[26F] With severe gastrointestinal symptoms, migraines, and irregular periods
Patient Description
A 26-year-old female presents with a range of concerning symptoms. She has been experiencing constant lower abdominal pain for the past 3 weeks, which she rates as a 6 out of 10 in severity. The pain feels like cramps and is not relieved by any measures. She has been vomiting 4-5 days a week for the past 6 months, especially when trying to eat, and sometimes randomly. The vomit often contains bright red blood. She has also noticed blood in her stool for about 6 months, sometimes just a few drops and other times more. Her stool can be watery or loose, and she has to go often. Occasionally, her stool is black or dark. For the past 2 weeks, she has had moderate to severe pain when swallowing, especially when trying to eat. She feels bloated in her stomach, arms, and legs, even though she can barely eat. Her periods have been very irregular for the past 9 months, sometimes not occurring for over 6 weeks, and when they do, they are very light and last only a day or two. She has been experiencing blurred vision that is between out of focus and hazy, and it's becoming more frequent. She has had migraines that come and go but have become more frequent in the past 3 months, with pain located on the top and forehead of her head, varying between sharp and throbbing, with a severity ranging from moderate to severe. She also reports frequent urination, inconsistent appetite, occasional dizziness or lightheadedness, and occasional chest pain or shortness of breath. She consumes between 128oz - 144oz of beer and smokes 3-8 cigarettes daily. She takes Tylenol (500mg, 3-5 times a day) and aspirin. Her mother had a hysterectomy.
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Arora's Assessment
What might be happening
It sounds like you are experiencing a range of symptoms that could be related to multiple underlying issues. Here are some possibilities:
Abdominal Pain, Vomiting with Blood, and Blood in Stool
- Gastrointestinal Bleeding: The presence of bright red blood in your vomit and stool is concerning for gastrointestinal bleeding. This could be due to conditions like peptic ulcers, gastritis, or esophageal varices. The use of aspirin and alcohol can exacerbate these conditions.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, diarrhea, and blood in the stool.
- Gastroesophageal Reflux Disease (GERD): GERD can cause painful swallowing and vomiting, although the presence of blood is more concerning and suggests a more serious condition.
Irregular Periods and Bloating
- Hormonal Imbalance: Irregular periods and bloating can be due to hormonal imbalances, which could be related to conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.
- Gynecological Issues: Conditions like endometriosis or fibroids can cause irregular periods and abdominal pain.
Blurred Vision and Migraines
- Migraine with Aura: Blurred vision and migraines can be related to migraine with aura, a type of migraine that includes visual disturbances.
- Hypertension: High blood pressure can cause headaches and blurred vision.
Frequent Urination and Appetite Changes
- Diabetes: Frequent urination and changes in appetite can be symptoms of diabetes, which can also cause blurred vision and fatigue.
Dizziness and Chest Pain
- Cardiovascular Issues: Dizziness and chest pain can be related to cardiovascular issues, especially given your alcohol and cigarette use.
What you can do
Abdominal Pain, Vomiting with Blood, and Blood in Stool
- Seek Immediate Medical Attention: These symptoms are concerning and require immediate medical evaluation. Go to the emergency department or contact your healthcare provider as soon as possible.
- Avoid Aspirin and Alcohol: Both can exacerbate gastrointestinal bleeding. Stop using them until you have been evaluated by a healthcare professional.
Irregular Periods and Bloating
- Consult a Gynecologist: A gynecologist can help evaluate hormonal imbalances and other gynecological issues.
- Track Your Symptoms: Use MDandMe to journal your symptoms, track your periods, and share this information with your healthcare provider.
Blurred Vision and Migraines
- See a Neurologist: A neurologist can help evaluate your migraines and blurred vision.
- Monitor Blood Pressure: Check your blood pressure regularly and consult your doctor if it is high.
Frequent Urination and Appetite Changes
- Consult a Primary Care Physician: A primary care physician can evaluate you for diabetes and other metabolic conditions.
- Monitor Blood Sugar Levels: If you have access to a glucometer, check your blood sugar levels and share the results with your doctor.
Dizziness and Chest Pain
- Seek Medical Evaluation: These symptoms can be related to cardiovascular issues and should be evaluated by a healthcare professional.
- Limit Alcohol and Cigarettes: Reducing or quitting alcohol and cigarettes can improve your overall health and reduce the risk of cardiovascular issues.
What you should look out for
Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:
- Severe Abdominal Pain: If the pain becomes unbearable or is accompanied by fever, chills, or vomiting blood.
- Severe Vomiting: If you cannot keep any food or liquids down.
- Severe Chest Pain: If you experience severe chest pain, shortness of breath, or fainting.
- Severe Dizziness: If you feel like you might faint or if the dizziness is accompanied by other severe symptoms.
Remember, while I can provide information and suggestions, I am not a doctor. Please seek care from real health professionals to receive a formal diagnosis and appropriate treatment.
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3 mo ago