Abdominal Pain, Vomiting, and Fever: A Gastrointestinal Perspective

Issues with stool, abdominal pain, chills, and fever?

Hello, Doctor.
Starting from the evening of the 27th, I began to experience persistent vomiting (every half hour) and chills.
On the morning of the 28th, I started vomiting yellow bile, and throughout the day, I continued to vomit without stopping.
I had several episodes of fever reaching 39.6 degrees Celsius, accompanied by severe pain in the upper left abdomen (just below the left chest).
Occasionally, I also experienced uncontrollable shivering and felt cold.
The symptoms of upper left abdominal pain, vomiting, chills, and fever persisted for the entire day.
On the 29th, I found that if I lay still, I did not feel discomfort (I cannot drink even a little water, as it makes me want to vomit).
When I stand up, abdominal pain begins, and yellow watery stools flow from my rectum, which contain some impurities.
By the 30th, I was able to eat and drink small amounts without vomiting, but the abdominal pain and watery stools continued.
Since this has been going on for four consecutive days, I am quite worried and would like to consult with you, Doctor.

Miss Hsu, 30~39 year old female. Ask Date: 2020/05/01

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please seek urgent medical evaluation and treatment as soon as possible.

Reply Date: 2020/05/01

More Info

Abdominal pain, vomiting, and fever can be indicative of various gastrointestinal issues, and the symptoms you describe suggest a potentially serious condition that warrants immediate medical attention. Based on your timeline and symptoms, it appears that you may be experiencing an acute gastrointestinal infection or inflammation, possibly involving the stomach or intestines.

Possible Causes
1. Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by viral or bacterial infections. Symptoms typically include vomiting, diarrhea, abdominal pain, and fever. The yellow liquid you are vomiting could be bile, which often occurs when the stomach is empty.

2. Appendicitis: Although your pain is primarily in the left upper abdomen, appendicitis can sometimes present atypically. It usually starts with generalized abdominal pain that localizes to the right lower quadrant, but in some cases, it can cause pain in other areas.

3. Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain, vomiting, and fever. The pain is often located in the upper abdomen and can radiate to the back.

4. Cholecystitis: Inflammation of the gallbladder can cause severe pain in the upper right abdomen, but it can also present with left-sided pain. It is often accompanied by nausea and vomiting.

5. Bowel Obstruction: This can lead to severe abdominal pain, vomiting, and changes in bowel movements. The presence of water stools with impurities may suggest a blockage or severe irritation in the intestines.

Recommended Actions
Given that you have experienced these symptoms for several days, it is crucial to seek medical attention as soon as possible. Here are some steps you should consider:
1. Hydration: Since you are experiencing vomiting and diarrhea, it is essential to stay hydrated. However, if drinking water induces vomiting, you may need intravenous fluids, which can be administered in a hospital setting.

2. Diagnostic Tests: A healthcare provider may recommend several tests to determine the cause of your symptoms, including:
- Blood tests to check for signs of infection or inflammation.

- Imaging studies such as an abdominal ultrasound or CT scan to visualize the organs and identify any abnormalities.

- Stool tests to check for pathogens if gastroenteritis is suspected.

3. Symptomatic Treatment: Depending on the diagnosis, treatment may include medications to control nausea and vomiting, antibiotics if a bacterial infection is present, or other specific treatments based on the underlying cause.

4. Monitoring Symptoms: Keep track of your symptoms, including the frequency and nature of your vomiting, any changes in abdominal pain, and your temperature. This information will be valuable for your healthcare provider.

Conclusion
In summary, the combination of abdominal pain, vomiting, and fever can indicate a range of gastrointestinal issues, some of which may require urgent medical intervention. It is essential to consult a healthcare professional who can perform a thorough evaluation and provide appropriate treatment. Do not delay seeking help, especially since your symptoms have persisted for several days. Your health and well-being are paramount, and timely medical care can make a significant difference in your recovery.

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