[47F] Experiencing vomiting, constipation, and abdominal pain

Patient Description

A 47-year-old female presents with a 3-month history of vomiting, particularly after consuming onion rings, occurring 3-12 hours post-ingestion. The vomit is described as watery. She also reports a 9-month history of constipation, unresponsive to Colace, with infrequent bowel movements producing hard, pebble-like stools. Additionally, she experiences aching, rumbling abdominal pain under the ribs on the right side and in the middle abdomen, which has been occurring intermittently for 15 months. The pain severity is rated 5 out of 10 and is associated with severe episodes preceding vomiting. The patient has also experienced one instance of bloody diarrhea. She reports a feeling of bloating and impending diarrhea that sometimes leads to vomiting or resolves on its own. Fatigue, tiredness, and occasional headaches are also present. She has a past medical history of elevated liver function tests, asthma, seasonal environmental allergies, and kidney stones, with the LFTs being noted as elevated as recently as August 2023. Her current medications include Zyrtec and Singulair, and she has a known allergy to sulfa drugs. No recent changes in medication or diet were reported, except for a 20-pound weight loss over the past 5 months.

Arora's Assessment

What might be happening

Based on the symptoms you've provided, several conditions could be causing your symptoms:

Gastroenteritis: This condition is an inflammation of the gastrointestinal tract, typically from a viral or bacterial infection. It can cause vomiting, diarrhea, and abdominal pain. However, it usually resolves within a few days and wouldn't account for your long-term symptoms.
Gallstones: These are hard deposits in the gallbladder that can cause pain in the upper right abdomen. The pain can come and go and is often worse after eating, especially fatty or greasy foods. Gallstones can also cause nausea and vomiting.
Gastritis: This is an inflammation of the stomach lining that can cause upper abdominal pain, nausea, and vomiting. It can be caused by long-term use of certain medications, bacterial infection, or regular use of alcohol.
Gastroesophageal Reflux Disease (GERD): This condition occurs when 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 and cause heartburn, vomiting, and discomfort in your upper abdomen.
Peptic Ulcer Disease: Ulcers are sores that develop on the lining of your stomach, upper small intestine or esophagus. They can cause a burning pain in your stomach, nausea, and vomiting.
Gastroparesis: This is a condition in which your stomach cannot empty itself of food in a normal fashion. It can cause nausea, vomiting, abdominal pain, and bloating.
Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.

Please note that these are possibilities based on the symptoms you've provided and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Dietary changes: Try to identify any foods or drinks that seem to trigger your symptoms and avoid them. This might include fatty or fried foods, spicy foods, alcohol, or caffeine.
Stay hydrated: Vomiting and diarrhea can cause you to lose fluids and electrolytes, which can lead to dehydration. Be sure to drink plenty of fluids, especially water.
Over-the-counter medications: Antacids can help with heartburn and stomach pain. Laxatives can help with constipation. However, these should only be used as a temporary measure and not a long-term solution.
Seek medical attention: Given the duration and severity of your symptoms, it's important to seek medical attention. Your healthcare provider can perform tests to determine the cause of your symptoms and recommend appropriate treatment.

What you should look out for

Seek immediate medical attention if you:

Have severe abdominal pain
Have bloody or black, tarry stools
Have bloody or green vomit
Have a fever over 100.4°F (38°C)
Are unable to keep down fluids
Have signs of dehydration, such as excessive thirst, dry mouth, little to no urine, severe weakness, dizziness, or lightheadedness

Remember, while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

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[47F] Experiencing vomiting, constipation, and abdominal pain

What might be happening

What you can do

What you should look out for

Experiencing symptoms?