[31F] Experiencing vomiting, constipation, and abdominal pain post-gallbladder removal

Patient Description

A 31-year-old female has been experiencing vomiting, constipation, and abdominal pain for several months. The patient reports vomiting three times in the past 24 hours, often in the mornings, accompanied by nausea throughout most days. The constipation has been on and off for months, with the last bowel movement described as hard, dark orange, and clay-like in texture. The patient also experiences a dull ache in the area where the gallbladder used to be, with occasional intensification of the pain. Additionally, the patient has noticed chills, slightly yellow skin around the eyes, dark urine, dizziness, and an increase in urination. The patient has a history of GERD, depression, anxiety, migraines, and has had her gallbladder removed. Current medications include Buspirone, Fluoxetine, Qulipta, Ondansetron, and Famotidine. The patient uses nicotine daily. No known drug allergies or family history of gallstones or gallbladder disease were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • 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. Symptoms include nausea, vomiting, and abdominal pain. You mentioned having a history of GERD, and it's possible that your current symptoms are related to this condition.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or even surgery may be required.

  • Gastroparesis: This is a condition that affects the stomach muscles and prevents proper stomach emptying. Symptoms can include nausea, vomiting, abdominal pain, and changes in blood sugar levels. Gastroparesis can be caused by damage to the vagus nerve, which controls the stomach muscles. This damage can be caused by various factors, including surgery.

    • Treatment typically involves dietary changes, medications, and in severe cases, feeding tubes or surgery.

  • Bile Acid Malabsorption (BAM): This is a condition where your intestines can't absorb bile acids properly. This results in too much bile acid in your colon, which can cause watery diarrhea and abdominal pain. BAM can occur in people who have had their gallbladder removed.

    • Treatment typically involves medications to bind the bile acids and reduce symptoms.

Please note that these are possibilities based on the symptoms you've described, and they are not definitive diagnoses. It's important to consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Keep a symptom diary: Note down when your symptoms occur, what you're eating, and any other relevant factors. This can help you and your healthcare provider identify any patterns or triggers.
  2. Stay hydrated: Vomiting and diarrhea can cause you to lose fluids and electrolytes, which can lead to dehydration. Make sure to drink plenty of fluids, and consider drinks with electrolytes if your symptoms are severe.
  3. Eat small, frequent meals: This can be easier on your stomach than large meals.
  4. Avoid triggers: If you notice that certain foods or activities make your symptoms worse, try to avoid them.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Severe dehydration symptoms, such as extreme thirst, very dry mouth, skin, or mucous membranes, little or no urination, severe weakness, dizziness, or lightheadedness, or feeling faint
  • Unexplained weight loss
  • Difficulty swallowing

Please remember that while I strive to provide accurate and helpful health information, this advice is not a substitute for professional medical advice. Always consult with a healthcare provider for an accurate diagnosis and treatment options.

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8 mo ago

People Also Ask

What are the common symptoms of GERD and how can they be managed?

Common symptoms of GERD include heartburn, regurgitation, nausea, vomiting, and abdominal pain. Management typically involves lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Medications like antacids, H2 blockers, or proton pump inhibitors may also be used.

What is gastroparesis and what are its potential causes?

Gastroparesis is a condition where the stomach cannot empty properly due to impaired muscle function. It can be caused by damage to the vagus nerve, diabetes, certain medications, or surgery. Symptoms include nausea, vomiting, abdominal pain, and bloating.

How does bile acid malabsorption affect individuals who have had their gallbladder removed?

Bile acid malabsorption can occur after gallbladder removal because the gallbladder's role in bile storage is disrupted. This can lead to excess bile acids in the colon, causing diarrhea and abdominal pain. Treatment often involves bile acid sequestrants to bind the bile acids and alleviate symptoms.

What are the signs of dehydration and how can it be prevented during episodes of vomiting?

Signs of dehydration include extreme thirst, dry mouth, decreased urination, dizziness, and weakness. To prevent dehydration during vomiting episodes, it's important to drink plenty of fluids, including oral rehydration solutions or drinks with electrolytes, and to seek medical attention if symptoms are severe.

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