[29F] Experiencing fatigue, nausea, and gastrointestinal symptoms

Patient Description

A 29-year-old female reports severe fatigue persisting for about a month, with no specific exacerbating factors but a possible consideration of caffeine impact. She experiences nausea rated 3-4 out of 10, which is worse in the morning and sometimes leads to vomiting of yellow stomach acid once a week. The patient has a low appetite and has noticed occasional blood in her stool, which she attributes to untreated hemorrhoids from childbirth several years ago. Her medical history includes treatment for Helicobacter pylori infection 7 years ago. She is not currently on any medications and reports no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several conditions could be causing your symptoms:

  • Gastroenteritis: This is an inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection. It can cause symptoms such as vomiting, nausea, and fatigue.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. In severe cases, antibiotics may be prescribed.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic 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 and cause symptoms like vomiting yellow acid, nausea, and fatigue.

    • Treatment typically involves lifestyle changes, over-the-counter medications, prescription medications, or even surgery in severe cases.
  • Peptic Ulcer: These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain, but they can also cause nausea, vomiting, and fatigue.

    • Treatment typically involves medications to decrease stomach acid and protect the lining of your stomach and duodenum.
  • Anemia: This is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. It can cause symptoms like fatigue and weakness.

    • Treatment depends on the cause of the anemia, but may include dietary changes, supplements, medications, procedures, or surgery to treat bleeding.
  • Hemorrhoids: These are swollen veins in your lower rectum. Internal hemorrhoids can cause painless, bright red blood around your stool or on your toilet paper after wiping. External hemorrhoids can cause pain and itching.

    • Treatment typically involves at-home remedies, over-the-counter creams or suppositories, minimally invasive procedures, or surgery.

Please note that this is not an exhaustive list and other conditions could also be causing your symptoms.

What you can do

  1. Make an appointment with your healthcare provider to discuss your symptoms. They may want to perform tests or refer you to a specialist.
  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can help your healthcare provider diagnose your condition.
  3. Stay hydrated, especially if you're experiencing vomiting. Dehydration can make many symptoms worse.
  4. Try to eat small, bland meals if you're experiencing nausea. Avoid foods that are spicy, fatty, or hard to digest.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or don't improve after a few days
  • You have severe abdominal pain
  • You're unable to keep down fluids due to vomiting
  • You notice a significant amount of blood in your stool or if your stool is black and tarry

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common causes of severe fatigue in young adults?

Severe fatigue in young adults can be caused by a variety of factors including stress, poor diet, lack of sleep, anemia, thyroid disorders, chronic infections, and mental health issues like depression or anxiety. It's important to consult a healthcare provider for a proper diagnosis.


How can I differentiate between GERD and a peptic ulcer based on symptoms?

GERD typically causes symptoms like heartburn, acid reflux, and regurgitation, while a peptic ulcer often presents with burning stomach pain, bloating, and nausea. Both conditions can cause fatigue and nausea, but a healthcare provider can perform tests like endoscopy or pH monitoring to differentiate between them.


What are the potential complications of untreated hemorrhoids?

Untreated hemorrhoids can lead to complications such as persistent pain, bleeding, anemia from chronic blood loss, and in severe cases, thrombosis or strangulation of the hemorrhoid. It's advisable to seek treatment to prevent these complications.


How is anemia diagnosed and treated?

Anemia is diagnosed through blood tests that measure levels of hemoglobin and red blood cells. Treatment depends on the cause and may include dietary changes, iron supplements, vitamin B12 or folic acid supplements, medications, or procedures to address underlying causes like bleeding.


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