[58F] With severe abdominal cramps, vomiting, and dizziness

Patient Description

A 58-year-old female has been experiencing severe stomach cramps, abdominal pain, fatigue, vomiting, lightheadedness, weakness, back pain, and nausea for about a year. The stomach cramps occur when she gets hot and last until she cools down, which usually takes about 30 minutes or longer. The abdominal pain is severe, rated as a 9 out of 10, and is located in the middle of her belly. She also feels weak and lacks energy after these episodes, making it difficult to carry out daily activities. Vomiting occurs every time she starts hurting and happens about twice a day. She experiences dizziness, described as the room spinning, with an intensity of 8 out of 10. Additionally, she has severe cramps in her lower leg, causing her foot to draw inward, and rates the weakness in her lower leg as a 5 out of 10. She has a history of severely high blood pressure, with readings as high as 220/113, and is currently taking Amlodipine 5 mg once in the morning. She also takes Tylenol. She is a recovering meth user and has been in recovery for 7 years. She smokes a vape. Her family history includes her mother having lung cancer and COPD. She has not noticed any changes in her stool, except that it looks like rabbit poop. She has not been exposed to any new environments, chemicals, or substances recently, and has not traveled to different climates or altitudes.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations for what might be happening:

Heat Intolerance and Dehydration

  • Heat Intolerance: Your symptoms of severe stomach cramps, vomiting, dizziness, and weakness when you get hot could be related to heat intolerance. This can be exacerbated by dehydration, which can cause muscle cramps, dizziness, and weakness.
  • Dehydration: Dehydration can lead to severe cramps, dizziness, and weakness. It can also cause your blood pressure to fluctuate, which might explain some of your symptoms.

High Blood Pressure (Hypertension)

  • Hypertension: Your history of severely high blood pressure (up to 220/113) is concerning. High blood pressure can cause headaches, dizziness, and weakness. It can also lead to more serious conditions like heart disease or stroke if not managed properly.

Gastrointestinal Issues

  • Gastrointestinal Issues: The severe abdominal pain and vomiting could be related to gastrointestinal issues such as gastritis, peptic ulcers, or other digestive disorders. Stress and high blood pressure can exacerbate these conditions.

Stress and Anxiety

  • Stress and Anxiety: Given the significant stress you've been under due to personal losses, it's possible that stress and anxiety are contributing to your symptoms. Stress can affect your gastrointestinal system, blood pressure, and overall energy levels.

Medication Side Effects

  • Medication Side Effects: Amlodipine, a medication for high blood pressure, can sometimes cause side effects such as dizziness, fatigue, and gastrointestinal issues. It's important to discuss these symptoms with your doctor to see if your medication needs adjustment.

What you can do

Heat Intolerance and Dehydration

  • Stay Hydrated: Drink plenty of water throughout the day, especially when you're working or in hot environments. Avoid caffeinated and alcoholic beverages as they can contribute to dehydration.
  • Cool Down: Take frequent breaks in a cool environment and use fans or air conditioning to help regulate your body temperature. Wear lightweight, breathable clothing.

High Blood Pressure

  • Monitor Your Blood Pressure: Keep a log of your blood pressure readings and share them with your doctor. This can help in adjusting your medication if needed.
  • Follow a Heart-Healthy Diet: Eat a diet rich in fruits, vegetables, whole grains, and lean proteins. Limit salt, sugar, and unhealthy fats.
  • Exercise Regularly: Engage in moderate physical activity, such as walking, for at least 150 minutes per week. Consult your doctor before starting any new exercise regimen.

Gastrointestinal Issues

  • Eat Small, Frequent Meals: Eating smaller, more frequent meals can help manage stomach cramps and vomiting. Avoid spicy, fatty, or acidic foods that can irritate your stomach.
  • Over-the-Counter Remedies: Consider using over-the-counter antacids or anti-nausea medications, but consult your doctor before starting any new medication.

Stress and Anxiety

  • Stress Management: Practice stress-reducing techniques such as deep breathing exercises, meditation, or yoga. Consider talking to a mental health professional for additional support.
  • Support System: Lean on friends, family, or support groups to help manage stress and anxiety.

Medication Side Effects

  • Consult Your Doctor: Discuss your symptoms with your doctor to see if your medication needs adjustment. Do not stop taking your medication without consulting your healthcare provider.

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 Persistent Pain: If your abdominal pain becomes unbearable or does not improve with cooling down.
  • Severe Vomiting: If you are unable to keep fluids down or if vomiting becomes more frequent.
  • High Blood Pressure: If your blood pressure readings remain dangerously high (e.g., above 180/120) despite medication.
  • Neurological Symptoms: If you experience confusion, difficulty speaking, or weakness in your limbs.
  • Heart Symptoms: If you experience chest pain, shortness of breath, or a rapid heartbeat.

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

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4 mo ago


People Also Ask


What are the potential causes of severe abdominal pain and vomiting?

Severe abdominal pain and vomiting can be caused by gastrointestinal issues such as gastritis, peptic ulcers, or other digestive disorders. Stress and high blood pressure can also exacerbate these conditions.


How can high blood pressure affect my overall health?

High blood pressure can lead to headaches, dizziness, and weakness. If not managed properly, it can result in more serious conditions like heart disease or stroke.


What are some effective ways to manage heat intolerance and dehydration?

To manage heat intolerance and dehydration, stay hydrated by drinking plenty of water, especially in hot environments. Take frequent breaks in a cool environment and wear lightweight, breathable clothing.


Could my medication be contributing to my symptoms, and what should I do about it?

Amlodipine, a medication for high blood pressure, can cause side effects such as dizziness, fatigue, and gastrointestinal issues. It's important to discuss these symptoms with your doctor to see if your medication needs adjustment.

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