[35M] Experiencing chronic nausea, fatigue, and other symptoms

Patient Description

A 35-year-old male has been experiencing chronic symptoms for several months, including severe nausea (rated 7/10) that occurs mostly in the morning and lasts for hours, fatigue, and a heavy feeling in the head (rated 3/10). The patient also reports a whistling sound in the throat, a runny liquid sensation not like snot, and headaches. Zofran has been ineffective in relieving the nausea. The patient has an allergy to Cephlaclore but is not currently on any medications. There is no significant past medical history, no recent weight loss, no difficulty swallowing, but there is a mention of a burning sensation and some difficulty breathing.

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Arora's Assessment

What might be happening

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

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when 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 and cause symptoms like nausea, a burning sensation, and throat discomfort.

    • Treatment typically involves lifestyle modifications (like avoiding certain foods, not eating before bed, and weight loss if overweight) and medications to reduce stomach acid.
  • Postnasal Drip: This is when excess mucus from your nose goes down the back of your throat. This can cause a runny liquid sensation in your throat, throat discomfort, and sometimes nausea.

    • Treatment typically involves identifying the cause of the excess mucus (like allergies or infections) and treating it. Over-the-counter decongestants and antihistamines may help.
  • Anxiety: Chronic stress or anxiety can cause a variety of physical symptoms, including nausea, headaches, fatigue, and difficulty breathing.

    • Treatment typically involves a combination of therapy, stress management techniques, and sometimes medication.

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

What you can do

  1. Try lifestyle modifications to manage potential GERD: avoid eating 2-3 hours before bed, avoid foods that trigger your symptoms (like spicy or fatty foods), and elevate the head of your bed.
  2. Try over-the-counter antihistamines or decongestants to manage potential postnasal drip.
  3. Practice stress management techniques, like deep breathing exercises, yoga, or meditation, to manage potential anxiety.
  4. Make an appointment with a healthcare provider for a formal evaluation.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or pressure
  • Difficulty breathing or shortness of breath
  • Sudden, severe headache
  • Fainting or loss of consciousness

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.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What are common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, chest pain, and a sensation of a lump in the throat. Nausea and throat discomfort can also occur.


How can postnasal drip lead to nausea and throat discomfort?

Postnasal drip occurs when excess mucus from the nose drips down the back of the throat, which can irritate the throat and lead to discomfort. This irritation can sometimes cause nausea, especially if the mucus is swallowed.


Can anxiety cause physical symptoms like nausea and headaches?

Yes, anxiety can manifest in physical symptoms such as nausea, headaches, fatigue, and difficulty breathing. These symptoms are often a result of the body's stress response.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD include avoiding foods and drinks that trigger reflux (such as spicy or fatty foods), not eating before bedtime, losing weight if overweight, and elevating the head of the bed to prevent nighttime symptoms.


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