Headaches and Nausea: Common Symptoms and Solutions

Headache with nausea and the urge to vomit?

Hello doctor, I suddenly started having a fever on Sunday night, which rose to 39 degrees Celsius within two to three hours.
I experienced body aches, dizziness, and nausea, so I quickly went to the emergency room for antipyretic treatment (PCR test was negative).
The doctor prescribed me medication for my stomach, antipyretics, and anti-diarrheal medication.
On Monday and Tuesday, I still had a fever, peaking at 38 degrees Celsius, and experienced diarrhea (once a day), along with occasional discomfort in my lower abdomen.
By Tuesday, the muscle aches had eased, but the headache and nausea were still prominent.
I have not actually vomited, but I often feel nauseous, especially when getting up after sitting for a long time.
The headache feels most intense during those times, or when I bend over or lower my head, I also experience a stronger sensation.

Miss Zhong, 20~29 year old female. Ask Date: 2021/07/28

Dr. Xiao Yongxun reply Family Medicine

Dear Miss Zhong,
1.
Nausea is an uncomfortable sensation that feels like you are about to vomit.
If it is accompanied by contractions of the gastrointestinal tract and muscles in the chest and abdomen, leading to the forceful expulsion of stomach contents through the mouth, it is referred to as vomiting.
Both nausea and vomiting can occur in many diseases; in fact, fever itself can cause such symptoms, along with headaches.
There are many causes of fever, with more than half stemming from infections, including bacteria, viruses, parasites, fungi, and rickettsiae.
Fever is actually a protective response of the body, often making it more difficult for pathogens to survive.
In other words, fever enhances the immune function of the body, increasing the activity of phagocytes to help eliminate certain bacteria, viruses, and harmful substances; it also enhances the liver's detoxification capabilities.
However, there are other causes of fever, such as pregnancy, ovulation, autoimmune diseases, hormonal imbalances, drug reactions, and cancers (such as lung cancer, liver cancer, kidney cancer, lymphoma, and leukemia).
Sometimes, the cause of fever is difficult to identify, and it may persist for more than two weeks, clinically referred to as fever of unknown origin, which poses significant challenges for both patients and clinicians.
2.
Your condition cannot be diagnosed here.
Given that you have had a fever for three days and experience more severe headaches upon standing, we would initially consider an infectious disease.
However, what is the source of the infection? It may be necessary to conduct a clinical physical examination, laboratory tests, bacterial cultures, serological tests, imaging studies, etc., to potentially identify the cause.
If we only consider infections in the lower abdomen, we would also think about pelvic inflammatory disease, urinary tract infections, appendicitis, diverticulitis, bowel obstruction, and so on.
3.
Please discuss your situation in detail with your family physician before making any decisions; alternatively, you may go directly to the emergency department or infectious disease department of a regional hospital or higher for medical care.

Reply Date: 2021/07/28

More Info

Hello! Based on your description, it sounds like you're experiencing a combination of symptoms that could be related to several underlying issues. The sudden onset of fever, body aches, headache, and nausea can be indicative of various conditions, including viral infections, gastrointestinal issues, or even tension headaches exacerbated by your overall discomfort.

Understanding Your Symptoms
1. Fever and Body Aches: The fever you experienced, reaching up to 39 degrees Celsius, along with body aches, suggests that your body is fighting off an infection. This could be viral, especially since your PCR test came back negative, ruling out COVID-19. Common viral infections can cause systemic symptoms like fever and muscle pain.

2. Headache and Nausea: The headaches you're experiencing, particularly when standing up or bending down, could be related to tension or could be a symptom of increased intracranial pressure, which can occur with certain infections. Nausea often accompanies headaches, especially if they are severe or if there is an underlying gastrointestinal issue.

3. Gastrointestinal Symptoms: The diarrhea and abdominal discomfort could be linked to a viral gastroenteritis, which can cause both gastrointestinal and systemic symptoms. It's also possible that the medications you were given (like the antipyretics or anti-nausea medications) could have gastrointestinal side effects.

Recommendations
1. Hydration: It's crucial to stay well-hydrated, especially if you're experiencing fever and diarrhea. Dehydration can exacerbate headaches and nausea. Consider electrolyte solutions if you're losing fluids.

2. Rest: Your body needs time to recover from whatever infection you might be dealing with. Ensure you get plenty of rest, as fatigue can worsen headaches and overall discomfort.

3. Pain Management: For your headaches, over-the-counter pain relievers like acetaminophen or ibuprofen can be effective. However, be cautious with the dosage and frequency, especially if you're also taking other medications.

4. Monitor Symptoms: Keep an eye on your symptoms. If your fever persists beyond a few days, or if your headaches worsen or become unmanageable, it would be wise to follow up with a healthcare provider. They may want to conduct further tests to rule out any serious conditions.

5. Avoid Triggers: If certain positions (like bending over) exacerbate your headaches, try to avoid those movements until your symptoms improve.
6. Consult a Specialist: If your symptoms do not improve or if you experience new symptoms (like severe abdominal pain, persistent vomiting, or changes in consciousness), seek medical attention promptly. A neurologist may be needed if headaches persist, while a gastroenterologist could help with ongoing gastrointestinal issues.

Conclusion
In summary, your symptoms suggest a possible viral infection affecting both your systemic health and gastrointestinal system. Managing hydration, rest, and appropriate pain relief are key steps in your recovery. However, do not hesitate to seek further medical advice if your condition does not improve or worsens. Your health is paramount, and timely intervention can make a significant difference in your recovery process.

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