[30M] With sharp upper abdominal pain and vomiting

Patient Description

A 30-year-old male presents with sharp upper abdominal pain that started suddenly 4 days ago. The pain is rated as a 6 out of 10 in severity and is somewhat alleviated by the application of heat. The patient also reports experiencing vomiting and a loss of appetite. There have been no changes in stool color or consistency. The patient has been using ketamine frequently, although the exact dosage is unknown. No recent changes in diet or new medications were reported prior to the onset of symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—sharp upper abdominal pain, frequent vomiting, and loss of appetite, along with recent ketamine use—there are a few possible explanations:

  1. Gastritis or Peptic Ulcer Disease: The use of substances like ketamine can irritate the stomach lining, potentially leading to gastritis or ulcers. These conditions can cause sharp abdominal pain and vomiting.

    • Treatment typically involves medications to reduce stomach acid and allow healing, such as proton pump inhibitors or H2 blockers. Avoiding irritants like alcohol, NSAIDs, and certain foods is also recommended.

  2. Pancreatitis: This is inflammation of the pancreas, which can cause sudden and severe abdominal pain, often accompanied by vomiting. Substance use can be a contributing factor.

    • Treatment usually requires hospitalization for pain management, IV fluids, and sometimes antibiotics.

  3. Substance-Induced Gastrointestinal Distress: Ketamine and other substances can cause gastrointestinal symptoms, including nausea and vomiting, due to their effects on the digestive system.

    • Reducing or stopping the use of the substance and seeking medical advice for support and management is crucial.

What you can do

It's important to consult a healthcare professional to get a proper diagnosis and treatment plan. In the meantime, you can try the following:

  1. Avoid Irritants: Try to avoid substances that can further irritate your stomach, such as alcohol, caffeine, and spicy foods.
  2. Stay Hydrated: Vomiting can lead to dehydration, so it's important to drink clear fluids like water or an electrolyte solution.
  3. Rest Your Stomach: Consider eating bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet) once you can tolerate food.
  4. Use MDandMe: You can use the MDandMe app to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

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

  • Severe or worsening abdominal pain
  • Blood in your vomit or stool
  • Signs of dehydration, such as dizziness, dry mouth, or reduced urination
  • Persistent vomiting that prevents you from keeping fluids down

Remember, while this information can be helpful, it's important to see a healthcare professional for a formal diagnosis and treatment plan.

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27 d ago

People Also Ask

What are the common symptoms of gastritis or peptic ulcer disease?

Common symptoms of gastritis or peptic ulcer disease include sharp or burning abdominal pain, nausea, vomiting, bloating, and a feeling of fullness. These symptoms can be exacerbated by certain foods, stress, or medications.

How does ketamine use affect the digestive system?

Ketamine use can affect the digestive system by causing nausea, vomiting, and abdominal pain. It can irritate the stomach lining and potentially lead to conditions like gastritis or ulcers.

What are the signs and symptoms of pancreatitis?

Signs and symptoms of pancreatitis include sudden and severe abdominal pain, nausea, vomiting, fever, and a rapid pulse. The pain often radiates to the back and may be relieved by leaning forward.

What dietary changes can help alleviate gastrointestinal distress?

Dietary changes that can help alleviate gastrointestinal distress include eating bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet), avoiding irritants such as alcohol, caffeine, and spicy foods, and staying hydrated with clear fluids.

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