[23F] Experiencing severe acid reflux and gastrointestinal discomfort

Patient Description

A 23-year-old female presents with severe acid reflux characterized by a burning sensation in the throat and a feeling of heat, which has worsened in the last 24 hours. The patient reports associated symptoms of nausea, bloating, loss of appetite, and episodes of black stools. She experiences fatigue, difficulty concentrating, increased anxiety, and a sensation of needing to use the bathroom frequently. The patient has a history of bipolar disorder, social anxiety, depression, and vertigo. She suspects IBS and lactose intolerance, conditions that run in her family. She takes loratadine for allergies, uses an unspecified nasal spray, and is on the Nexplanon implant and Taltz for guttate psoriasis. She has been using over-the-counter antacids to manage her symptoms. There is no known family history of gastrointestinal diseases, and she has not been taking NSAIDs. No allergies to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible conditions include:

  • Gastroesophageal Reflux Disease (GERD): This condition is characterized by frequent acid reflux, or heartburn. It happens when 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.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor may recommend prescription medications or surgery.
  • Peptic Ulcer Disease: Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain. However, a severe, untreated ulcer can sometimes lead to life-threatening complications.

    • Treatment usually involves medications to decrease stomach acid. If an H. pylori infection is present, antibiotics are also used.
  • Gastritis: Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).

    • Treatment involves taking antacids and other drugs to reduce stomach acid, thereby relieving gastritis symptoms. It may also be helpful to avoid hot and spicy foods.
  • Anxiety: Anxiety disorders can cause physical symptoms like headaches, rapid heartbeat, insomnia, and digestive issues, among others. You mentioned that your anxiety has been worse recently, which could be contributing to your symptoms.

    • Treatment typically involves psychotherapy, medication, or both.

Please note that this is not an exhaustive list of all possible conditions, and these conditions may coexist.

What you can do

  1. Try to identify any foods or drinks that trigger your acid reflux and avoid them. Common triggers include spicy foods, chocolate, citrus fruits, and caffeinated or alcoholic beverages.
  2. Eat smaller meals more frequently throughout the day rather than three large meals.
  3. Avoid lying down or going to bed for at least three hours after eating.
  4. Elevate the head of your bed by 4 to 6 inches to prevent acid reflux while you sleep.
  5. Over-the-counter antacids can provide quick relief from acid reflux symptoms. However, if you find yourself needing these frequently, it's important to see a doctor.
  6. If you're feeling anxious, try deep breathing exercises, meditation, or other relaxation techniques. Consider seeking help from a mental health professional if your anxiety continues to worsen.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe, sudden, or persistent stomach pain
  • Difficulty swallowing or painful swallowing
  • Vomiting blood or black material
  • Black or tarry stools
  • Unintentional weight loss
  • Signs of anemia, such as paleness, weakness, or shortness of breath

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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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 a burning sensation in the chest (heartburn), regurgitation of food or sour liquid, difficulty swallowing, and a sensation of a lump in the throat.


How can anxiety contribute to digestive issues?

Anxiety can lead to digestive issues by increasing stomach acid production, altering gut motility, and causing muscle tension in the digestive tract, which can result in symptoms like nausea, bloating, and changes in bowel habits.


What are the potential causes of black stools?

Black stools can be caused by bleeding in the upper gastrointestinal tract, such as from a peptic ulcer or gastritis. It can also result from taking certain medications or supplements, like iron or bismuth subsalicylate.


What lifestyle changes can help manage acid reflux symptoms?

Lifestyle changes to manage acid reflux include avoiding trigger foods and drinks, eating smaller meals, not lying down soon after eating, elevating the head of the bed, and maintaining a healthy weight.

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