[27M] Experiencing intense nausea and appetite loss with elevated bilirubin

Patient Description

A 27-year-old male presents with intense nausea persisting for 9 days without vomiting. The nausea is exacerbated by eating, leading to a severe lack of appetite and subsequent weight loss. The patient has been prescribed Phenergan (25 mg every 6 hours), which provides partial relief. The patient's urine is darker, particularly in the morning, and stools are lighter with a mucus-like substance, but no severe abdominal pain or blood has been noted. There is a family history of fatty liver disease and gallbladder removal in the patient's father. The patient's medical history is notable for seasonal allergies and childhood asthma, with current medications including over-the-counter Omeprazole for indigestion and recently prescribed Phenergan for nausea. No known drug allergies or use of recreational drugs, alcohol, or unprescribed medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can cause nausea, vomiting, and changes in bowel movements. However, it usually resolves within a few days, so the duration of your symptoms is a bit unusual for this condition.

    • Treatment typically involves rest, hydration, and eating bland foods as tolerated.

  • Gallbladder disease: Given your family history of gallbladder disease, this is also a possibility. Gallbladder disease can cause nausea, changes in bowel movements, and jaundice (yellowing of the skin and eyes), which could explain your slightly elevated bilirubin levels. However, it typically also causes abdominal pain, which you have not reported.

    • Treatment can range from dietary changes to surgery, depending on the severity and type of gallbladder disease.

  • Liver disease: Conditions such as hepatitis or cirrhosis can cause nausea, changes in bowel movements, and jaundice. Your elevated bilirubin levels and potential slight yellowing of the skin could be indicative of liver disease. However, these conditions are typically associated with risk factors such as alcohol use, drug use, or certain medical conditions, which you have not reported.

    • Treatment depends on the specific type of liver disease and its severity, but can include medication, lifestyle changes, or in severe cases, liver transplantation.

What you can do

Given the duration and severity of your symptoms, it's important to seek medical attention. Your doctor may want to run further tests, such as blood tests or imaging studies, to better understand what's causing your symptoms. In the meantime, continue to stay hydrated and eat as tolerated.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool or dark, tarry stools
  • High fever (temperature over 100.4°F)
  • Persistent vomiting
  • Yellowing of the skin or eyes

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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9 mo ago

People Also Ask

What could be causing persistent nausea without vomiting?

Persistent nausea without vomiting can be caused by various conditions, including gastroenteritis, gallbladder disease, or liver issues. It's important to consult a healthcare provider for a proper diagnosis, especially if symptoms persist.

How does family history of gallbladder disease affect my symptoms?

A family history of gallbladder disease can increase your risk of developing similar issues. Symptoms like nausea and changes in bowel movements could be related, but a medical evaluation is necessary to determine the exact cause.

What are the signs that my symptoms might be related to liver disease?

Signs that your symptoms might be related to liver disease include jaundice (yellowing of the skin and eyes), dark urine, light-colored stools, and elevated bilirubin levels. It's important to seek medical evaluation for these symptoms.

What lifestyle changes can help manage nausea and digestive issues?

To manage nausea and digestive issues, consider eating smaller, more frequent meals, avoiding fatty or spicy foods, staying hydrated, and avoiding alcohol and caffeine. It's also important to follow any specific dietary recommendations from your healthcare provider.

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