[27F] Experiencing chronic stomach pain, dizziness, and rapid heart rate

Patient Description

A 27-year-old female presents with a 10-year history of chronic stomach pain described as sharp in the center of the stomach and cramp-like in the intestines, rated a 6 out of 10 in severity on most days. The pain typically occurs within 5 minutes after eating. Additionally, she experiences moderate dizziness, particularly when getting up or walking up or down stairs, which has been ongoing for 3 months. She also reports a rapid heart rate, severe chest pain, and episodes of vomiting light red blood despite an EGD showing no ulcers. The patient has signs of anemia but tests negative for it, feels tired all the time, and sleeps a lot. She has a family history of gastrointestinal issues and has been diagnosed with Acid Reflux as a baby, IBS C at age 16, and Bile Reflux at age 27. Gallbladder removal is noted in her surgical history. She reports an adverse reaction to Ablilify and IV contrast. No current medications were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing 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, causing heartburn and other symptoms. You've mentioned a diagnosis of acid reflux, which is a key symptom of GERD.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend stronger medications or surgery.
  • Bile Reflux: This condition occurs when bile — a digestive liquid produced in your liver — flows upward from your small intestine into your stomach and esophagus. Bile reflux may accompany acid reflux, but the two are separate conditions. They can occur together because the same muscle prevents acid and bile reflux.

    • Treatment involves medications that reduce the production of bile or decrease its present symptoms.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

    • Treatment focuses on relieving symptoms so that you can live as normally as possible.
  • Postcholecystectomy Syndrome (PCS): This refers to a complex of heterogeneous symptoms, including persistent abdominal pain and dyspepsia that recur and persist after cholecystectomy (gallbladder removal).

    • Treatment is based on the specific cause of the patient's symptoms and may involve medications or further surgery.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. This could explain your dizziness and fast heart rate.

    • Treatment depends on the cause of your orthostatic hypotension. Simple lifestyle measures or medications can be used.

What you can do

  1. Lifestyle changes: Avoid food and drinks that trigger heartburn. These include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Try to eat smaller meals and avoid eating before bedtime.
  2. Over-the-counter treatments: Antacids can neutralize stomach acid. Medications to reduce acid production can help. These include H-2-receptor blockers and Proton pump inhibitors.
  3. Prescription medications: If over-the-counter treatments aren't helping, your doctor might recommend prescription-strength H-2-receptor blockers and proton pump inhibitors.
  4. Stay hydrated: Make sure to drink plenty of fluids to avoid dehydration from vomiting.
  5. Monitor your symptoms: Keep track of your symptoms and what you eat. This could help identify triggers for your symptoms and can be useful when discussing your condition with your doctor.

What you should look out for

If you notice any of the following symptoms, seek medical attention immediately:

  • Severe, persistent abdominal pain
  • Bloody or black stools
  • Bloody or black vomit
  • Difficulty swallowing
  • Unexplained weight loss
  • Chest pain, shortness of breath, jaw pain, or arm pain

Please remember that while I strive to provide accurate and helpful health information, this advice is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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9 mo ago


People Also Ask


What could be causing my chronic stomach pain and cramping after eating?

Chronic stomach pain and cramping after eating could be due to conditions like Gastroesophageal Reflux Disease (GERD), Bile Reflux, or Irritable Bowel Syndrome (IBS). These conditions can cause discomfort and pain after meals due to acid or bile reflux and intestinal cramping.


Why am I experiencing dizziness and a rapid heart rate when standing up?

Dizziness and a rapid heart rate when standing up could be symptoms of orthostatic hypotension, a condition where blood pressure drops significantly upon standing. This can lead to dizziness and an increased heart rate as the body tries to compensate.


What are the potential treatments for bile reflux?

Treatment for bile reflux may involve medications that reduce bile production or alleviate symptoms, such as bile acid sequestrants. In some cases, surgery might be considered if medications are not effective.


How can I manage symptoms of IBS effectively?

Managing IBS symptoms often involves dietary changes, such as increasing fiber intake, avoiding trigger foods, and possibly using medications to relieve symptoms like cramping and diarrhea or constipation. Stress management and regular exercise can also help.

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