[55F] Experiencing persistent nausea and abdominal pain

Patient Description

A 55-year-old female with a history of gastric bypass surgery 16 years ago presents with persistent nausea since the previous evening, which worsens with stress, movement, eating, drinking, and smoking. She finds temporary relief with small sips of Coke, bread, and remaining still. The nausea has gradually worsened and is accompanied by moderate abdominal pain near the top of the stomach, waves of queasiness, dizziness, fatigue, a slight headache, heart palpitations coinciding with nausea, a very dry mouth, and slight brain fog. The patient has a medical history of chronic heart failure, thyroid cancer, bipolar disorder, anemia, hypothyroidism, hyperthyroidism, anxiety, and a history of kidney stones and infections. She missed her heart and thyroid medications while away but has resumed them, although symptoms have worsened. Current medications include Bisoprolol, Buspirone, Levothyroxine, and Spironolactone. The patient has allergies to NSAIDs and a vagal response to Benadryl. She reports no similar symptoms related to her gastric bypass in the past and no recent complications from the surgery. The patient works as a bartender and has been exposed to multiple individuals with illnesses, though her throat remains unaffected.

Arora's Assessment

What might be happening

Your symptoms could be related to several factors:

Gastroenteritis or Food Poisoning: Given your recent dietary intake, nausea, stomach pain, and diarrhea could be due to a stomach infection or food poisoning. These conditions often resolve on their own but can be uncomfortable.
Medication Effects: Missing and then resuming your heart and thyroid medications might contribute to your symptoms, including nausea and palpitations.
Dehydration: Your dry mouth and dizziness could indicate dehydration, especially with diarrhea and inadequate fluid intake.
Stress and Anxiety: Your history of stress-induced cardiomyopathy and current stress levels might exacerbate symptoms like palpitations and brain fog.

What you can do

For Nausea and Stomach Pain:

Try to stay hydrated with small sips of clear fluids like water or an electrolyte solution.
Eat bland foods like toast or crackers if you can tolerate them.
Rest as much as possible to allow your body to recover.

For Dehydration:

Increase your fluid intake gradually. Consider oral rehydration solutions if you continue to have diarrhea.
Monitor for signs of severe dehydration, such as decreased urination or extreme thirst.

For Stress and Anxiety:

Practice relaxation techniques such as deep breathing or meditation.
Consider reaching out to a mental health professional if stress becomes overwhelming.

Medication Management:

Ensure you take your medications as prescribed. If you have concerns about side effects, consult your healthcare provider.

Symptom Tracking:

Use MDandMe to journal your symptoms, track progress, and share notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

Severe or worsening abdominal pain.
Persistent vomiting or inability to keep fluids down.
Signs of severe dehydration, such as confusion or fainting.
Worsening heart palpitations or chest pain.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

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[55F] Experiencing persistent nausea and abdominal pain

What might be happening

What you can do

What you should look out for

Experiencing symptoms?