[42F] Experiencing gastrointestinal and respiratory symptoms

Patient Description

A 42-year-old female presents with a 6-month history of daily bloating characterized by a distended abdomen and significant pressure, which is somewhat alleviated by assuming a knees-to-chest position while lying face down. Additionally, she reports severe acid reflux for the past 10 months, rating it 10/10 in severity, which is triggered by overeating or consuming spicy foods and is exacerbated by bending over or lying down, leading to aspiration if lying flat. The patient also experiences constipation, diarrhea, cramping, fatigue, and shortness of breath. She notes a sensation of food getting stuck when swallowing, though without pain. The patient's medication regimen includes Adderall (15mg twice daily) and ibuprofen (200mg as needed, 3-4 times weekly), as well as aspirin. There is no reported family history of gastrointestinal diseases, but a family member has had an ulcer. The patient denies any known allergies, unintended weight loss, blood in stool or vomit, and does not have any pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • 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, causing symptoms like heartburn and acid reflux. Overeating, spicy foods, bending over, or lying down can make these symptoms worse. Long-term GERD can cause difficulty swallowing.

    • Treatment usually involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

    • Treatment focuses on relieving symptoms so that you can live as normally as possible.
  • Gastric Ulcer: This is a sore that develops on the lining of the esophagus, stomach, or small intestine. Ulcers occur when stomach acid damages the lining of the digestive tract. Common causes include the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin.

    • Treatment usually involves killing the bacteria, if present, eliminating or reducing use of aspirin, and reducing acid with medication.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Avoid foods and drinks that trigger your heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse.
  2. Eat smaller meals. Avoid overeating by eating smaller meals.
  3. Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.

What you should look out for

Reasons to see a doctor more urgently:

  • If you notice blood in your stool or vomit
  • If you have difficulty swallowing or feel like food is getting stuck
  • If you have severe abdominal pain
  • If you have a fever (temperature over >100.4°F) or chills
  • If you cannot identify a trigger or your symptoms worsen

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes for managing GERD include avoiding trigger foods and drinks, eating smaller meals, not lying down immediately after eating, and elevating the head of the bed. These changes can help reduce the frequency and severity of acid reflux symptoms.


How can IBS be managed on a daily basis?

IBS can be managed by identifying and avoiding food triggers, managing stress, maintaining a regular eating schedule, and staying hydrated. Some people find relief with dietary changes such as increasing fiber intake or following a low FODMAP diet.


What are the common triggers for acid reflux and how can they be avoided?

Common triggers for acid reflux include fatty or fried foods, spicy foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Avoiding these foods and eating smaller meals can help prevent acid reflux episodes.


What are the potential side effects of long-term use of ibuprofen and aspirin?

Long-term use of ibuprofen and aspirin can lead to gastrointestinal issues such as ulcers, bleeding, and stomach irritation. It's important to use these medications as directed and consult a healthcare provider if you experience any adverse effects.


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