[66F] Experiencing severe nausea, vomiting, lethargy, and headache

Patient Description

A 66-year-old female presents with a 24-hour history of severe nausea and vomiting, which has led to dry heaving as there is nothing left in the stomach to expel. The patient rates the nausea as an 8 out of 10 in severity, which worsens with movement and the smell of food. Vomiting seems to temporarily relieve the nausea, and the patient has been unable to tolerate looking at food. Additionally, the patient reports lethargy, with an inability to perform activities and a need for extended periods of sleep. The patient has also developed a headache over the last 5 hours, described as a constant ache on the left side above the ear. There is no history of similar headaches. The patient is experiencing neck stiffness and photophobia but no fever. There is also a reported cognitive change, including confusion, and body aches with a severity of 7 out of 10, without any recent history of injury. The patient describes an internal feeling of painful coldness in the feet, though no external chill is noted by the partner. The patient has not reported any recent travel, sick contacts, or changes in medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Gastroenteritis: This is an inflammation of the stomach and intestines, usually caused by a viral or bacterial infection. It can cause nausea, vomiting, and lethargy. The body aches could be part of a general feeling of being unwell that often accompanies this condition.

    • Treatment typically involves rest and rehydration. Antibiotics may be prescribed if a bacterial cause is suspected.
  • Migraine: This is a type of headache characterized by severe, throbbing pain, usually on one side of the head. Nausea and vomiting are common symptoms. The sensitivity to light and movement could also be consistent with a migraine.

    • Treatment typically involves pain relief medication and rest in a dark, quiet room.
  • Meniere's Disease: This is a disorder of the inner ear that can cause vertigo (a sensation of spinning), tinnitus (ringing in the ear), hearing loss, and a feeling of fullness or pressure in your ear. Nausea, vomiting, and lethargy can also occur.

    • Treatment typically involves medications to control vertigo and nausea, as well as lifestyle changes such as a low-salt diet and avoiding caffeine and alcohol.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

In the meantime, here are some things you can do to help manage your symptoms:

  1. Rest: It's important to get plenty of rest when you're feeling unwell. This can help your body recover and can also help manage symptoms such as lethargy and body aches.

  2. Stay hydrated: If you're vomiting, you may be at risk of dehydration. Try to sip on small amounts of water or a rehydration solution regularly.

  3. Over-the-counter medication: Over-the-counter medication may help manage some of your symptoms. For example, pain relief medication can help with body aches and headaches, while anti-nausea medication can help with nausea and vomiting.

What you should look out for

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

  • Severe headache or a headache that is getting progressively worse
  • Severe abdominal pain
  • Blood in your vomit
  • Signs of dehydration, such as dark urine, dry mouth, and feeling extremely thirsty
  • Confusion or difficulty thinking clearly
  • A high fever (temperature over 100.4°F)

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 accurate information.

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11 mo ago

People Also Ask


What are the common causes of severe nausea and vomiting in adults?

Severe nausea and vomiting in adults can be caused by a variety of conditions, including gastroenteritis, food poisoning, migraines, inner ear disorders like Meniere's Disease, and sometimes more serious conditions like appendicitis or pancreatitis. It's important to consult a healthcare provider for an accurate diagnosis.


How can I differentiate between a migraine and other types of headaches?

Migraines are typically characterized by a severe, throbbing headache on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. Other types of headaches, like tension headaches, usually involve a dull, aching sensation on both sides of the head without the additional symptoms. Cluster headaches are intense and occur in cyclical patterns or clusters.


What are the symptoms of dehydration and how can it be prevented during vomiting?

Symptoms of dehydration include dark urine, dry mouth, extreme thirst, dizziness, and fatigue. To prevent dehydration during vomiting, it's important to sip small amounts of water or oral rehydration solutions frequently, rather than drinking large amounts at once, which can trigger more vomiting.


What lifestyle changes can help manage Meniere's Disease symptoms?

Lifestyle changes that can help manage Meniere's Disease symptoms include following a low-salt diet, avoiding caffeine and alcohol, managing stress, and avoiding sudden movements that can trigger vertigo. Medications may also be prescribed to help control symptoms.


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