[24F] Experiencing nausea, vomiting, and abdominal pain with a history of PCOS and endometriosis

Patient Description

A 24-year-old female presents with ongoing nausea for two weeks, unrelated to meals, rating the severity at 6 out of 10. The patient experienced an episode of vomiting chunky white bile two days ago and has since been reluctant to eat due to an increase in nausea. Additionally, the patient reports severe abdominal pain from two weeks ago, constipation, and extreme fatigue. The patient has lost approximately 10 pounds in a week and a half. Mood swings, anxiety, agitation, and confusion have been noted, which have been impacting personal life and relationships. The patient has a history of PCOS diagnosed in March 2023, endometriosis diagnosed in May 2022, and a lifelong history of anxiety, with depression first noted in 2020. There is a family history of thyroid disorders, but the patient's thyroid levels are normal. No known drug allergies and no current medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, several conditions could be contributing to your symptoms:

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can lead to nausea, vomiting, abdominal pain, and diarrhea. However, gastroenteritis usually resolves within a few days, and your symptoms have been present for two weeks.

    • Treatment typically involves rest, hydration, and over-the-counter medications to manage symptoms.
  • Gastroesophageal Reflux Disease (GERD): This condition occurs 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 and cause nausea and vomiting.

    • Treatment usually involves lifestyle changes and over-the-counter medications.
  • Gallstones: These are hardened deposits in the gallbladder that can cause nausea, vomiting, and abdominal pain. However, gallstones usually cause pain in the upper right abdomen, not the center.

    • Treatment may involve surgery to remove the gallbladder or medications to dissolve the gallstones.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and changes in bowel habits (diarrhea, constipation, or both).

    • Treatment usually involves long-term management of diet, lifestyle changes, and stress.
  • Depression and Anxiety: These mental health conditions can cause physical symptoms like nausea, fatigue, and changes in appetite and weight. The mood swings, agitation, and brain fog you're experiencing could also be related to these conditions.

    • Treatment usually involves a combination of medication and psychotherapy.
  • Polycystic Ovary Syndrome (PCOS) and Endometriosis: These conditions can cause hormonal imbalances that might contribute to your symptoms. However, they don't typically cause nausea or vomiting.

    • Treatment usually involves managing symptoms and preventing complications.

Please note that this is not an exhaustive list and other conditions could also be causing your symptoms. It's also possible that more than one condition could be contributing to your symptoms.

What you can do

Given the duration and severity of your symptoms, it's important that you seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your primary care provider. They can perform a physical examination and order tests to help determine the cause of your symptoms.
  2. Maintain a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider in diagnosing your condition.
  3. Stay hydrated and eat small, frequent meals. This can help manage your nausea and vomiting.
  4. Try to get regular exercise and adequate sleep. This can help manage your fatigue and mood symptoms.
  5. Reach out to a mental health professional. They can provide support and treatment for your anxiety and depression.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Severe or worsening constipation
  • Rapid weight loss
  • Severe fatigue or weakness
  • New or worsening mood symptoms

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare professional for an accurate diagnosis and treatment.

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What are the common causes of nausea and vomiting that last for more than a week?

Common causes of prolonged nausea and vomiting include gastrointestinal infections, gastroesophageal reflux disease (GERD), gallstones, irritable bowel syndrome (IBS), and sometimes psychological factors like anxiety and depression. It's important to consult a healthcare provider for a proper diagnosis.


How can anxiety and depression contribute to physical symptoms like nausea and fatigue?

Anxiety and depression can lead to physical symptoms such as nausea, fatigue, and changes in appetite due to the body's stress response. These conditions can also affect sleep and energy levels, contributing to overall physical discomfort.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD include eating smaller meals, avoiding foods and drinks that trigger reflux (such as spicy foods, caffeine, and alcohol), not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed.


How can PCOS and endometriosis affect overall health and well-being?

PCOS and endometriosis can cause hormonal imbalances, leading to symptoms like irregular periods, pain, and fertility issues. They can also impact mental health, contributing to anxiety and depression. Managing these conditions often involves a combination of medication, lifestyle changes, and regular medical check-ups.


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