[23F] Experiencing severe postprandial nausea, vomiting with blood, and high blood sugars

Patient Description

A 23-year-old female has been experiencing severe nausea rated 7 out of 10, food aversions, early satiety, and vomiting, sometimes with blood, for several months. These symptoms occur after eating just a couple of bites of any food. Additionally, she reports severe abdominal pain multiple times a week, described as a stabbing sensation. She has observed black stools on a few occasions, which could indicate gastrointestinal bleeding. The patient has also noted uncontrolled high blood sugars despite dietary management, which is unusual as she has been diagnosed with type 1 diabetes and had previously managed her condition without insulin. She has a history of asthma since childhood. No current medications are reported, and there are no known drug allergies.

Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

Gastroparesis: This is a condition where the stomach cannot empty itself of food in a normal fashion. It is often seen in people with type 1 diabetes. Symptoms can include nausea, vomiting, feeling full quickly when eating, abdominal bloating, and weight loss.
- Treatment typically involves dietary changes, medication to stimulate the stomach muscles, and in severe cases, feeding tubes or intravenous feeding.
Peptic Ulcer Disease: This condition is characterized by sores that develop on the inside lining of your stomach, upper small intestine or esophagus. Symptoms can include burning stomach pain, feeling of fullness, bloating or belching, intolerance to fatty foods, heartburn, and nausea. The presence of blood in your vomit and black stools could indicate bleeding ulcers.
- Treatment typically involves medications to decrease stomach acid and protect the lining of your stomach and small intestine. In some cases, endoscopy or surgery may be required.
Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This acid reflux can irritate the lining of your esophagus and cause nausea.
- Treatment typically involves lifestyle changes, over-the-counter medications to reduce acid, and prescription medications. In severe cases, surgery may be required.

Please note that these are potential explanations for your symptoms, but there could be other causes. It's important to consult with a healthcare professional to get a definitive diagnosis.

What you can do

Make an appointment with your healthcare provider as soon as possible. The presence of blood in your vomit and black stools are concerning symptoms that need immediate medical attention.
Try to eat smaller, more frequent meals instead of three large meals a day.
Avoid foods that exacerbate your symptoms. These can include fatty and fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
Stay upright after meals. Lying down or going to bed right after a meal can lead to reflux and heartburn.