[26M] Experiencing severe abdominal pain, difficulty swallowing, and exhaustion

Patient Description

A 26-year-old male has been experiencing a range of concerning symptoms for approximately 3 months, which include severe burning and stabbing pain on the right side of the abdomen just below the ribs, rated as a 7 out of 10 in severity, and a burning pain in the stomach. The patient also reports difficulty swallowing, particularly with spicy foods and meats, describing a sensation of throat swelling or obstruction. Additionally, there is pain and dryness in the throat, with the patient spitting up blood and a tanish substance each morning. The patient is experiencing extreme exhaustion and fatigue, a significant loss of appetite, and difficulty eating due to pain. There are also reported issues with recognizing the need to use the restroom, with the most recent bowel movement being described as diarrhea. The patient has been diagnosed with acid reflux since 2016 and is currently taking omeprazole 20mg once daily. No recent injuries, fever, or chills have been reported. The patient has had similar issues on and off for years, suggesting a chronic condition. No other pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastroesophageal Reflux Disease (GERD): This is a more severe form of acid reflux, which you have been previously diagnosed with. GERD can cause burning pain in the stomach and throat, difficulty swallowing, and even blood in the vomit if the esophagus is severely irritated.

    • Treatment usually involves lifestyle changes and medications like proton pump inhibitors (which you are already taking), but in severe cases, surgery may be necessary.

  • Peptic Ulcer Disease: This condition involves sores that develop in the lining of the stomach, upper small intestine or esophagus. Symptoms can include burning stomach pain, feeling of fullness, bloating, fatty food intolerance, heartburn, and nausea.

    • Treatment usually involves medications to decrease stomach acid and protect the lining of the stomach, and in some cases, antibiotics to treat a bacterial infection.

  • Gastritis: This is an inflammation of the stomach lining, which can cause burning pain in the stomach, nausea, vomiting, and feeling of fullness in your upper abdomen after eating.

    • Treatment usually involves medications to reduce stomach acid, and in some cases, antibiotics to treat a bacterial infection.

  • Gallstones: These are hardened deposits in the gallbladder that can cause pain in the upper right abdomen.

    • Treatment can range from watchful waiting to surgical removal of the gallbladder.

Please note that these are potential diagnoses and it's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed medication (omeprazole) as directed by your doctor.
  2. Try to identify any triggers for your symptoms and avoid them. Common triggers for GERD and gastritis include spicy foods, caffeine, alcohol, and fatty foods.
  3. Eat smaller, more frequent meals instead of three large meals a day.
  4. Don't lie down or go to sleep immediately after eating. Wait at least three hours after your last meal of the day before going to bed.
  5. Elevate the head of your bed or use a wedge-shaped pillow to help keep stomach acid in your stomach where it belongs.
  6. Drink plenty of fluids to stay hydrated, especially if you're experiencing diarrhea.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool or black, tarry stools
  • Blood in your vomit or vomit that looks like coffee grounds
  • Unexplained weight loss
  • Difficulty swallowing
  • Signs of dehydration, such as dry mouth, extreme thirst, little to no urination, severe weakness, dizziness, or lightheadedness

Remember, I'm an AI and this advice is based on the symptoms you told me. It's important to consult with a healthcare professional who can evaluate your health and provide a formal diagnosis.

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9 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, difficulty swallowing, chest pain, and a sensation of a lump in the throat. Chronic cough, laryngitis, and new or worsening asthma can also be associated with GERD.

How can peptic ulcers be treated effectively?

Peptic ulcers are typically treated with medications that reduce stomach acid, such as proton pump inhibitors or H2-receptor antagonists. If a bacterial infection (H. pylori) is present, antibiotics may be prescribed. Lifestyle changes, such as avoiding NSAIDs, reducing stress, and avoiding alcohol and smoking, can also help.

What lifestyle changes can help manage gastritis symptoms?

To manage gastritis symptoms, it is recommended to avoid irritants like alcohol, spicy foods, and caffeine. Eating smaller, more frequent meals, managing stress, and avoiding lying down immediately after eating can also help. Medications to reduce stomach acid may be prescribed by a doctor.

What are the signs that gallstones might require surgical intervention?

Signs that gallstones might require surgical intervention include severe and persistent abdominal pain, jaundice (yellowing of the skin and eyes), fever, and signs of infection. If gallstones cause complications like pancreatitis or cholecystitis, surgery to remove the gallbladder may be necessary.

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1 Comments

Leo#3962

8 mo ago

Did you get any insights into what is happening? The best test would probably be an endoscopy, not sure if you got one?

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