[47F] With fatigue, nausea, vomiting, and back pain

Patient Description

A 47-year-old female has been feeling generally unwell for the past three days, with symptoms including fatigue, nausea, vomiting, and back pain. She reports feeling tired, having no energy, and has been throwing up since last night. She describes a knot and pain on the right side of her lower back, behind her ribs. Additionally, she has experienced some constipation and a loss of appetite, leading to some weight loss. She has been drinking alcohol more frequently than usual, about three drinks a day for the past week, and feels dehydrated with a dry mouth and decreased urine output. She also mentioned tasting copper sometimes and having a swollen face. However, she has not experienced any fever, nasal congestion, post-nasal drip, abdominal bloating, changes in urine color, or yellowing of her skin or eyes. She has no significant past medical history or chronic illnesses, and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Dehydration: Given your increased alcohol consumption and decreased fluid intake, dehydration is a likely cause of your fatigue, nausea, vomiting, and dry mouth. Dehydration can also lead to a metallic taste in your mouth and facial swelling.

  2. Alcohol-related Gastritis: The nausea and vomiting could be due to irritation of your stomach lining from increased alcohol consumption. This condition, known as gastritis, can cause discomfort and digestive issues.

  3. Kidney or Liver Issues: The pain on the right side of your lower back, behind your ribs, could be related to your kidneys or liver. Alcohol can affect both organs, leading to pain and other symptoms like swelling and changes in appetite.

  4. Constipation: Your constipation could be contributing to your overall discomfort and fatigue. Dehydration and changes in diet can exacerbate constipation.

What you can do

Dehydration:

  • Increase Fluid Intake: Start drinking more water and non-alcoholic fluids immediately. Aim for at least 8 glasses of water a day.
  • Electrolyte Solutions: Consider drinking oral rehydration solutions or sports drinks to replenish lost electrolytes.

Alcohol-related Gastritis:

  • Limit Alcohol Consumption: Reduce or stop alcohol intake to allow your stomach lining to heal.
  • Eat Small, Frequent Meals: Eating smaller, more frequent meals can help reduce stomach irritation.
  • Avoid Irritating Foods: Stay away from spicy, acidic, or fried foods that can further irritate your stomach.

Kidney or Liver Issues:

  • Consult a Doctor: Given the pain in your lower back and the potential for kidney or liver involvement, it's important to see a healthcare provider for a thorough evaluation.
  • Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, changes in urine output, or yellowing of the skin or eyes.

Constipation:

  • Increase Fiber Intake: Eat more fruits, vegetables, and whole grains to help alleviate constipation.
  • Stay Hydrated: Drinking plenty of water can also help with bowel movements.
  • Physical Activity: Gentle exercise, like walking, can stimulate bowel movements.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe or Worsening Pain: If the pain in your lower back becomes severe or spreads.
  • Persistent Vomiting: If you continue to vomit and cannot keep fluids down.
  • Signs of Severe Dehydration: Such as dizziness, confusion, or fainting.
  • Yellowing of Skin or Eyes: This could indicate liver issues.
  • Changes in Urine Output: Such as very dark urine or significantly reduced urine output.

Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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5 mo ago

People Also Ask

What are the common symptoms of dehydration and how can it be treated?

Common symptoms of dehydration include fatigue, dry mouth, decreased urine output, dizziness, and confusion. It can be treated by increasing fluid intake, especially water and electrolyte solutions, and avoiding alcohol and caffeine.

How does alcohol consumption lead to gastritis and what are the symptoms?

Alcohol consumption can irritate the stomach lining, leading to gastritis. Symptoms include nausea, vomiting, stomach pain, and loss of appetite. Reducing alcohol intake and eating small, non-irritating meals can help manage symptoms.

What could cause pain on the right side of the lower back, behind the ribs?

Pain on the right side of the lower back, behind the ribs, could be related to kidney or liver issues. It is important to consult a healthcare provider for a thorough evaluation, especially if the pain is severe or persistent.

How can constipation be managed effectively?

Constipation can be managed by increasing fiber intake through fruits, vegetables, and whole grains, staying hydrated, and engaging in regular physical activity. Over-the-counter laxatives may also be used if necessary, but it's best to consult a healthcare provider for persistent issues.

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