[38F] Experiencing nausea, abdominal pain, and other symptoms

Patient Description

A 38-year-old female presents with daily nausea, crampy left lower stomach pain, headaches, vaginal pain during intercourse, fatigue, and depression. The nausea has persisted for six months, with vomiting occurring approximately once a week, and is exacerbated by eating but somewhat alleviated by sleep. The stomach pain has been present for the same duration, with a severity rating of 8/10. Headaches occur once or twice a week, presenting as an aching or throbbing sensation across the forehead. The patient has been experiencing vaginal pain during intercourse for three years, described as a feeling of tightness and potential tearing. She has been feeling persistently sad and 'blah' since the birth of her son. The patient has type two diabetes, diagnosed a few months ago, and is on multiple medications including hydrochlorothiazide, bupropion, dextroamphetamine-amphetamine, Freestyle Libre 3, buprenorphine-naloxone, varenicline, metoprolol, omeprazole, and duloxetine. No known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Gastroenteritis: This is inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhea. Your symptoms of nausea, vomiting, and lower left abdominal pain could be indicative of this condition.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Severe cases may require medical attention.
  • Migraines: Recurrent headaches that can cause 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. Your description of your headaches could suggest this condition.

    • Treatment typically involves pain relieving medications and preventive medications.
  • Dyspareunia: This is persistent or recurrent genital pain that occurs just before, during or after intercourse. Your description of vaginal pain during sex is consistent with this condition.

    • Treatment can involve physical therapy, counseling, and topical or oral medications.
  • Postpartum Depression: This is a serious mental illness that involves the brain and affects your behavior and physical health. You mentioned feeling depressed since shortly after the birth of your son, which could suggest this condition.

    • Treatment typically involves psychotherapy (talk therapy), medications, and self-care.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. Your symptoms of constant fatigue could be indicative of this condition.

    • Treatment can involve cognitive behavioral therapy, graded exercise therapy, and medications to control symptoms.

Please note that these are potential diagnoses based on the symptoms you've described. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. For your nausea and vomiting, try to stay hydrated and eat small, bland meals. Over-the-counter anti-nausea medications may also be helpful.
  2. For your headaches, over-the-counter pain relievers may provide some relief. Try to rest in a quiet, dark room.
  3. For your vaginal pain during sex, try using a lubricant. If the pain continues, it would be best to consult with a healthcare provider.
  4. For your feelings of depression, consider reaching out to a mental health professional. They can provide treatment and support.
  5. For your fatigue, try to get plenty of rest and eat a healthy diet. Regular physical activity can also help boost your energy levels.

What you should look out for

Reasons to seek immediate medical attention include:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Severe headache or a headache that comes on suddenly
  • Thoughts of harming yourself or others
  • Extreme fatigue that prevents you from doing your daily activities

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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11 mo ago

People Also Ask


What could be causing my persistent nausea and stomach pain?

Persistent nausea and stomach pain could be caused by conditions such as gastroenteritis, which involves inflammation of the stomach and intestines. It's important to consult with a healthcare provider for an accurate diagnosis. In the meantime, staying hydrated and eating small, bland meals may help alleviate symptoms.


How can I manage headaches that occur frequently?

Frequent headaches, especially those described as throbbing or aching, could be migraines. Managing them often involves using pain-relieving medications and preventive treatments. Resting in a quiet, dark room and avoiding known headache triggers can also be beneficial.


What are some treatments for vaginal pain during intercourse?

Vaginal pain during intercourse, known as dyspareunia, can be treated with physical therapy, counseling, and medications. Using lubricants during intercourse may provide temporary relief. It's important to discuss this with a healthcare provider for a tailored treatment plan.


What steps can I take to address feelings of depression after childbirth?

Feelings of depression after childbirth, known as postpartum depression, can be addressed through psychotherapy, medications, and self-care strategies. Reaching out to a mental health professional can provide the necessary support and treatment to manage these feelings effectively.


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