[25F] Experiencing gastrointestinal symptoms and swollen lymph nodes

Patient Description

A 25-year-old female reports a loss of appetite, nausea, vomiting, stomach burn sensation, altered sense of smell, stomach pain, gas, and acid reflux. The patient has also noticed swollen lymph nodes in the armpit. Symptoms such as nausea and vomiting are triggered by certain foods or smells and have been present for 2 weeks, with a severity level of 6 out of 10. Vomiting occurs once and contains bile. The abdominal pain is described as crampy and burning, with a severity of 8 out of 10, affecting both upper and lower abdomen. The patient has been experiencing a weird sense of smell, perceiving non-sour items as sour, and has a dry throat with a choking sensation. There is a history of asthma, fibroids, PCOS, and allergies diagnosed 8-10 years ago. The patient is currently taking Zofran (4mg every 8 hours) and Protonix (20mg once daily before meals) and has been on One A Day women's vitamins for a couple of months. There is a family history of gastrointestinal diseases, and the patient has been losing weight due to a decreased appetite. No night sweats have been reported, but there has been a small amount of blood in the vomit. The patient uses alcohol, tobacco, or recreational drugs and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This is a condition where 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. Symptoms can include heartburn, regurgitation of food or sour liquid, and a sensation of a lump in your throat.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Gastritis: This is an inflammation of the stomach lining. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Other common causes include regular use of certain pain relievers or drinking too much alcohol. Symptoms can include nausea, vomiting, a feeling of fullness in your upper abdomen after eating, and abdominal pain.

    • Treatment typically involves taking antacids and other drugs to reduce stomach acid, which can help relieve symptoms and promote healing.
  • Gastroparesis: This is a condition that affects the normal spontaneous movement of the muscles (motility) in your stomach. Ordinarily, strong muscular contractions propel food through your digestive tract. But if you have gastroparesis, your stomach's motility is slowed down or doesn't work at all, preventing your stomach from emptying properly. Symptoms can include nausea, vomiting, abdominal bloating, feeling full quickly when eating, heartburn, and abdominal pain.

    • Treatment typically involves dietary changes, medication, and, in severe cases, feeding tubes and surgery.
  • Lymphadenitis: This is the medical term for enlargement in one or more lymph nodes, usually due to infection. Lymph nodes, which appear throughout your body, are an important part of your immune system. They contain white blood cells that help you fight off infections by attacking bacteria, viruses, and other harmful pathogens that invade your body. Symptoms can include swollen, painful lymph nodes in the neck, armpits, or groin, as well as possible fever, night sweats, and weight loss.

    • Treatment typically involves antibiotics and over-the-counter pain medication.

What you can do

  1. Make an appointment with your doctor to discuss your symptoms. They may refer you to a gastroenterologist for further evaluation.
  2. Try to identify any triggers for your symptoms and avoid them if possible. This could include certain foods, drinks, or activities.
  3. Continue taking your prescribed medications as directed by your doctor.
  4. Stay hydrated and try to eat small, frequent meals instead of three large meals a day.

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
  • Difficulty swallowing
  • Unexplained weight loss
  • Persistent or worsening symptoms

Please remember that 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.

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10 mo ago

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, and a sensation of a lump in your throat. It can also cause chest pain, difficulty swallowing, and chronic cough.


How can gastritis be treated and managed effectively?

Gastritis can be treated with antacids and medications that reduce stomach acid, such as proton pump inhibitors or H2 blockers. Avoiding alcohol, spicy foods, and pain relievers like NSAIDs can also help manage symptoms.


What dietary changes can help manage gastroparesis symptoms?

Dietary changes for managing gastroparesis include eating smaller, more frequent meals, avoiding high-fat and high-fiber foods, and opting for soft or liquid foods that are easier to digest. Staying hydrated is also important.


What could cause swollen lymph nodes in the armpit?

Swollen lymph nodes in the armpit can be caused by infections, such as bacterial or viral infections, or conditions like lymphadenitis. They can also be a response to inflammation or, in rare cases, indicate more serious conditions like lymphoma.


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