[40F] Experiencing severe nausea, vomiting, and constipation with underlying MS and other conditions

Patient Description

A 40-year-old female has been experiencing severe nausea and vomiting, which have significantly impacted her daily activities over the past two days. The patient reports vomiting three times, with much of it being dry heaving, and rates the severity of nausea as 8/10 and vomiting as 4-5/10. The nausea worsens upon standing and walking. To manage, the patient finds relief in lying down, swallowing easily, and taking short breaths. Additionally, the patient has chronic constipation, describing the last bowel movement, occurring four to five days ago, as hard and Play-Doh-like. The patient has a history of multiple sclerosis (MS), diagnosed four years ago, which is currently exacerbating muscle tightness and spasms, affecting mobility. Other significant medical history includes cerebral palsy diagnosed 20 years ago, hypothyroidism diagnosed 25 years ago, and Hepatitis C diagnosed 17 years ago. The patient's current medications include Macrobid (twice daily for one week), Synthroid (125 micrograms), Wellbutrin (150 mg), and Suboxone (18 mg). The patient started Macrobid one day ago to address pain and burning in the urethra, suggesting a urinary tract infection. No recent weight changes, injuries, or blood in urine were reported, but the patient mentioned a small amount of abdominal pain and a possible fever.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible explanations for your symptoms include:

  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system — your kidneys, bladder, ureters, and urethra. Most UTIs are caused by bacteria, but some are caused by viruses and fungi. UTIs are more common in women than men. They can occur at any age but are more common in older adults. Your symptoms of frequent urination and burning in the urethra are common symptoms of UTIs.

    • Treatment typically involves antibiotics to kill the bacteria causing the infection. Your doctor may prescribe Macrobid (nitrofurantoin) to treat your UTI.

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is particularly common and highly infectious. Your symptoms of nausea, vomiting, and constipation could be due to gastroenteritis.

    • Treatment usually consists of self-care measures, such as staying hydrated and resting. In some cases, medication may be prescribed to relieve symptoms such as nausea and vomiting.

  • Multiple Sclerosis (MS) Flare: MS is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Your symptom of muscle tightness could be due to a flare-up of your MS.

    • Treatment for MS flares typically involves corticosteroids and physical therapy to manage symptoms.

Please note that these are potential explanations for your symptoms based on the information you have provided, and it's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed medications as directed by your doctor. This includes Macrobid for your UTI, Synthroid for your hypothyroidism, Wellbutrin for depression (if applicable), and Suboxone for opioid dependence (if applicable).
  2. Stay hydrated and rest as much as possible to help your body recover.
  3. Monitor your symptoms closely. If your symptoms worsen or you develop new symptoms, seek medical attention immediately.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool or urine
  • High fever (temperature over 100.4°F)
  • Severe or worsening muscle weakness or tightness
  • Difficulty breathing

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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7 mo ago

People Also Ask

What are common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain in women.

How can multiple sclerosis (MS) affect daily life during a flare-up?

During a flare-up, MS can cause increased muscle tightness, spasms, fatigue, difficulty walking, and other neurological symptoms, which can significantly impact mobility and daily activities.

What are some effective ways to manage severe nausea and vomiting?

To manage severe nausea and vomiting, it's important to stay hydrated, rest, eat small and bland meals, and avoid strong odors. Medications like antiemetics may also be prescribed to help relieve symptoms.

How does hypothyroidism impact overall health and what are its common symptoms?

Hypothyroidism can lead to fatigue, weight gain, cold intolerance, dry skin, and depression. It affects metabolism and energy levels, and is typically managed with thyroid hormone replacement therapy.

1 Comments

Janice#4034

7 mo ago

How are you feeling? I also have been having vomiting and nausea and have history of MS not sure if they are related

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