[33F] With severe vomiting, stomach pain, and lightheadedness

What might be happening

Based on the information you have provided, there are several potential diagnoses that could explain your symptoms:

• Gastrointestinal Disorders: Conditions such as gastroparesis (delayed stomach emptying) or cyclic vomiting syndrome (CVS) could cause severe vomiting, stomach pain, and difficulty keeping food down. Gastroparesis can be related to nerve damage, which might be relevant given your history of substance use. CVS is characterized by recurrent, severe episodes of vomiting.

  • Treatment: Treatment for gastroparesis may include dietary changes, medications to stimulate stomach emptying, and managing underlying conditions. For CVS, treatment often involves anti-nausea medications, hydration, and sometimes medications to prevent episodes.

• Adrenal Insufficiency: This condition, where the adrenal glands do not produce enough hormones, can cause symptoms like severe vomiting, abdominal pain, weight loss, and lightheadedness upon standing (orthostatic hypotension).

  • Treatment: Treatment typically involves hormone replacement therapy to correct the deficiency.

• Substance Withdrawal or Side Effects: Given your recent switch from methadone to Suboxone, it's possible that some of your symptoms could be related to withdrawal or side effects from these medications.

  • Treatment: Managing withdrawal symptoms often requires medical supervision and sometimes adjusting the medication regimen.

• Infections or Inflammatory Conditions: Conditions such as chronic pancreatitis or intestinal infections could cause severe abdominal pain, vomiting, and weight loss.

  • Treatment: Treatment would depend on the specific condition but might include antibiotics for infections or medications to manage inflammation and pain.

What you can do

1. Seek Medical Attention: Given the severity and duration of your symptoms, it is crucial to consult a healthcare provider as soon as possible. They can perform a thorough evaluation, including blood tests, imaging studies, and possibly endoscopic procedures, to determine the cause of your symptoms.

2. Stay Hydrated: Try to sip on clear fluids like water, oral rehydration solutions, or electrolyte drinks to prevent dehydration. Avoid caffeinated or sugary drinks, as they can worsen dehydration.

3. Monitor Your Symptoms: Keep a detailed record of your symptoms, including the timing, triggers, and severity of vomiting episodes, as well as any other symptoms you experience. This information will be helpful for your healthcare provider.

4. Rest and Avoid Triggers: Try to rest as much as possible and avoid any known triggers that could worsen your symptoms. This might include certain foods, stress, or physical exertion.

What you should look out for

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

• Severe Dehydration: Symptoms include dry mouth, extreme thirst, little or no urination, and dizziness.
• Severe Abdominal Pain: If the pain becomes unbearable or is accompanied by a fever, it could indicate a more serious condition.
• Blood in Vomit or Stool: This could be a sign of gastrointestinal bleeding and requires urgent medical attention.
• Severe Lightheadedness or Fainting: If you feel like you are about to faint or actually lose consciousness, seek help immediately.

Remember, while this information can provide some guidance, it is essential to see a healthcare professional for a formal diagnosis and appropriate treatment.