Dizziness, Nausea, and Bloating: Seeking the Right Medical Help

Frequent dizziness, nausea, and abdominal bloating?

Hello Dr.
Wu: Since the beginning of this month, I have been experiencing dizziness and nausea (I have had these symptoms before, but not as severely as this month).
The symptoms are milder during the day, but I still feel dizzy and nauseous.
In the evenings, the symptoms become more severe.
Last week, one night, while lying down, I felt extremely dizzy, very nauseous, my heart was racing, and I had difficulty breathing, as if I was about to suffocate.
I also felt weak all over, and my hands lacked strength.
The next day, I visited a neurologist who suggested that it might be due to inner ear imbalance.
However, when I visited an ENT specialist this week, the doctor mentioned that it could be caused by anemia.
I really don’t know what to do.
Should I see a neurologist? Additionally, since I had gastroenteritis last year, I have been experiencing bloating, and even a small amount of food triggers nausea.
Occasionally, I hear gurgling sounds from my stomach, and I also feel a lump in my throat with little appetite.
I would like to know what might be causing these symptoms.
P.S.
Which specialty should I consult, and how can I prevent this?

shan, 20~29 year old female. Ask Date: 2010/03/17

Dr. Wu Fangcan reply Family Medicine

Your symptoms may indicate anemia, and individuals with allergic rhinitis often experience nasal congestion, which can also occur after a cold.
If you have tinnitus, decreased hearing, and dizziness, Meniere's disease should be suspected.
If dizziness occurs during menstruation, the likelihood of anemia increases.
Additionally, poor sleep quality can also lead to feelings of dizziness.
Some individuals with poor blood circulation may experience dizziness when turning their heads.
Those on medication should be screened for any drugs that may cause dizziness as a side effect.
After gastroenteritis, it is common to experience indigestion and bloating; it is recommended to consume light porridge or oatmeal and to avoid cold, greasy foods, legumes, and excessive dairy (which can contribute to bloating).
It is best to first consult a family physician, who can then evaluate and refer you to other specialists if necessary.

Reply Date: 2010/03/17

More Info

It sounds like you are experiencing a complex array of symptoms that can be quite distressing. Dizziness, nausea, and bloating can stem from various underlying conditions, and it’s essential to approach this situation methodically to identify the root cause and receive appropriate treatment.

Understanding Your Symptoms
1. Dizziness and Nausea: These symptoms can be linked to several factors, including vestibular disorders (related to the inner ear), neurological issues, or even gastrointestinal problems. The fact that your symptoms worsen at night and are accompanied by a rapid heartbeat and shortness of breath could indicate a more serious condition that requires further investigation.

2. Bloating and Gastrointestinal Issues: Your history of gastroenteritis could be significant. After an episode of gastroenteritis, some individuals may develop post-infectious irritable bowel syndrome (IBS), which can lead to symptoms like bloating, gas, and changes in bowel habits. The sensation of fullness and the gurgling sounds you hear could be related to increased gas production or altered gut motility.

3. Anemia: The suggestion from the ENT specialist that anemia could be a contributing factor is also worth considering. Anemia can lead to fatigue, dizziness, and weakness, and it can be caused by various factors, including dietary deficiencies, chronic diseases, or gastrointestinal bleeding.

Recommended Steps
1. Consult a Primary Care Physician: Given the complexity of your symptoms, it would be beneficial to start with a primary care physician (PCP). They can perform a comprehensive evaluation, including a physical examination and necessary laboratory tests, to assess for anemia, electrolyte imbalances, or other underlying conditions.

2. Follow-Up with Specialists: Based on the findings from your PCP, you may need to follow up with specialists:
- Neurologist: If your dizziness persists or worsens, a neurologist can conduct further tests to rule out any central nervous system issues.

- Gastroenterologist: Given your gastrointestinal symptoms, a gastroenterologist can evaluate for conditions such as IBS, food intolerances, or other digestive disorders.

- Hematologist: If anemia is confirmed, a hematologist can help determine the cause and appropriate treatment.

3. Lifestyle Modifications: While you await appointments, consider some lifestyle changes that may alleviate your symptoms:
- Dietary Adjustments: Keeping a food diary can help identify any food triggers that exacerbate your bloating and nausea. Smaller, more frequent meals may also help.

- Hydration: Ensure you are adequately hydrated, as dehydration can worsen dizziness and fatigue.

- Stress Management: Stress and anxiety can exacerbate gastrointestinal symptoms and contribute to feelings of dizziness. Techniques such as mindfulness, yoga, or gentle exercise may be beneficial.

4. Monitoring Symptoms: Keep a detailed log of your symptoms, noting their frequency, duration, and any potential triggers. This information will be invaluable for your healthcare providers in diagnosing and managing your condition.

Conclusion
Navigating health concerns can be overwhelming, especially when symptoms overlap across different systems in the body. By taking a systematic approach to your care, starting with a primary care physician and potentially involving specialists, you can work towards a clearer understanding of your health issues and find effective treatment options. Remember, it’s essential to advocate for yourself and seek the help you need to improve your quality of life.

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