Abdominal Pain and Symptoms After Extreme Weight Loss

Neck pain, dizziness, palpitations, tremors, and dull pain in the right abdomen?

Since last year, I decided to lose weight and have tried various methods, possibly too extreme (such as inducing vomiting, following a monk's diet by not eating after 2 PM, and if hungry, drinking milk or eating fruit and crackers).
Additionally, I haven't taken good care of myself.
Over the year, although I have lost weight, I feel that my body is not very healthy because I experience bloating and discomfort after eating.
Recently, I have been feeling a sharp, stabbing sensation in the area below my right rib cage, between my navel and waist (a palm-sized area below the right rib cage and above the navel, extending towards the waist).
Sometimes, it feels like I'm being pinched, and the muscles on the right side of my lower back are sore, along with some discomfort in my back, which feels muscular rather than visceral.
When lying flat to sleep, it feels like the organs in my right abdomen are heavy, pressing down on the bed.

I hope this is simply due to my menstrual period causing some fatigue over the past couple of days.
Suddenly, I have been experiencing neck pain, dizziness, palpitations, and tingling in my scalp.
In severe cases, my hands tremble.
However, the dull pain in my right abdomen feels different from menstrual cramps.
After eating, I am left with persistent neck pain, dizziness, and a shallow feeling of breathlessness.
I have been very worried these past few days and don't know what is happening.
I'm a bit scared because I usually feel a slight stabbing pain in my right abdomen, but it hasn't appeared for a while.
Now, unfortunately, I am in the U.S.
visiting relatives and don't know how to alleviate or assess my symptoms.

My skin and sclera do not appear yellow, and my urine is relatively normal, with a slight yellow tint.
I do not have a lack of appetite (though I am controlling my diet out of fear of gaining weight).
I have bowel movements about every two to three days, which are neither hard nor soft, and I do not have difficulty passing them.
I am unsure whether I should immediately change my flight back to Taiwan or how to observe myself for any necessary actions.
In the U.S., I don't know how to get tested, as I am unfamiliar with the area.
Thank you, doctor.

Xiao Bi, 20~29 year old female. Ask Date: 2007/05/13

Dr. Chen Shidian reply Gastroenterology and Hepatology

Dear Miss Xiao Bi,
Discomfort in the upper right abdomen may be due to causes such as duodenal ulcers, gallstones, or right kidney stones.
Generally, if medication adjustments do not alleviate the discomfort, an ultrasound should be performed, and if necessary, an upper gastrointestinal endoscopy may be considered.
Additionally, you have shown some signs of sympathetic nervous system dysregulation (possibly due to high stress or excessive hunger?).
Please reduce stress and maintain a regular routine.
Changhua Hospital cares about your health.
Sincerely,
Chen Shidian

Reply Date: 2007/05/13

More Info

It sounds like you are experiencing a range of concerning symptoms following significant weight loss and changes in your eating habits. Let's break down your situation and address your concerns regarding abdominal pain and other symptoms.

Understanding Your Symptoms
1. Abdominal Pain: The sharp, stabbing pain you describe in your right abdomen, particularly below the rib cage and above the belly button, could be related to several factors. Given your history of extreme dieting and potential malnutrition, your digestive system may be reacting negatively. The sensation of fullness and discomfort after eating could indicate issues such as gastritis, which is inflammation of the stomach lining, or even gallbladder issues, especially if you have been consuming a high-fat diet intermittently.

2. Muscle Pain and Discomfort: The aching in your right side and back could be muscular, especially if you have been engaging in physical activity or if your posture has changed due to discomfort. Stress and anxiety can also lead to muscle tension, which might explain the neck pain and headaches you are experiencing.

3. Gastrointestinal Distress: The bloating and discomfort after meals suggest that your digestive system may not be functioning optimally. This could be due to a lack of essential nutrients, which can occur with extreme dieting practices. Your body may be struggling to process food efficiently, leading to feelings of heaviness and discomfort.

4. Other Symptoms: The neck pain, dizziness, heart palpitations, and tingling sensations could be signs of anxiety or stress, especially if you are feeling overwhelmed by your health concerns. However, they could also indicate a more serious issue, particularly if they persist.

Recommendations
1. Seek Medical Attention: Since you are currently in the United States, it is crucial to seek medical attention. You can visit an urgent care facility or a local hospital to discuss your symptoms with a healthcare professional. They may recommend imaging studies, such as an ultrasound or CT scan, to evaluate your abdominal organs and rule out any serious conditions.

2. Monitor Your Symptoms: Keep a detailed log of your symptoms, including when they occur, their intensity, and any associated factors (like food intake or stress levels). This information will be valuable for healthcare providers.

3. Dietary Adjustments: Given your history of extreme dieting, it may be beneficial to gradually reintroduce a balanced diet rich in whole foods, including fruits, vegetables, lean proteins, and whole grains. Avoiding extreme caloric restriction and focusing on nutrient-dense foods can help your body recover.

4. Hydration: Ensure you are drinking enough water throughout the day. Dehydration can exacerbate feelings of dizziness and fatigue.

5. Stress Management: Consider incorporating stress-reducing techniques such as mindfulness, meditation, or gentle exercise like yoga. These practices can help alleviate muscle tension and improve your overall well-being.

6. Follow-Up Care: Once you return to your home country, consider scheduling a follow-up appointment with a healthcare provider to discuss your symptoms in detail. They may recommend further testing or a referral to a specialist, such as a gastroenterologist or a nutritionist.

Conclusion
Your symptoms warrant attention, especially given the significant changes in your health and lifestyle. While some discomfort may be related to dietary changes or stress, it is essential to rule out any serious underlying conditions. Seeking medical care promptly will help you get the answers you need and guide you toward a healthier path. Remember, your health is a priority, and taking the steps to address these concerns is crucial.

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