[44F] Experiencing heartburn, headache, stomachache, and worsening vision

Patient Description

A 44-year-old female presents with moderate heartburn that starts around 8am and worsens throughout the day, persisting for two weeks. Additionally, she experiences daily headaches around 1pm, described as throbbing and aching behind the forehead and eyes, with a severity of 7 out of 10, ongoing for a year. She also reports a stomachache with nausea and cramping, rated 8 out of 10 in severity, lasting for about 3 hours. Her bowel movements are described as soft with a foul smell. Her vision has been declining over the past 2-3 months, with increasing blurriness rated at a severity of 7 out of 10. The patient also suffers from lethargy, feeling extremely tired all the time, which has been a long-term issue. She has a medical history of high blood pressure, being overweight, anxiety, depression, and insomnia, all diagnosed years ago. No known drug allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Gastroesophageal Reflux Disease (GERD): This condition is characterized by heartburn, which is a burning sensation in the chest, usually after eating. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach.

    • Treatment typically includes lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be necessary.
  • Chronic Migraines: Migraines are a type of headache characterized by severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

    • Treatment typically involves pain relieving medications and preventive medications.
  • Functional Dyspepsia: This condition is characterized by chronic or recurrent pain in the upper abdomen. It's not related to digestion or any identifiable cause (such as peptic ulcer disease, GERD, or gallstones).

    • Treatment typically involves lifestyle changes and medications to control the symptoms.
  • Presbyopia: This is a common type of vision disorder that occurs as you age. It involves the gradual loss of your eyes' ability to focus actively on nearby objects.

    • Treatment typically involves wearing corrective lenses or undergoing refractive surgery.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest.

    • Treatment typically involves a combination of lifestyle changes, medication to control symptoms, and therapy to help cope with the condition.

Please remember that these are only possible diagnoses. You should consult with a healthcare professional for a formal diagnosis and treatment.

What you can do

  1. For GERD, try to avoid foods that trigger your heartburn, eat smaller meals, avoid lying down after a meal, and maintain a healthy weight.
  2. For migraines, try to identify and avoid triggers, maintain a regular sleep schedule, and stay hydrated.
  3. For functional dyspepsia, try to eat smaller, more frequent meals, avoid foods that trigger your symptoms, and manage stress.
  4. For presbyopia, consider getting an eye exam and wearing corrective lenses if necessary.
  5. For CFS, try to pace yourself and avoid overexertion, improve your sleep habits, and eat a balanced diet.

What you should look out for

You should seek immediate medical attention if you experience:

  • Severe, sudden-onset heartburn
  • A headache that is different from your usual migraines
  • Severe abdominal pain
  • Sudden vision loss
  • Extreme fatigue that prevents you from performing daily activities

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 appropriate examination, testing, and care recommendations.

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1 yr ago

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

People Also Ask


What are common triggers for GERD and how can I manage them?

Common triggers for GERD include spicy foods, fatty foods, chocolate, caffeine, alcohol, and large meals. To manage GERD, avoid these triggers, eat smaller meals, avoid lying down after eating, and maintain a healthy weight.


How can I differentiate between a regular headache and a migraine?

Migraines are typically more severe than regular headaches and are often accompanied by symptoms like nausea, vomiting, and sensitivity to light and sound. They usually present as a throbbing pain on one side of the head.


What lifestyle changes can help alleviate symptoms of functional dyspepsia?

Lifestyle changes for functional dyspepsia include eating smaller, more frequent meals, avoiding foods that trigger symptoms, managing stress, and avoiding lying down immediately after eating.


What are the treatment options for presbyopia?

Treatment options for presbyopia include wearing corrective lenses such as reading glasses or bifocals, using contact lenses, or undergoing refractive surgery to improve near vision.


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