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I have the following symptoms: severe nausea, upper

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Hi I have the...

Hi I have the following symptoms: severe nausea, upper abdominal pain and distention, shaking/trembling, dizziness, headache, and feeling that I will faint whenever I get up or move too much.

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

Episodic for both, but the nausea is so severe that I feel like vomiting all the time. I have felt this way for the past 2 hours

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Im currently taking escitalopram and hydroxyzine. i have had problems with my digestive tract my whole life (issues with lactose and gluten intolerance), but this doesn't feel like that it feels different. and now I also have tightness in my chest

Submitted: 4 months ago.Category: Medical
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Answered in 26 minutes by:
4/2/2018
Doctor: Dr. Muneeb Ali, Doctor replied 4 months ago
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 10,185
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi,
Welcome to Ja and thanks for this question. I'm sorry to hear about your symptoms. I just came online to see that you have been waiting for some time so ill quickly answer this question for you. Actually from what you are describing there are a couple of possibilities here. The first one which comes to mind is that you could have developed autonomic neuropathy. This is a condition in which the autonomic nervous system which controls the involuntary functions in the body may be damaged. This can lead to sudden changes in heart rate blood pressure and all the symptoms that you have mentioned. This can be due to many causes including autoimmune conditions, diabetes and numerous other disorders. The diagnosis can be made with a clinical examination and also with the help of various tests including tilt table testing. The treatment is with various drugs including Midodrine.
Another cause for this could be due to a endocrinological disorders. It could be due to a adrenal gland disorder such as Addison disease which causes decreased cortisol production in the body. A serum cortisol level along with other tests would be diagnostic. The treatment would be with supplemental steroids.
Now if the symptoms are short in nature which means that they have just started then I would consider acute abdominal issues as a possibility. If the pain is in the upper part of the abdomen just under the ribcage then I would consider acute pancreatitis as a possibility. This is inflammation of the pancreas. A CT scan would be diagnostic. The treatment is with IV fluids and antibiotics. Similarly an infection if the gallbladder which is known as cholecystitis should also be considered. Again a CT scan or abdominal ultrasound would be diagnostic.
Lastly if you are above the age of 40 then I would also consider cardiac issues as a possibility because heart pain can radiate down into the upper abdomen as well. An EKG would be needed at this time.
So in short if the symptoms have just started and they are worsening then I would strongly recommend that you proceed directly to the er.
Do you have anymore questions?
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Doctor: Dr. Muneeb Ali, Doctor replied 4 months ago

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

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