[26F] Experiencing nausea and gastrointestinal symptoms

Patient Description

A 26-year-old female has been experiencing nausea for about a week, occurring 7-8 times daily, with a sudden onset. Zofran provides temporary relief, but the nausea returns. Additional symptoms include constipation, acid or bitter taste in the mouth, vomiting, headaches, heartburn, and regurgitation. The patient has a history of GERD, diagnosed at age 16. There are no specific triggers or times of day when symptoms worsen, and no abdominal pain or unintentional weight loss has been reported. The patient consumes 1-2 cups of caffeine daily and is not taking any over-the-counter medications or supplements. Current medications include Risperidone 2 mg at night, Famotidine 40 mg twice daily, and Xanax as needed for anxiety. The patient has an allergy to Bactrim.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Gastroesophageal Reflux Disease (GERD): Since you have a history of GERD, it's possible that your current symptoms, including nausea, acid taste in your mouth, and heartburn, are related to this condition. GERD 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. Treatment typically involves lifestyle changes and medications like famotidine, which you're already taking.

  • Stress-Induced Symptoms: Stress can exacerbate GERD symptoms and contribute to nausea, headaches, and changes in bowel habits like constipation. Managing stress through relaxation techniques, exercise, or counseling can be beneficial.

  • Medication Side Effects: Some medications, including those for anxiety and mental health conditions, can cause gastrointestinal symptoms like nausea and constipation. It's important to discuss these side effects with your healthcare provider.

What you can do

  1. Dietary Adjustments: Avoid foods and drinks that trigger reflux, such as spicy foods, caffeine, and alcohol. Eating smaller, more frequent meals can also help.

  2. Lifestyle Changes: Elevate the head of your bed, avoid lying down immediately after eating, and maintain a healthy weight to reduce GERD symptoms.

  3. Stress Management: Practice stress-reducing techniques such as deep breathing exercises, yoga, or meditation. Consider speaking with a mental health professional if stress is significantly impacting your life.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and identify potential triggers. This information can be valuable for your healthcare provider.

What you should look out for

  • Seek Medical Attention If:
    • Your symptoms worsen or do not improve with current treatment.
    • You experience severe abdominal pain, difficulty swallowing, or unintentional weight loss.
    • You notice blood in your vomit or stool.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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6 d ago


People Also Ask


What are common symptoms of GERD and how can they be managed?

Common symptoms of GERD include heartburn, acid reflux, nausea, regurgitation, and a bitter taste in the mouth. Management typically involves lifestyle changes such as avoiding trigger foods, eating smaller meals, and medications like famotidine to reduce stomach acid.


Can stress really affect gastrointestinal symptoms like nausea and constipation?

Yes, stress can significantly impact gastrointestinal symptoms. It can exacerbate conditions like GERD, leading to increased nausea, headaches, and constipation. Stress management techniques such as relaxation exercises, yoga, and counseling can help alleviate these symptoms.


What are potential side effects of medications like Risperidone and Xanax on the digestive system?

Risperidone and Xanax can cause gastrointestinal side effects, including nausea and constipation. It's important to discuss any side effects with your healthcare provider, as they may need to adjust your medication or provide additional treatments to manage these symptoms.


How can dietary and lifestyle changes help in managing GERD symptoms?

Dietary and lifestyle changes can greatly help in managing GERD symptoms. Avoiding foods that trigger reflux, such as spicy foods and caffeine, eating smaller meals, and not lying down immediately after eating can reduce symptoms. Elevating the head of the bed and maintaining a healthy weight are also beneficial strategies.

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