[37F] Experiencing a range of symptoms including severe heartburn and headache

Patient Description

A 37-year-old female presents with a 2-week history of severe heartburn rated 7/10 in pain, not exacerbated by meals or certain foods, and a constant headache described as sharp, stabbing, or squeezing, also rated 7/10 in severity, worsened by bright lights, loud noises, and stress at work. The patient also reports a mild sore throat for 1 week, a low-grade fever for 2 weeks, and widespread hives with red, raised bumps for 1 week. Joint pain with a dull ache in the knees, elbows, wrists, hips, and upper back has been present for 2 weeks, rated 5/10 in severity. The patient has difficulty taking deep breaths but no severe chest pain, vision changes, confusion, slurred speech, or weakness. There is no known family history of autoimmune diseases. The patient has been diagnosed with anxiety and depression since high school and is currently taking Bupropion (50 mg) and Sertraline (25 mg) with no known drug allergies or recent changes in medication or dosage.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Viral Infection: Your symptoms of fever, fatigue, joint pain, and sore throat could be due to a viral infection. Hives can also occur as a reaction to a viral infection.

    • Treatment usually involves rest, hydration, and over-the-counter medication to manage symptoms.
  • Autoimmune Disease: Conditions such as lupus or rheumatoid arthritis can cause symptoms like joint pain, fatigue, fever, and skin rashes. However, these conditions usually develop over a longer period of time and are less likely given the short duration of your symptoms.

    • Treatment typically involves medication to manage symptoms and slow disease progression.
  • Allergic Reaction: Hives, difficulty breathing, and fatigue can be symptoms of an allergic reaction. However, it's less common for an allergic reaction to cause joint pain and fever.

    • Treatment involves avoiding the allergen and taking medication to manage symptoms.
  • Gastroesophageal Reflux Disease (GERD): This is a 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 and cause heartburn.

    • Treatment typically involves lifestyle changes and over-the-counter medication. If these don't help, your doctor might recommend prescription medication or surgery.

Please note that these are possibilities and not a definitive diagnosis. It is important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Rest and hydrate: If your symptoms are due to a viral infection, rest and hydration are key to recovery.
  2. Over-the-counter medication: Over-the-counter medication can help manage symptoms like fever, joint pain, and heartburn. However, it's important to consult with a healthcare professional before starting any new medication.
  3. Avoid potential allergens: If you suspect an allergic reaction, try to identify and avoid potential allergens.
  4. Lifestyle changes: If your heartburn is due to GERD, lifestyle changes such as maintaining a healthy weight, avoiding foods that trigger heartburn, eating smaller meals, and not lying down after a meal can help.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or do not improve after a few days
  • You experience severe chest pain or difficulty breathing
  • You develop new symptoms

Remember, it's important to consult with a healthcare professional for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What are common causes of hives and how can they be treated?

Hives can be caused by allergic reactions, stress, infections, or unknown factors. Treatment typically involves antihistamines to reduce itching and swelling, and avoiding known triggers.


How can I differentiate between heartburn and a more serious condition like GERD?

Heartburn is a burning sensation in the chest, often after eating. GERD is a chronic condition where heartburn occurs more than twice a week. GERD may require lifestyle changes and medication to manage.


What are the typical symptoms of a viral infection and how long do they usually last?

Common symptoms of a viral infection include fever, fatigue, sore throat, and joint pain. These symptoms usually last from a few days to two weeks, depending on the virus.


Can anxiety and depression medications like Bupropion and Sertraline cause joint pain or hives?

While Bupropion and Sertraline are not commonly known to cause joint pain or hives, side effects can vary. It's important to discuss any new symptoms with a healthcare provider to rule out medication-related causes.


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