[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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4 mo ago
