[33F] Experiencing upper back pain, vomiting, and diarrhea

Patient Description

A 33-year-old female presents with a one-week history of upper back pain, vomiting, and diarrhea. The diarrhea is described as smelly and loose, occurring twice daily, without any specific food triggers or presence of blood or mucus. Vomiting occurs once nightly, a few hours after eating, and involves the expulsion of a full meal. The patient also experiences a constant dull upper back pain before vomiting, which resolves post-emesis. The pain is rated as a 4 out of 10 in severity and is not affected by movements or activities. The patient denies any recent travel, fever, chills, severe abdominal pain, signs of dehydration, unintentional weight loss, difficulty breathing, or jaundice. There is no family history of gastrointestinal or gallbladder diseases, no known drug allergies, and no recent use of alcohol or recreational drugs. The patient's medical history is unremarkable, with no pre-existing conditions or chronic illnesses. Current medications include Vilazodone and Rosuvastatin, both at 10 mg once daily, with no reported side effects. There is no history of recent injuries or accidents that could account for the back pain.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastroenteritis: An inflammation of the digestive tract, often caused by a viral or bacterial infection. It typically presents with diarrhea, vomiting, and sometimes abdominal pain.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics may be prescribed if a bacterial infection is suspected.

  • Gastritis: Inflammation of the stomach lining, which can cause vomiting and upper abdominal pain. It can be caused by prolonged use of certain medications, excessive alcohol consumption, chronic stress, or certain bacterial infections.

    • Treatment typically involves antacids, proton pump inhibitors, and avoiding irritant substances.

  • Gallstones: Hardened deposits in the gallbladder that can cause pain in the upper right abdomen or upper back, especially after eating a meal. The pain can be constant and may last from a few minutes to several hours.

    • Treatment can range from watchful waiting to surgical removal of the gallbladder, depending on the severity and frequency of symptoms.

  • Pancreatitis: Inflammation of the pancreas, which can cause upper abdominal pain that radiates to the back, as well as nausea and vomiting. It can be caused by gallstones, excessive alcohol consumption, or certain medications.

    • Treatment typically involves hospitalization for pain management and hydration.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Stay hydrated: Diarrhea and vomiting can cause you to lose a lot of fluids and electrolytes quickly, which can lead to dehydration. Be sure to drink plenty of fluids, preferably with electrolytes (like sports drinks or oral rehydration solutions).

  2. Rest: Your body needs energy to fight off an infection or recover from an illness. Make sure you're getting plenty of sleep and taking it easy.

  3. Over-the-counter remedies: There are several over-the-counter medications that can help manage diarrhea and vomiting. Be sure to follow the instructions on the packaging.

  4. Seek medical attention: If your symptoms persist or worsen, or if you develop new symptoms such as severe abdominal pain, blood in your stool or vomit, or signs of dehydration (like dizziness, dry mouth, or decreased urination), seek medical attention immediately.

What you should look out for

  • Severe abdominal pain
  • Blood in your stool or vomit
  • Signs of dehydration (like dizziness, dry mouth, or decreased urination)
  • Unintentional weight loss
  • Yellowing of your skin or eyes

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago

People Also Ask

What are the common causes of upper back pain accompanied by vomiting and diarrhea?

Common causes of upper back pain with vomiting and diarrhea include gastroenteritis, gastritis, gallstones, and pancreatitis. Each condition has distinct characteristics, but they can overlap, so a medical evaluation is important.

How can I differentiate between gastroenteritis and gastritis based on symptoms?

Gastroenteritis often involves diarrhea and vomiting due to an infection, while gastritis typically involves upper abdominal pain and vomiting due to stomach lining inflammation. Gastroenteritis may also present with fever and dehydration, whereas gastritis might be linked to specific irritants like certain medications or stress.

What are the potential risks of untreated gallstones or pancreatitis?

Untreated gallstones can lead to complications such as cholecystitis (inflammation of the gallbladder), pancreatitis, or bile duct obstruction. Pancreatitis, if untreated, can cause severe complications like infection, tissue damage, or systemic inflammation.

What steps can I take at home to manage symptoms of vomiting and diarrhea?

To manage symptoms at home, stay hydrated with fluids containing electrolytes, rest, and consider over-the-counter medications for symptom relief. Avoid irritant foods and seek medical attention if symptoms persist or worsen.

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