[28F] With nausea, diarrhea, and abdominal pain

Patient Description

A 28-year-old female has been experiencing nausea, diarrhea, and abdominal pain for the past three days. The nausea is relatively constant and came on suddenly, with no relief from bland foods or other measures. The abdominal pain is described as crampy and located in the mid to lower abdomen, with a severity of 4 out of 10. The patient also reports diarrhea with loose, foul-smelling stools that come in tiny pieces. She has not traveled recently or been exposed to new foods or environments. Additionally, she experiences mild regurgitation with a sour taste in the back of her throat, sometimes accompanied by burping that tastes like throw up. Her stomach also makes strange noises. She has not experienced any fever or chills and has not started any new medications recently. The patient works in a school and has been in contact with people, some of whom tested positive for COVID, but her test came back negative. Her medical history includes ADHD (diagnosed in 2013), hypoglycemia (diagnosed around 2009), anemia (diagnosed in 2016), and occasional acid reflux with a clear endoscopy in 2020. She is currently taking Adderall (15 mg twice a day) and iron supplements (65 mg once a day). She has allergies to Rocephin and pollen.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms typically include nausea, diarrhea, stomach pain, and sometimes regurgitation. Given your work environment in a school, it's possible you may have been exposed to a virus or bacteria causing these symptoms.

    • Treatment: Gastroenteritis usually resolves on its own within a few days. Staying hydrated and resting are key. In some cases, over-the-counter medications can help manage symptoms.

  • Food Poisoning: This occurs when you consume contaminated food or water. Symptoms can include nausea, diarrhea, stomach pain, and regurgitation. Eating at restaurants recently could be a potential source.

    • Treatment: Similar to gastroenteritis, food poisoning often resolves on its own. Hydration and rest are important. If symptoms persist, a doctor may prescribe antibiotics if a bacterial infection is suspected.

  • Acid Reflux (GERD): Although you mentioned no heartburn, regurgitation with a sour taste in the throat can be a symptom of gastroesophageal reflux disease (GERD). This condition occurs when stomach acid flows back into the esophagus.

    • Treatment: Lifestyle changes such as eating smaller meals, avoiding certain foods, and not lying down immediately after eating can help. Over-the-counter antacids or medications may also be recommended.

  • Irritable Bowel Syndrome (IBS): This is a chronic condition that affects the large intestine, causing symptoms like crampy abdominal pain, diarrhea, and changes in bowel habits. Stress and certain foods can trigger symptoms.

    • Treatment: Managing IBS often involves dietary changes, stress management, and sometimes medications to relieve symptoms.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Stay Hydrated: Drink plenty of fluids, such as water, clear broths, or oral rehydration solutions, to prevent dehydration from diarrhea.
  2. Eat Bland Foods: Stick to bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet) until your symptoms improve.
  3. Rest: Give your body time to recover by getting plenty of rest.
  4. Avoid Triggers: Avoid foods and drinks that can irritate your stomach, such as caffeine, alcohol, fatty foods, and spicy foods.
  5. Use MDandMe: Journal your symptoms, track your progress, and get insights. This can help you and your healthcare provider understand your condition better and make informed decisions.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe Dehydration: Signs include excessive thirst, dry mouth, little or no urination, and dizziness.
  • Persistent Symptoms: If your symptoms do not improve after a few days or worsen.
  • Blood in Stool: If you notice blood in your stool or black, tarry stools.
  • High Fever: A fever over 100.4°F (38°C) that does not go away.
  • Severe Abdominal Pain: Pain that is intense and does not go away.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.

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3 mo ago

People Also Ask

What are the common causes of nausea and diarrhea?

Common causes of nausea and diarrhea include viral or bacterial infections (such as gastroenteritis), food poisoning, stress, and certain medications. It's important to consider recent dietary changes or exposure to sick individuals.

How can I differentiate between gastroenteritis and food poisoning?

Gastroenteritis and food poisoning can have similar symptoms, such as nausea, diarrhea, and abdominal pain. Gastroenteritis is often viral and can spread from person to person, while food poisoning is typically caused by consuming contaminated food or water. The onset of symptoms in food poisoning is usually more rapid after eating the contaminated food.

What lifestyle changes can help manage acid reflux symptoms?

To manage acid reflux symptoms, try eating smaller meals, avoiding foods that trigger symptoms (like spicy or fatty foods), not lying down immediately after eating, elevating the head of your bed, and maintaining a healthy weight. Over-the-counter antacids may also provide relief.

When should I seek medical attention for abdominal pain and diarrhea?

Seek medical attention if you experience severe dehydration, persistent symptoms that do not improve after a few days, blood in your stool, a high fever, or severe abdominal pain that does not go away. These could be signs of a more serious condition requiring medical intervention.

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