Your Symptoms: When to Seek Medical Help for Discomfort

Physical discomfort?

Hello Doctor: In recent months, I have been experiencing various pains, and I'm unsure if they are due to stress or if there are actual health issues.
For the past few weeks, I have been feeling very dizzy, accompanied by a constant desire to sleep.
Often, I feel the urge to sleep just two hours after getting up, and even after sleeping, there is a high chance that I still feel unrefreshed.
The dizziness is particularly noticeable when I am at a height.
I frequently experience dry heaving, especially when I wake up too early, which exacerbates the situation.
I also have symptoms of gastroesophageal reflux.
My gums have been bleeding frequently over the past few weeks, and I have had two instances of nosebleeds from my right nostril after showering.
My sleep schedule has been irregular over the past two weeks; initially, I would often sleep for 8 to 9 hours, but recently, I can only manage 3 to 4 hours before I am unable to fall back asleep.
I often feel chest tightness; I used to experience chest tightness and palpitations 5 to 6 years ago, which had subsided for a while, but now it has returned.
My appetite has decreased to about half of what it used to be; I used to finish a full meal, but now I feel full after eating just half, to the point of feeling nauseous.
I have been experiencing bloating for nearly six months, and my bowel movements have become irregular; I used to have a bowel movement once a day, but now it takes 2 to 3 days.
Sometimes, when wiping, I notice small pieces that feel undigested, and occasionally the color of the stool is reddish or brownish.
I have had three instances of blood in my stool: two were dark red, and one was bright red.
When I consulted a doctor, they mentioned slight internal hemorrhoids, which might be the cause.
I often experience abdominal pain, and it also hurts when I have a bowel movement.
I frequently feel sharp pain below my knees, and my hands often feel tight.
If there are health issues, could you please advise which specialist I should see or what health checks I should undergo? Thank you for taking the time to read through this disorganized content.
I appreciate your effort.

Xue, 20~29 year old female. Ask Date: 2019/02/10

Dr. Xu Peiqi reply Family Medicine

Hello Mr.
Hsueh, thank you for your inquiry, and I appreciate your efforts regarding your health condition.
To summarize your concerns, you are experiencing dizziness and fatigue, nausea, poor appetite, acid reflux, irregular bowel movements with blood, and occasional chest tightness and palpitations.
The most common cause of these symptoms is indeed excessive stress and poor adaptation to life changes.
Therefore, I recommend that you adjust your daily routine and lifestyle, incorporating appropriate stress relief and rest, as this may be the most effective solution.
However, it is better to be cautious, so I still advise you to schedule an appointment for an outpatient consultation, where a physician can help rule out more serious issues.
Given your symptoms, the first concern to exclude would be gastrointestinal malignancies, so I recommend arranging for a gastrointestinal endoscopy.
Common tests such as hemoglobin levels and an electrocardiogram can also be performed as needed.
Wishing you a speedy recovery.

Reply Date: 2019/02/10

More Info

Hello! Thank you for reaching out with your concerns. It sounds like you are experiencing a multitude of symptoms that are causing you significant discomfort and distress. I want to emphasize that seeking medical help is crucial when you have such a complex array of symptoms, especially when they affect your daily life and well-being.

From what you’ve described, your symptoms include severe dizziness, excessive sleepiness, gastrointestinal issues (such as gastroesophageal reflux and changes in bowel habits), bleeding gums, nasal bleeding, chest tightness, and significant changes in appetite. These symptoms can be interconnected, and they may stem from a combination of physical health issues and psychological stressors.

When to Seek Medical Help
1. Persistent Symptoms: If your symptoms have been ongoing for several months and are worsening, it is essential to consult a healthcare professional. Persistent dizziness, for example, can indicate various underlying conditions, including vestibular disorders, anemia, or even neurological issues.

2. Gastrointestinal Concerns: The gastrointestinal symptoms you mentioned, such as gastroesophageal reflux and changes in bowel habits (including blood in your stool), warrant immediate medical evaluation. Blood in the stool can be a sign of serious conditions, including hemorrhoids, diverticulitis, or even more severe gastrointestinal diseases.

3. Changes in Mental Health: The combination of physical symptoms and feelings of fatigue and sleep disturbances can also be indicative of underlying mental health issues, such as anxiety or depression. Mental health can significantly impact physical health, and vice versa. If you find that your mood is low or you are feeling overwhelmed, it’s important to address these feelings with a professional.

4. Physical Symptoms: Symptoms like chest tightness, especially if they are recurrent, should not be ignored. They could be related to anxiety, but they could also indicate cardiovascular issues that need to be ruled out.

Recommended Steps
1. Primary Care Physician: Start by scheduling an appointment with your primary care physician (PCP). They can conduct a thorough evaluation of your symptoms, take a detailed medical history, and perform a physical examination. Your PCP may order blood tests, imaging studies, or refer you to specialists based on their findings.

2. Specialist Referrals: Depending on your symptoms, your PCP may refer you to specialists:
- Gastroenterologist: For your gastrointestinal symptoms, especially the blood in your stool and reflux.

- Cardiologist: If your chest tightness and previous history of palpitations are concerning.

- Neurologist: If your dizziness and neurological symptoms persist.

- Psychiatrist or Psychologist: If there are significant mental health concerns.

3. Diagnostic Tests: Be prepared for your doctor to recommend various tests, such as:
- Blood tests (to check for anemia, thyroid function, etc.)
- Endoscopy (to evaluate gastrointestinal issues)
- Imaging studies (like an MRI or CT scan if neurological issues are suspected)
- Cardiac evaluations (like an EKG or echocardiogram)

Conclusion
It’s understandable to feel overwhelmed by your symptoms, but addressing them with a healthcare professional is the best course of action. They can help you untangle the web of symptoms and provide a comprehensive treatment plan tailored to your needs. Remember, you are not alone in this, and there are resources and professionals available to help you navigate through these challenges. Please take care of yourself and prioritize seeking the help you need.

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