[23F] With chronic vomiting, abdominal pain, and other symptoms
Patient Description
A 23-year-old female has been experiencing chronic vomiting, abdominal pain, nausea, diarrhea, and lightheadedness for over a year. The vomiting occurs almost every time she eats, starting with nausea and diarrhea, followed by stomach pain and worsened nausea. Vomiting episodes sometimes last all day, leading to dry heaving and passing out. She has been to the hospital multiple times and has been prescribed Phenergan and Zofran, which only help when administered via IV. The abdominal pain is rated between 6 and 7 out of 10 in severity. Diarrhea occurs 1 to 3 times a day, with stools being watery or loose. Lightheadedness, rated 7 out of 10, occurs during sick episodes. Blood sugar levels fluctuate, being high even without eating or drinking. She experiences chills during episodes and has a decreased appetite, leading to occasional days without eating and some weight loss. She has seen small amounts of blood in her vomit occasionally. Menstrual irregularities have been noted, with periods occurring more frequently. Family history includes diabetes, hypoglycemia, Crohn's disease, and IBS. The patient has alpha-1 antitrypsin deficiency and rheumatoid arthritis, diagnosed at ages 2 and 3, respectively. Medications include Phenergan, Zofran, and occasional Ativan for nerves. No known allergies to medications.
Show More
Arora's Assessment
What might be happening
It sounds like you are dealing with a complex set of symptoms that could be related to multiple underlying issues. Here are some possibilities:
Vomiting, Diarrhea, and Stomach Pain
- Gastrointestinal Disorders: Conditions like Crohn's disease or Irritable Bowel Syndrome (IBS) could explain your chronic vomiting, diarrhea, and stomach pain. These conditions often cause inflammation and irritation in the digestive tract.
- Gastroparesis: This condition slows down the movement of food from your stomach to your intestines, causing nausea, vomiting, and stomach pain.
- Infections: Chronic infections, such as Helicobacter pylori, can cause persistent gastrointestinal symptoms.
Blood Sugar Fluctuations
- Diabetes: Given your family history, undiagnosed diabetes could explain the high blood sugar levels, even when you haven't eaten.
- Hypoglycemia: Episodes of low blood sugar could also be contributing to your dizziness and lightheadedness.
Dizziness and Lightheadedness
- Dehydration: Chronic vomiting and diarrhea can lead to dehydration, which can cause dizziness and lightheadedness.
- Electrolyte Imbalance: Vomiting and diarrhea can also lead to imbalances in electrolytes like sodium and potassium, contributing to these symptoms.
Chills
- Infections: Chronic infections or inflammatory conditions can cause chills.
- Autoimmune Conditions: Given your history of rheumatoid arthritis, other autoimmune conditions could be contributing to your symptoms.
Menstrual Irregularities
- Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can cause irregular menstrual cycles.
What you can do
Vomiting, Diarrhea, and Stomach Pain
- See a Gastroenterologist: A specialist can perform tests like endoscopy, colonoscopy, or specific blood tests to diagnose conditions like Crohn's disease or IBS.
- Dietary Changes: Try eating smaller, more frequent meals and avoid foods that trigger your symptoms. Keeping a food diary can help identify triggers.
- Hydration: Drink plenty of fluids to stay hydrated. Oral rehydration solutions can help maintain electrolyte balance.
Blood Sugar Fluctuations
- Monitor Blood Sugar: Keep a log of your blood sugar levels, especially during episodes of vomiting and diarrhea. Share this information with your healthcare provider.
- Consult an Endocrinologist: A specialist can perform tests to diagnose diabetes or other endocrine disorders.
Dizziness and Lightheadedness
- Stay Hydrated: Ensure you are drinking enough fluids, especially if you are losing fluids through vomiting and diarrhea.
- Electrolyte Solutions: Consider using oral rehydration solutions to maintain electrolyte balance.
Chills
- Monitor for Fever: Keep an eye on your temperature. If you develop a fever, seek medical attention as it could indicate an infection.
- Consult Your Doctor: Discuss your chills with your healthcare provider to rule out infections or other underlying conditions.
Menstrual Irregularities
- Track Your Cycle: Keep a menstrual diary to track any irregularities and share this information with your healthcare provider.
- Consult a Gynecologist: A specialist can perform tests to diagnose hormonal imbalances or other conditions affecting your menstrual cycle.
What you should look out for
Given the severity and chronic nature of your symptoms, it's important to seek medical care as soon as possible. Here are some specific signs to watch for:
- Severe Dehydration: Signs include dry mouth, extreme thirst, little or no urination, and dizziness. Seek immediate medical attention if you experience these symptoms.
- Severe Abdominal Pain: If your pain becomes unbearable or is accompanied by fever, vomiting blood, or blood in your stool, seek emergency medical care.
- Uncontrolled Blood Sugar: If you experience symptoms of very high or very low blood sugar, such as confusion, fainting, or seizures, seek immediate medical attention.
Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
Show More
2
Hugs
0
Comments
Save
3 mo ago