[30F] Experiencing persistent nausea and anxiety

Patient Description

A 30-year-old female has been experiencing persistent nausea for months, which worsens with the smell of food and during episodes of diarrhea or heart palpitations. The nausea is present every morning and has been constant throughout the day for the past two days. The patient also reports anxiety and panic attacks that have been ongoing for months, significantly impacting her daily life by causing frequent crying, poor sleep, and short temper with loved ones. Additional symptoms include headaches, heart palpitations, loss of appetite, and diarrhea. The patient has experienced chest pain but no fainting episodes or recent changes in weight. There is no family history of anxiety or other mental health disorders, and the patient is not currently taking any medications.

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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:

  • Generalized Anxiety Disorder (GAD): This condition can cause persistent and excessive worry about various aspects of life. Symptoms often include anxiety, panic attacks, heart palpitations, headaches, nausea, loss of appetite, and gastrointestinal issues like diarrhea.

    • Treatment: Treatment typically involves a combination of medication (such as SSRIs or benzodiazepines) and therapy (such as cognitive-behavioral therapy). Lifestyle changes, such as regular exercise and mindfulness practices, can also be beneficial.
  • Panic Disorder: This condition is characterized by recurrent, unexpected panic attacks, which can include symptoms like heart palpitations, sweating, trembling, shortness of breath, and gastrointestinal symptoms.

    • Treatment: Similar to GAD, treatment often includes medication and therapy. Learning relaxation techniques and avoiding triggers can also help manage symptoms.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like diarrhea, cramping, and nausea. Stress and anxiety can exacerbate IBS symptoms.

    • Treatment: Treatment may include dietary changes, medications to manage symptoms, and stress management techniques.
  • Gastroesophageal Reflux Disease (GERD): This condition can cause nausea, heartburn, and other gastrointestinal symptoms, which may be worse on an empty stomach.

    • Treatment: Treatment typically involves dietary changes, medications to reduce stomach acid, and lifestyle modifications like avoiding lying down after eating.

What you can do

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

  1. Practice Stress Management: Techniques such as deep breathing exercises, meditation, and yoga can help manage anxiety and reduce the frequency of panic attacks.
  2. Maintain a Healthy Diet: Eating small, frequent meals and avoiding foods that trigger your symptoms can help manage nausea and gastrointestinal issues. Keeping a food diary might help identify triggers.
  3. Stay Hydrated: Drink plenty of water, especially if you are experiencing diarrhea.
  4. Regular Exercise: Physical activity can help reduce anxiety and improve overall well-being.
  5. Sleep Hygiene: Establish a regular sleep routine and create a calming bedtime environment to improve sleep quality.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Persistent Chest Pain: This could be a sign of a more serious condition and should be evaluated by a healthcare professional.
  • Severe Abdominal Pain or Blood in Stool: These symptoms could indicate a more serious gastrointestinal issue.
  • Worsening Symptoms: If your symptoms continue to worsen despite trying the above measures, it is important to seek medical advice.

Remember, while these suggestions can help manage your symptoms, it is crucial to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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7 mo ago

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

People Also Ask


What are the common symptoms of Generalized Anxiety Disorder (GAD)?

Common symptoms of Generalized Anxiety Disorder (GAD) include persistent and excessive worry, anxiety, panic attacks, heart palpitations, headaches, nausea, loss of appetite, and gastrointestinal issues like diarrhea.


How can stress and anxiety affect gastrointestinal health?

Stress and anxiety can exacerbate gastrointestinal issues by increasing stomach acid production, altering gut motility, and affecting the gut-brain axis, leading to symptoms like nausea, diarrhea, and cramping.


What lifestyle changes can help manage symptoms of panic disorder?

Lifestyle changes that can help manage symptoms of panic disorder include practicing relaxation techniques such as deep breathing and meditation, engaging in regular physical exercise, avoiding known triggers, and maintaining a healthy sleep routine.


What are some dietary recommendations for managing Irritable Bowel Syndrome (IBS)?

Dietary recommendations for managing Irritable Bowel Syndrome (IBS) include eating small, frequent meals, avoiding foods that trigger symptoms (such as high-fat or spicy foods), increasing fiber intake gradually, and staying hydrated. Keeping a food diary can help identify specific triggers.


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