[44F] Experiencing nausea and vomiting while cycling

Patient Description

A 44-year-old female has been experiencing nausea when riding her bike during the daytime for the past few days. The nausea recently led to vomiting yellow liquid. Symptoms improve when she cools off and are not triggered by specific activities, smells, or foods. Additional symptoms include dry mouth, decreased urination, weight loss, and excessive sweating. The patient was recently deferred from donating plasma due to an unusually high pulse. She has a history of severe anxiety, severe depression, and bipolar 2 disorder, diagnosed a couple of years ago, with a recent increase in anxiety. She is not currently taking any medications, over-the-counter medications, supplements, or herbal remedies, and has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Heat Exhaustion or Heat Stroke: Given that your symptoms occur during daytime bike rides, it's possible that you are experiencing heat-related illnesses. Symptoms of heat exhaustion can include excessive sweating, nausea, vomiting, dry mouth, and decreased urination. If left untreated, heat exhaustion can progress to heat stroke, which is a medical emergency.

    • Treatment typically involves cooling down, hydrating, and resting. Severe cases may require medical attention.
  • Dehydration: Your symptoms of dry mouth, decreased urination, and nausea could be indicative of dehydration, especially if you are not drinking enough fluids during your bike rides.

    • Treatment involves increasing fluid intake, particularly water and electrolyte solutions.
  • Anxiety: Your history of severe anxiety and recent increase in anxiety levels could be contributing to your nausea and high pulse rate. Anxiety can manifest with physical symptoms such as nausea, sweating, and an elevated heart rate.

    • Treatment may involve stress management techniques, therapy, or medication prescribed by a healthcare provider.
  • Gastroesophageal Reflux Disease (GERD): Although less likely given the context, GERD can cause nausea and vomiting, especially if you are exercising soon after eating.

    • Treatment involves dietary changes, medications, and lifestyle modifications.

What you can do

  1. Stay Hydrated: Make sure you are drinking plenty of water before, during, and after your bike rides. Consider electrolyte solutions if you are sweating excessively.
  2. Cool Down: Take frequent breaks in the shade and avoid riding during the hottest parts of the day. Wear lightweight, breathable clothing.
  3. Monitor Your Symptoms: Keep track of when your symptoms occur and any potential triggers. This information will be helpful for your healthcare provider.
  4. Manage Anxiety: Practice stress-relief techniques such as deep breathing exercises, meditation, or yoga. Consider speaking with a mental health professional for additional support.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or persistent vomiting
  • Signs of severe dehydration such as dizziness, confusion, or fainting
  • High fever or chills
  • Severe abdominal pain
  • Symptoms of heat stroke, such as a high body temperature, confusion, or loss of consciousness

Remember, it's important to consult with a healthcare provider for a formal diagnosis and appropriate treatment. Your symptoms could be due to a variety of factors, and a medical professional can help determine the best course of action for you.

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6 mo ago


People Also Ask


What are the symptoms of heat exhaustion and how can it be treated?

Symptoms of heat exhaustion include excessive sweating, nausea, vomiting, dry mouth, and decreased urination. Treatment involves cooling down, hydrating, and resting. Severe cases may require medical attention.


How can dehydration be identified and managed effectively?

Dehydration can be identified by symptoms such as dry mouth, decreased urination, and nausea. It can be managed by increasing fluid intake, particularly water and electrolyte solutions.


Can anxiety cause physical symptoms like nausea and high pulse rate?

Yes, anxiety can cause physical symptoms such as nausea, sweating, and an elevated heart rate. Managing anxiety may involve stress management techniques, therapy, or medication prescribed by a healthcare provider.


What lifestyle changes can help manage symptoms of GERD during exercise?

To manage GERD symptoms during exercise, consider dietary changes, medications, and lifestyle modifications such as avoiding exercise soon after eating and choosing low-impact activities.


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