[35F] Experiencing chronic gastrointestinal and neurological symptoms
Patient Description
A 35-year-old female presents with a constellation of symptoms persisting for over a year, including chronic nausea, which is present all day and exacerbated by high stress, particularly worse in the early morning and afternoon. The patient finds relief using marijuana. Additionally, the patient reports occasional blurred vision, described as a difficulty in focusing, lasting for about six months. Dizziness is also reported, characterized by an initial spinning sensation that transitions to lightheadedness, occurring at least once daily and rated as moderate in severity. The patient experiences constipation with bowel movements every 3-4 days, with the last stool described as hard, lumpy, and dark brown with small, white, stringy globs of mucus. The patient also suffers from headaches, occurring at least once a week, with severe episodes lasting 2-3 days, poorly responsive to over-the-counter analgesics, and presenting as aching to throbbing in nature, localized to the temples, behind the eyes, and the forehead. The patient has noted recent changes in weight. Past medical history includes intermittent constipation since childhood. No other medical history, current medications, or allergies have been reported.
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Arora's Assessment
What might be happening
Based on the information you've provided, here are some possible explanations for your symptoms:
- Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like abdominal pain, bloating, gas, and either diarrhea or constipation. The exact cause of IBS is unknown, but it can be triggered by things like stress, hormonal changes, or certain foods. Treatment typically involves lifestyle changes like diet modifications, stress management, and sometimes medications.
- Migraines: These are a type of headache characterized by severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. Treatment typically involves medications to help reduce the frequency and severity of migraines.
- Anxiety disorders: Chronic nausea can sometimes be a symptom of an anxiety disorder. Other symptoms can include restlessness, feeling tense, rapid heart rate, and trouble concentrating. Treatment typically involves psychotherapy, medications, or both.
- Malnutrition or Vitamin Deficiency: Rapid weight loss and a reduced appetite can lead to deficiencies in important nutrients, which can cause a variety of symptoms including dizziness, blurred vision, and skin changes. Treatment would involve addressing the deficiency, often through dietary changes or supplements.
What you can do
- Try to identify any triggers for your symptoms. For example, certain foods might make your IBS symptoms worse, or certain situations might trigger your migraines or anxiety. Avoiding these triggers can help to reduce your symptoms.
- Make sure you're eating a balanced diet and getting enough nutrients. If you're struggling with this, a dietitian might be able to help.
- Try to manage your stress levels. Techniques like deep breathing, meditation, and yoga can be helpful for this.
- Regular physical activity can help to reduce symptoms of IBS and anxiety, and can also help to prevent migraines.
- Over-the-counter medications can help to manage some of your symptoms. For example, there are medications available to help with constipation and nausea. However, you should always check with a healthcare provider before starting any new medication.
What you should look out for
You should seek immediate medical attention if you experience any of the following:
- Severe abdominal pain
- Blood in your stool
- Unexplained weight loss
- Severe or worsening headaches
- Any new or worsening symptoms
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 appropriate examination, testing, and care recommendations.
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11 mo ago