avoid foods that trigger your symptoms.

  2. Stay hydrated: This is especially important if you're experiencing vomiting and diarrhea, as these can lead to dehydration.

  3. Manage stress: Stress can worsen many of the conditions mentioned above. Techniques such as deep breathing, yoga, and meditation can help manage stress levels.

  4. Regular exercise: Regular physical activity can help manage symptoms of IBS and migraines.

  5. Consult a healthcare professional: It's important to consult with a healthcare professional who can provide an accurate diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Unexplained weight loss
  • Severe headache or migraine
  • Signs of dehydration such as dry mouth, decreased urination, and feeling dizzy when standing up

Remember, while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for accurate information.

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11 mo ago

People Also Ask


What are the possible causes of chronic vomiting and diarrhea?

Chronic vomiting and diarrhea can be caused by conditions such as gastroenteritis, irritable bowel syndrome (IBS), gastroparesis, or cyclic vomiting syndrome (CVS). It's important to consult a healthcare professional for an accurate diagnosis.


How can migraines be managed alongside other chronic symptoms?

Migraines can be managed with medications prescribed by a doctor, lifestyle changes such as regular sleep patterns, stress management techniques, and avoiding known triggers. It's important to work with a healthcare provider to find the best management plan.


What lifestyle changes can help alleviate symptoms of IBS or gastroparesis?

Lifestyle changes that may help include maintaining a balanced diet, avoiding trigger foods, staying hydrated, managing stress through techniques like yoga or meditation, and engaging in regular physical activity. These can help manage symptoms of IBS or gastroparesis.


When should someone with these symptoms seek immediate medical attention?

Immediate medical attention should be sought if there is severe abdominal pain, blood in vomit or stool, unexplained weight loss, severe headache or migraine, or signs of dehydration such as dry mouth, decreased urination, and dizziness when standing up.


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