[28F] Experiencing stomach acid discharge from nose with headache and limb swelling

Patient Description

A 28-year-old female reports a sudden onset of stomach acid pouring out of her nose upon waking, continuing as a slow drip for approximately 4-5 hours. She is not experiencing vomiting, and the symptom is isolated to nasal discharge. Accompanying symptoms include an aching headache rated 5/10 in intensity, located at the back of the head, which worsens with movement and has been present for about 5 hours. Additionally, the patient describes bilateral tight and painful swelling in the calves, ankles, and forefoot, persisting for about 8 hours. The patient is a known type 2 diabetic diagnosed in 2018 and is currently taking Tylenol (500mg three times daily) for chronic back pain. She has allergies to NSAIDs, iodine, and IV dye. No other medications or recent changes in medication have been 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 condition 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 and cause symptoms like the one you're experiencing.

    • Treatment often includes lifestyle modifications and over-the-counter medications. In severe cases, prescription medications or surgery might be recommended.
  • Sinusitis: This is inflammation or swelling of the tissue lining the sinuses. It can cause mucus build-up that can drip down the back of the throat (post-nasal drip), leading to a sore throat or nausea. However, it's less common for it to cause the sensation of stomach acid in the nose.

    • Treatment usually involves self-care measures and medical therapy.
  • Edema: This is swelling caused by excess fluid trapped in your body's tissues. It can be the result of medication, pregnancy, or an underlying disease — often congestive heart failure, kidney disease, or cirrhosis of the liver.

    • Treatment typically focuses on managing the underlying condition that's causing the edema.

What you can do

  1. For GERD, lifestyle changes can often help reduce heartburn. These include eating smaller meals, avoiding food and drinks that trigger heartburn (such as fatty or fried foods, tomato sauce, alcohol, mint, garlic, onion, and caffeine), not lying down after a meal, maintaining a healthy weight, and quitting smoking.

  2. For sinusitis, you can try a few home remedies such as applying a warm compress to your face, inhaling steam, and using a saline nasal spray.

  3. For edema, you can try elevating your legs when you're lying down, and moving your legs frequently when you're sitting.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty swallowing
  • Persistent vomiting
  • Vomit that's bloody or looks like coffee grounds
  • Shortness of breath or chest pain
  • An irregular heartbeat

Remember, I'm an AI and this advice is based on the information you've provided. It's always a good idea to consult with a healthcare professional who can evaluate your symptoms and medical history.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What could cause stomach acid to come out of the nose without vomiting?

Stomach acid coming out of the nose without vomiting could be due to severe gastroesophageal reflux disease (GERD), where acid flows back into the esophagus and potentially into the nasal passages. It's important to consult a healthcare provider for proper diagnosis and treatment.


How can I manage headaches that worsen with movement?

Headaches that worsen with movement could be tension headaches or related to sinus issues. Managing them may involve rest, hydration, and over-the-counter pain relief like acetaminophen, but it's best to consult a doctor for persistent or severe headaches.


What are common causes of swelling in the calves, ankles, and feet?

Swelling in the calves, ankles, and feet, known as edema, can be caused by various factors including prolonged sitting or standing, high salt intake, certain medications, or underlying health conditions like heart, kidney, or liver issues. It's important to seek medical advice to determine the cause.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD symptoms include eating smaller meals, avoiding trigger foods and drinks, not lying down immediately after eating, maintaining a healthy weight, and quitting smoking. These changes can help reduce the frequency and severity of acid reflux.


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