Managing Diarrhea, Chest Tightness, and Palpitations: A Patient's Journey

Diarrhea, chest tightness, and palpitations?

Hello doctor, on the night of June 5th around 11 PM, I experienced diarrhea with watery stools twice, followed by chest tightness and palpitations.
The next morning, I had another bowel movement, and I took over-the-counter cold and stomach medications.
On June 8th, I visited a gastroenterologist who diagnosed me with gastroenteritis and prescribed BIOFERMIN, BUSCOPAN, K.B.T (XX), STRICAINE 5MG, and GASCON (to be taken six times), as well as INDERAL and VALIUM (which I took once on the night of June 9th due to chest tightness and palpitations that kept me awake).
I did not take IMODIUM because I had no diarrhea after seeing the doctor.

On the morning of June 10th, I had watery stools again, so I went to the emergency room where I underwent chest and abdominal X-rays, an electrocardiogram, and blood tests (including a complete blood count, white blood cell differential, coagulation tests, blood glucose, sodium, and potassium), all of which were normal, except for some residual stool in my abdomen.
The doctor prescribed an antidiarrheal, a heart rhythm medication, and a tranquilizer.
I did not take the antidiarrheal in the following days because I had no diarrhea.

On the night of June 14th, after finishing my medications, I experienced chest tightness and palpitations that kept me awake, so I took some heart rhythm medication (leftover from a family member who takes it regularly) and half a sleeping pill, which allowed me to fall asleep.
On June 15th, due to ongoing chest tightness and palpitations, I returned to the same clinic to see a cardiologist.
The doctor prescribed the same gastrointestinal medications and antidiarrheal, along with two different medications for chest tightness and palpitations.
However, I still experienced chest tightness and palpitations.
During the day, I could manage it, especially when I was focused on gaming or reading, but at night, I struggled to sleep because I became aware of my breathing rate and had to get up to take heart rhythm medication and half a sleeping pill to fall asleep.

On June 16th, my stool was formed.
On June 17th, after dinner, I had watery stools again (that day I ate lean meat porridge, scrambled eggs, vegetables, fish, and a pack of seaweed).
The recurring diarrhea and chest tightness with palpitations have been very distressing and have persisted for two weeks.

Ye, 10~19 year old female. Ask Date: 2021/06/17

Dr. Chen Shidian reply Gastroenterology and Hepatology

There may be gastrointestinal dysfunction and autonomic nervous system disorders, which may require treatment from gastroenterologists and psychosomatic medicine specialists if necessary.

Reply Date: 2021/06/17

More Info

Managing symptoms such as diarrhea, chest tightness, and palpitations can be quite challenging, especially when they persist over a period of time. Based on your detailed account, it appears that you have been experiencing a combination of gastrointestinal and cardiovascular symptoms that have significantly impacted your daily life and sleep quality.

Understanding Your Symptoms
1. Diarrhea: Your episodes of diarrhea, particularly watery stools, suggest a possible gastrointestinal infection or inflammation, commonly referred to as gastroenteritis. This can be caused by viral, bacterial, or parasitic infections, and it often presents with symptoms such as abdominal cramps, nausea, and vomiting. The fact that you experienced diarrhea multiple times, along with the presence of residual stool noted in your emergency visit, indicates that your gastrointestinal system may still be recovering.

2. Chest Tightness and Palpitations: The sensations of chest tightness and palpitations can be distressing and may be linked to several factors. Stress and anxiety can exacerbate these symptoms, particularly in the context of gastrointestinal distress. Additionally, medications such as Inderal (a beta-blocker) and Valium (a benzodiazepine) can influence heart rate and rhythm, potentially leading to feelings of palpitations. It is also important to consider that dehydration from diarrhea can lead to electrolyte imbalances, which can affect heart function and contribute to palpitations.

Management Strategies
1. Hydration and Electrolyte Balance: Given your history of diarrhea, it is crucial to maintain proper hydration. Oral rehydration solutions or electrolyte drinks can help replenish lost fluids and electrolytes. Avoiding caffeine and alcohol is advisable, as these can exacerbate dehydration and gastrointestinal symptoms.

2. Dietary Adjustments: Following a bland diet may help manage your gastrointestinal symptoms. Foods such as bananas, rice, applesauce, and toast (the BRAT diet) are often recommended during recovery from diarrhea. Gradually reintroducing other foods, while monitoring your body's response, can be beneficial.

3. Medication Review: It’s essential to discuss your current medications with your healthcare provider. If you are experiencing side effects from Inderal or Valium, your doctor may consider adjusting the dosage or switching to alternative medications that may have a more favorable side effect profile. Additionally, if you have not taken Imodium due to the absence of diarrhea, it may be worth discussing its use if diarrhea recurs.

4. Monitoring Symptoms: Keeping a symptom diary can help you and your healthcare provider identify patterns or triggers related to your chest tightness and palpitations. Note the timing, duration, and intensity of these symptoms, as well as any associated activities or stressors.

5. Stress Management: Since anxiety can exacerbate both gastrointestinal and cardiovascular symptoms, incorporating stress management techniques such as deep breathing exercises, meditation, or gentle yoga may provide relief. Cognitive-behavioral strategies can also be beneficial in managing anxiety related to your symptoms.

6. Follow-Up Care: Given the persistence of your symptoms over two weeks, it is advisable to have a follow-up appointment with your healthcare provider. They may recommend further investigations, such as blood tests to check for infections or electrolyte imbalances, or imaging studies if warranted. If symptoms worsen or new symptoms arise, seeking immediate medical attention is crucial.

Conclusion
In summary, managing your symptoms of diarrhea, chest tightness, and palpitations requires a multifaceted approach that includes hydration, dietary modifications, medication review, and stress management. Regular follow-up with your healthcare provider is essential to monitor your condition and make necessary adjustments to your treatment plan. Remember, your health is a priority, and addressing these symptoms holistically can lead to improved well-being.

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