[53F] Experiencing fatigue, abdominal pain, and headache

Patient Description

A 53-year-old female reports severe fatigue, preventing her from attending work, and has been persistent since the onset of symptoms yesterday. She has experienced a slight weight loss of 2-3 pounds. The patient describes a burning ache in her transverse colon or lower stomach, rating the pain as 4-5 out of 10, which started a day ago. Additionally, she has a dull headache with a severity of 4 out of 10, located behind her eyes, accompanied by pressure and sensitivity to light since yesterday. The patient's medical history includes psoriatic arthritis, asthma, hyperthyroidism, Parahyperthyroidism, and immunocompromise due to Humira, which she takes every two weeks. Other medications include Synthroid 175mcg daily on an empty stomach, Vitamin D 1000 IU daily, Lexapro 5mg daily, Symbicort, and Nucala. She has been in contact with someone who had vomiting, diarrhea, and fever. There are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Viral Gastroenteritis: Also known as the stomach flu, this condition can cause nausea, vomiting, diarrhea, and abdominal pain. It's often accompanied by other symptoms such as fatigue, headache, and low-grade fever. This could be a possibility given your recent contact with a sick individual.

    • Treatment typically involves rest, hydration, and over-the-counter remedies to manage symptoms.
  • Migraine: This is a type of headache characterized by severe pain, often accompanied by nausea and sensitivity to light. The pain is often described as throbbing or pulsing and may be felt behind the eyes.

    • Treatment typically involves rest, hydration, and over-the-counter or prescription medications.
  • Side effects of medication: Some of the medications you're taking, such as Humira, can cause side effects like fatigue, headache, and abdominal pain.

    • If this is the case, you should discuss this with your doctor, who may be able to adjust your medication regimen.

Please note, this is not an exhaustive list and other conditions could also explain your symptoms.

What you can do

  1. Rest and stay hydrated. Dehydration can worsen symptoms of fatigue and headache.
  2. Over-the-counter pain relievers may help with your headache and abdominal pain.
  3. Avoid bright lights and loud sounds, as these can worsen headaches.
  4. Monitor your symptoms. If they worsen or persist for more than a few days, seek medical attention.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool or vomit
  • High fever (temperature over 100.4°F)
  • Severe headache or a headache that is different from your usual headaches
  • Any new or worsening symptoms

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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9 mo ago


People Also Ask


What are the common symptoms of viral gastroenteritis?

Common symptoms of viral gastroenteritis include nausea, vomiting, diarrhea, abdominal pain, fatigue, headache, and sometimes a low-grade fever.


Can migraines cause sensitivity to light and pressure behind the eyes?

Yes, migraines can cause sensitivity to light (photophobia) and pressure or pain behind the eyes, often described as throbbing or pulsing.


What are some potential side effects of Humira?

Potential side effects of Humira include fatigue, headache, abdominal pain, nausea, and increased risk of infections due to its immunosuppressive effects.


How can I differentiate between medication side effects and a new illness?

Differentiating between medication side effects and a new illness can be challenging. Monitoring the timing of symptoms in relation to medication intake, consulting with a healthcare provider, and considering recent exposures to illnesses can help clarify the cause.

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