[25F] Experiencing gastrointestinal and vasomotor symptoms

Patient Description

A 25-year-old female presents with a constellation of symptoms including constipation, severe nausea, vomiting, diarrhea, hot flashes, and cold sweats persisting for a couple of weeks. She reports an urge to defecate but passes only a small amount of dark green/black stool with occasional stringy material. Nausea is constant from waking, rated 7/10 in severity, and exacerbated by movement. Vomiting occurs 1-3 times daily, without clear triggers. Diarrhea is frequent, with up to 10 loose or watery stools per day. The patient experiences hot flashes and cold sweats throughout the day, each lasting 10-30 minutes. Additionally, she reports severe abdominal pain, dizziness, and lightheadedness. The patient has a history of hypothyroidism, Hashimoto's disease, gestational diabetes, endometriosis, acid reflux, GERD, anemia, and stomach ulcers. She is currently on multiple medications, including Estradiol, Vitamin B12, Folic Acid, Ferrous Sulfate, Adderall, Levothyroxine, Depakote, Seroquel, and Indomethacin, with recent changes to all except Levothyroxine. She experiences heart palpitations with Sudafed. The patient's symptoms and recent medication changes warrant a thorough medical evaluation to determine the underlying cause and appropriate treatment.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This condition, often called the stomach flu, can cause nausea, vomiting, diarrhea, and abdominal pain. It's typically caused by a viral or bacterial infection.

    • Treatment usually involves rest, hydration, and over-the-counter remedies to manage symptoms.
  • Irritable Bowel Syndrome (IBS): This is a chronic condition that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and changes in bowel habits (diarrhea, constipation, or both).

    • Treatment typically involves long-term management of diet, lifestyle, and stress. More severe symptoms might be managed with medication and counseling.
  • Hyperthyroidism: This condition occurs when your thyroid gland produces too much of the hormone thyroxine, which can accelerate your body's metabolism and cause unintentional weight loss and a rapid or irregular heartbeat. It could also explain your hot flashes and cold sweats.

    • Treatment can include radioactive iodine, medications, and sometimes surgery.
  • Side effects of medications: Some of the symptoms you're experiencing could be side effects of the medications you're taking. For example, Adderall can cause gastrointestinal problems, and Depakote can cause nausea and vomiting.

    • Treatment would involve consulting with your doctor to adjust your medication regimen.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis.

What you can do

  1. Keep yourself hydrated: With symptoms like vomiting and diarrhea, it's easy to become dehydrated. Make sure to drink plenty of fluids, preferably water or rehydration solutions available over the counter.

  2. Rest: Your body needs energy to fight off an infection. Getting rest will help.

  3. Consult your doctor: Given the range and severity of your symptoms, it's important to consult a healthcare professional. They can provide a more accurate diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if you experience:

  • Blood in your stool or vomit
  • Severe abdominal pain
  • Symptoms of dehydration, such as extreme thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness
  • A high fever (over 101.5°F)

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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9 mo ago


People Also Ask


What could cause a combination of constipation, diarrhea, nausea, and vomiting?

A combination of constipation, diarrhea, nausea, and vomiting can be caused by conditions such as gastroenteritis, irritable bowel syndrome (IBS), or side effects from medications. It is important to consult a healthcare provider for an accurate diagnosis.


How can medication changes affect gastrointestinal symptoms?

Changes in medication can affect gastrointestinal symptoms by altering the body's response to the drugs, potentially causing side effects like nausea, vomiting, diarrhea, or constipation. It's important to monitor symptoms and discuss any changes with a healthcare provider.


What are the potential side effects of taking multiple medications like Adderall and Depakote?

Potential side effects of taking multiple medications like Adderall and Depakote include gastrointestinal issues such as nausea, vomiting, and diarrhea, as well as other symptoms like dizziness, changes in mood, or heart palpitations. It's crucial to discuss any side effects with a doctor.


When should someone with these symptoms seek immediate medical attention?

Immediate medical attention should be sought if there is blood in the stool or vomit, severe abdominal pain, symptoms of dehydration (such as extreme thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness), or a high fever over 101.5°F.

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