[23F] With chronic vomiting and weight loss

Patient Description

A 23-year-old female has been experiencing chronic vomiting for about a year, occurring 3 to 4 times every other day, without specific triggers. This has led to significant weight loss, and she has been eating less to manage the vomiting. She also reports occasional heartburn, rated as a 4 out of 10 in severity, and abdominal cramps near her C-section area, but no changes in bowel movements. She has not undergone any diagnostic tests like an endoscopy. She smokes 6-10 cigarettes a day and has noticed her menstrual cycle starting about a week early in the last two months. Her medical history includes seizures since age 3, and she is allergic to penicillin and certain nose sprays. She is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Gastroesophageal Reflux Disease (GERD): This condition can cause frequent vomiting and heartburn. It occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach.

    • Treatment often includes lifestyle changes, dietary adjustments, and medications to reduce stomach acid.

  • Gastroparesis: This is a condition where the stomach takes too long to empty its contents, leading to nausea and vomiting.

    • Treatment may involve dietary changes, medications, and sometimes procedures to help the stomach empty more effectively.

  • Peptic Ulcer: Sores that develop on the lining of the stomach or the first part of the small intestine can cause pain and vomiting.

    • Treatment typically involves medications to reduce stomach acid and antibiotics if an infection is present.

  • Smoking-Related Issues: Smoking can exacerbate reflux and other gastrointestinal issues.

    • Reducing or quitting smoking can significantly improve symptoms.

What you can do

  1. Dietary Adjustments: Try eating smaller, more frequent meals and avoid foods that trigger reflux, such as spicy or fatty foods.
  2. Elevate Your Head: When sleeping, elevate the head of your bed to prevent acid from flowing back into the esophagus.
  3. Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you're vomiting frequently.
  4. Track Symptoms: Use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider.

What you should look out for

  • Seek Medical Attention: If your symptoms worsen or you experience severe pain, blood in vomit, or significant weight loss, see a healthcare provider promptly.
  • Monitor for Dehydration: Watch for signs of dehydration, such as dizziness, dry mouth, or dark urine.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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2 mo ago

People Also Ask

What are the potential causes of chronic vomiting without specific triggers?

Chronic vomiting without specific triggers can be caused by conditions such as gastroesophageal reflux disease (GERD), gastroparesis, peptic ulcers, or other gastrointestinal disorders. It's important to consult a healthcare provider for a proper diagnosis.

How can smoking affect gastrointestinal symptoms like vomiting and heartburn?

Smoking can exacerbate gastrointestinal symptoms by increasing stomach acid production and weakening the lower esophageal sphincter, which can lead to increased reflux and heartburn. Quitting smoking can help improve these symptoms.

What lifestyle changes can help manage symptoms of GERD or gastroparesis?

Lifestyle changes to manage GERD or gastroparesis include eating smaller, more frequent meals, avoiding trigger foods (like spicy or fatty foods), elevating the head while sleeping, and staying hydrated. These adjustments can help reduce symptoms and improve quality of life.

Why might my menstrual cycle be starting earlier than usual?

An early menstrual cycle can be influenced by various factors, including stress, changes in weight, hormonal imbalances, or underlying health conditions. It's advisable to discuss any significant changes in your menstrual cycle with a healthcare provider.

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