[23M] Experiencing gastrointestinal discomfort and systemic symptoms

Patient Description

A 23-year-old male is reporting a constellation of symptoms that began this morning. He describes a dull discomfort in the stomach, with a sensation of something sitting at the top of the stomach, causing a weird feeling near the ribs. The patient rates the stomach discomfort as 7 out of 10 in severity. Additionally, he experiences dry, heavy, and slightly blurry eyes, moderate to severe episodes of faintness, and nasal congestion. His muscles feel tight and crampy. The patient has a history of Sydenham's chorea diagnosed at age 10 and is currently taking Omeprazole (20 mg daily) for an unspecified condition, and Humira bi-weekly for Rheumatoid Arthritis. He has been using ibuprofen as recommended for the past week and takes multivitamins regularly. The patient has allergies to Penicillin and sulfur-based drugs. No recent changes in bowel movements, vomiting, diarrhea, rash, or skin changes have been reported. The patient also mentioned experiencing chills and slight chest pains earlier, which have since resolved.

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Arora's Assessment

What might be happening

Based on your symptoms, several conditions could be causing your discomfort:

  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. This could explain the sensation of something sitting in the lower part of your chest and the stomach discomfort.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or surgery might be needed.
  • Generalized Anxiety Disorder (GAD): This is a common anxiety disorder that involves chronic worrying, nervousness, and tension. This could explain your feelings of panic and faintness.

    • Treatment typically involves psychotherapy, medication, or both.
  • Dry Eye Syndrome: This is a condition in which your eyes do not produce enough tears, or the tears evaporate too quickly. This could explain the dryness and heaviness in your eyes.

    • Treatment typically involves eye drops, lifestyle changes, or a procedure to close your tear ducts.
  • Common Cold: This is a viral infection of your nose and throat. This could explain your nasal congestion and general feeling of being unwell.

    • Treatment typically involves rest, fluids, and over-the-counter medications.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare professional to get a formal diagnosis and appropriate treatment.

What you can do

  1. For GERD, try to avoid foods and drinks that trigger heartburn such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Also, try to eat smaller meals and avoid eating within 2-3 hours of bedtime.

  2. For GAD, try to manage your stress levels. This could involve regular exercise, relaxation techniques such as deep breathing, meditation, yoga, or tai chi, and getting enough sleep.

  3. For Dry Eye Syndrome, try to avoid air blowing in your eyes, add moisture to the air with a humidifier, and take breaks during long tasks to reduce eyestrain.

  4. For the common cold, rest and hydrate. Over-the-counter cold remedies can relieve symptoms.

What you should look out for

If your symptoms persist or worsen, you should seek medical attention. Specifically, if you experience severe chest pain, difficulty breathing, or fainting, you should seek immediate medical attention.

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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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, chest pain, and the sensation of a lump in the throat.


How can Generalized Anxiety Disorder (GAD) affect physical health?

GAD can lead to physical symptoms such as muscle tension, headaches, stomach issues, fatigue, and difficulty sleeping. It can also cause feelings of panic and faintness.


What are some effective treatments for Dry Eye Syndrome?

Effective treatments for Dry Eye Syndrome include using artificial tears or lubricating eye drops, lifestyle changes like reducing screen time, and in some cases, procedures to block tear ducts to prevent tears from draining away too quickly.


What are the typical symptoms of a common cold?

Typical symptoms of a common cold include a runny or stuffy nose, sore throat, cough, congestion, slight body aches, sneezing, and low-grade fever.


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