[56F] Experiencing severe nausea, vomiting, headache, and fatigue

Patient Description

A 56-year-old female presents with severe nausea, unable to retain solids for nearly four days, and frequent episodes of violent vomiting every few hours, primarily resulting in dry heaving. The patient reports significant fatigue and a non-migraine, band-like throbbing headache rated at a severity of 6 out of 10. Zofran provides slight relief for nausea, and Tylenol is being used for headache management. The patient has a medical history of rheumatoid arthritis and epilepsy, diagnosed approximately 25 years ago, and is currently on Depakote, Mirapex, Dayvigo, and Zofran. The patient is allergic to Penicillin. No new medications or dietary changes have been reported that could be associated with the current symptoms.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the stomach and intestines that can cause nausea, vomiting, and fatigue. It's often caused by a viral or bacterial infection.

    • Treatment typically involves rest, hydration, and over-the-counter remedies to manage symptoms. In severe cases, hospitalization may be required for intravenous fluids and medications.
  • Gastritis: This is an inflammation of the stomach lining that can cause nausea, vomiting, and a feeling of fullness in your upper abdomen, especially after eating.

    • Treatment usually involves medications to decrease stomach acid, which allows your stomach lining to heal.
  • Migraines: While you've mentioned that your current headache doesn't feel like your usual migraines, migraines can sometimes present differently. They can cause nausea, vomiting, and fatigue, in addition to headaches.

    • Treatment typically involves medications to relieve symptoms and prevent future migraines.
  • Side effects of medications: Some of the medications you're taking, such as Depakote and Zofran, can cause nausea, vomiting, and fatigue as side effects.

    • If you suspect your symptoms are due to your medications, you should consult your doctor. They may be able to adjust your dosage or switch you to a different medication.

Please note that this is not an exhaustive list of possibilities and these conditions can coexist. You should consult a healthcare professional for a formal diagnosis.

What you can do

While you should seek medical attention for your symptoms, here are some things you can do in the meantime:

  1. Stay hydrated: Dehydration can worsen your symptoms and lead to other complications. Try to drink small sips of water, clear broths, or rehydration solutions.

  2. Rest: Fatigue can be your body's way of telling you to slow down and recover.

  3. Avoid triggers: If there are certain foods or activities that seem to worsen your symptoms, try to avoid them.

  4. Over-the-counter remedies: Over-the-counter medications can help manage your symptoms. However, you should consult a healthcare professional before starting any new medication.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Signs of dehydration, such as dark urine, dry mouth, and feeling lightheaded when standing up
  • A headache that is different from your usual headaches or the worst headache you've ever had
  • 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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11 mo ago

People Also Ask


What are the common causes of severe nausea and vomiting?

Common causes of severe nausea and vomiting include gastroenteritis, gastritis, migraines, and side effects from medications. It's important to consult a healthcare professional for an accurate diagnosis.


Can my current medications cause nausea and fatigue?

Yes, medications like Depakote and Zofran can cause nausea and fatigue as side effects. If you suspect your symptoms are related to your medications, consult your doctor for advice on adjusting your treatment.


What are the signs that I should seek immediate medical attention for my symptoms?

You should seek immediate medical attention if you experience severe abdominal pain, blood in your vomit or stool, signs of dehydration, a headache that is different from your usual headaches, or any new or worsening symptoms.


How can I manage nausea and vomiting at home while waiting to see a doctor?

To manage nausea and vomiting at home, stay hydrated by sipping water or rehydration solutions, rest to help your body recover, avoid known triggers, and consider over-the-counter remedies after consulting with a healthcare professional.


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