[38F] With excessive sweating, weight gain, and digestive issues

Question

My urine is dark sometimes strong like ammonia

Patient Description

A 38-year-old female reports experiencing excessive sweating for the past couple of years, which has become severe enough to cause embarrassment and discomfort, particularly in the heat. The patient also reports significant weight gain of 100 lbs over the past four years, which she attributes to heavy alcohol consumption (ranging from a pint to over a fifth a day). Additionally, the patient experiences episodes of feeling extremely unwell a couple of times a month, characterized by whole-body drenched sweating, excessive belching, and a sensation of being 'deathly ill.' These episodes last for a day or two. Daily nausea has been present for a couple of years, and bowel movements are often very loose and watery, with occasional undigested food and color changes. The patient denies any yellowing of the skin or eyes, blood in the stool, or fever. She has a history of major depression, anxiety, borderline personality disorder (BPD), high blood pressure, and chronic obstructive pulmonary disease (COPD), all diagnosed within the last 10 years. No known drug allergies. The patient is unable to provide a current list of medications.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations:

Excessive Sweating and Weight Gain

  • Alcohol Use: Heavy alcohol consumption can lead to a variety of health issues, including weight gain and excessive sweating. Alcohol can affect your metabolism and lead to weight gain, while also causing dehydration and affecting your body's ability to regulate temperature.
  • Hyperhidrosis: This is a condition characterized by excessive sweating. It can be triggered by various factors, including stress, anxiety, and certain medications.
  • Hormonal Imbalances: Conditions like hyperthyroidism can cause excessive sweating and weight changes.

Nausea and Loose Stools

  • Gastrointestinal Issues: Chronic alcohol use can lead to gastrointestinal problems, including gastritis, pancreatitis, and liver disease, which can cause nausea and changes in bowel movements.
  • Irritable Bowel Syndrome (IBS): This condition can cause symptoms like loose stools, nausea, and abdominal pain.
  • Liver Disease: Given your alcohol consumption, liver disease is a concern. Symptoms can include nausea, abdominal pain, and changes in bowel movements.

Upper Left Abdominal Pain

  • Pancreatitis: Inflammation of the pancreas, often related to heavy alcohol use, can cause upper abdominal pain.
  • Gastritis or Peptic Ulcer Disease: These conditions can cause pain in the upper abdomen and are often exacerbated by alcohol.

What you can do

Excessive Sweating and Weight Gain

  • Reduce Alcohol Intake: Cutting back on alcohol can help alleviate many of your symptoms. Seek support if needed, such as counseling or support groups.
  • Stay Hydrated: Drink plenty of water to help your body regulate temperature.
  • Wear Breathable Clothing: Choose fabrics that allow your skin to breathe to help manage sweating.

Nausea and Loose Stools

  • Dietary Changes: Avoid foods and drinks that irritate your stomach, such as spicy foods, caffeine, and alcohol.
  • Stay Hydrated: Drink plenty of fluids to prevent dehydration from loose stools.
  • Over-the-Counter Medications: Antacids or anti-nausea medications may provide some relief.

Upper Left Abdominal Pain

  • Avoid Alcohol: Reducing or eliminating alcohol can help alleviate abdominal pain.
  • Small, Frequent Meals: Eating smaller, more frequent meals can help manage pain and nausea.
  • Consult a Doctor: Seek medical advice for a proper diagnosis and treatment plan.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Abdominal Pain: This could indicate a serious condition like pancreatitis or a peptic ulcer.
  • Yellowing of the Skin or Eyes: This could be a sign of liver disease.
  • Blood in Stool: This could indicate gastrointestinal bleeding.
  • Severe Nausea and Vomiting: This could lead to dehydration and other complications.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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3 mo ago

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People Also Ask

Can excessive alcohol consumption cause excessive sweating and weight gain?

Yes, excessive alcohol consumption can lead to both excessive sweating and weight gain. Alcohol affects metabolism and can lead to dehydration, impacting the body's ability to regulate temperature. It also contributes to weight gain by adding extra calories and affecting how the body processes nutrients.

What are the possible causes of chronic nausea and loose stools?

Chronic nausea and loose stools can be caused by several factors, including gastrointestinal issues related to alcohol use, irritable bowel syndrome (IBS), and liver disease. These conditions can disrupt normal digestion and lead to symptoms like nausea and diarrhea.

How can heavy alcohol use affect the gastrointestinal system?

Heavy alcohol use can lead to various gastrointestinal issues such as gastritis, pancreatitis, and liver disease. These conditions can cause symptoms like abdominal pain, nausea, and changes in bowel movements due to inflammation and damage to the digestive organs.

What are the signs that indicate a serious liver condition?

Signs of a serious liver condition include yellowing of the skin or eyes (jaundice), severe abdominal pain, dark urine, pale stools, and unexplained weight loss. If you experience these symptoms, it is important to seek medical attention promptly.

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1 Comments

Arora (Bot)#28060

3 mo ago

Dark urine and a strong ammonia smell can be concerning and may indicate several potential issues. Here are some possibilities to consider:

  1. Dehydration: Not drinking enough water can concentrate your urine, making it darker and giving it a stronger smell.
  2. Diet: Certain foods and drinks, such as asparagus or coffee, can affect the color and odor of your urine.
  3. Medications and Supplements: Some medications and vitamin supplements can change the color and smell of your urine.
  4. Liver Disease: Given your history of heavy alcohol consumption, liver disease could be a concern. Dark urine can be a sign of liver problems, especially if accompanied by other symptoms like yellowing of the skin or eyes.
  5. Urinary Tract Infection (UTI): A UTI can cause dark, strong-smelling urine, often accompanied by pain or burning during urination.

It's important to stay hydrated and monitor your symptoms. If the dark urine and strong smell persist, or if you experience other symptoms like pain, fever, or yellowing of the skin or eyes, you should seek medical attention for a proper diagnosis and treatment plan.

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