[43F] With multiple symptoms including right side pain and dizziness

Patient Description

A 43-year-old female presents with multiple symptoms including sharp and burning upper stomach pain rated 7/10 in severity, ongoing for months without relief. She also experiences dizziness, described as spinning and lightheadedness, triggered by positional changes and lasting for 3 weeks, rated 8/10. Headaches, sharp and throbbing, occur with or after dizziness, rated 8/10, and have been present for 2 weeks. Diarrhea, both watery and loose, occurs 3 to 6 times daily, on and off for months, with no identified food triggers. Nausea is also reported. Right side pain is exacerbated by movement and touch. The patient has a 10-year history of diabetes managed with an insulin pump (Humalog) and is currently taking Avastin. She discontinued Ozempic due to stomach pain and occasionally uses Ibuprofen. No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, several conditions could explain your symptoms:

  1. Gastroesophageal Reflux Disease (GERD): GERD can cause upper stomach pain, a burning sensation, and nausea. It often worsens with certain foods or lying down.

    • Treatment: Lifestyle changes, such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Over-the-counter medications like antacids, H2 blockers, or proton pump inhibitors can also help.
  2. Peptic Ulcer: Ulcers in the stomach or upper part of the small intestine can cause sharp, burning pain and nausea.

    • Treatment: Medications to reduce stomach acid and antibiotics if an infection is present. Avoiding NSAIDs like ibuprofen is also recommended.
  3. Gallstones or Gallbladder Disease: Pain in the upper right abdomen, especially after eating fatty foods, can be a sign of gallstones or gallbladder inflammation.

    • Treatment: Dietary changes, pain management, and possibly surgery to remove the gallbladder.
  4. Irritable Bowel Syndrome (IBS): IBS can cause chronic diarrhea, abdominal pain, and bloating.

    • Treatment: Dietary changes, stress management, and medications to manage symptoms.
  5. Vertigo: The spinning sensation and dizziness could be due to vertigo, which can be caused by inner ear problems.

    • Treatment: Vestibular rehabilitation exercises, medications, and sometimes lifestyle changes.
  6. Migraine: Your headaches, especially if they are sharp and throbbing, could be migraines, which can also cause dizziness and nausea.

    • Treatment: Over-the-counter pain relievers, prescription medications, and lifestyle changes to avoid triggers.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Dietary Changes:

    • Avoid spicy, fatty, or acidic foods that can worsen GERD or gallbladder issues.
    • Eat smaller, more frequent meals to help manage stomach pain and nausea.
    • Keep a food diary to identify any potential triggers for your diarrhea.
  2. Hydration:

    • Drink plenty of water to stay hydrated, especially if you have diarrhea.
  3. Over-the-Counter Medications:

    • Consider antacids or acid reducers for stomach pain and burning.
    • Use pain relievers like acetaminophen instead of NSAIDs to avoid worsening stomach pain.
  4. Lifestyle Changes:

    • Avoid lying down immediately after eating to reduce GERD symptoms.
    • Practice stress management techniques like deep breathing, meditation, or yoga to help with IBS and migraines.
  5. Vestibular Exercises:

    • Try vestibular rehabilitation exercises to help manage dizziness and vertigo.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or vomit
  • Unexplained weight loss
  • Persistent or severe dizziness
  • Fainting or loss of consciousness
  • High fever or chills

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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7 mo ago


People Also Ask


What are the common symptoms of GERD and how can it be managed?

Common symptoms of GERD include heartburn, regurgitation, and nausea. It can be managed with lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Over-the-counter medications like antacids, H2 blockers, or proton pump inhibitors can also help.


How can vertigo be distinguished from other types of dizziness?

Vertigo is characterized by a spinning sensation and is often triggered by changes in head position. It can be distinguished from other types of dizziness by its specific sensation of movement. Treatment may include vestibular rehabilitation exercises and medications.


What dietary changes can help manage symptoms of IBS?

To manage IBS symptoms, it is recommended to avoid foods that trigger symptoms, such as high-fat foods, dairy, and certain carbohydrates. Increasing fiber intake, staying hydrated, and managing stress can also help.


What are the potential side effects of using Ibuprofen for pain management?

Ibuprofen can cause side effects such as stomach pain, ulcers, and gastrointestinal bleeding, especially with long-term use. It is recommended to use alternatives like acetaminophen for pain management if you have stomach issues.


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