Abdominal Pain, Headaches, and Fever: Possible Causes and Solutions

Q: Abdominal Pain, Headaches, and Fever: Possible Causes and Solutions

Hello： Please be aware of gastrointestinal symptoms that may be caused by a cold (viral infection). <br>It is advisable to seek medical attention for a proper evaluation by a physician, who can arrange appropriate tests. <br>Antipyretic and analgesic medications can help reduce f

Stomach pain + headache + fever

Hello Dr.
Tsai, I apologize for the lengthy message.

(1) About a month ago, I underwent an endoscopy and was diagnosed with a gastric ulcer.
After taking medication for nearly three weeks, I felt much better, so last Saturday I went out for hot pot with my family (I consumed some hot food and iced tea).
The next day, I started experiencing stomach pain again, although I did not have diarrhea.
The pain felt like it started a few minutes after eating.

(2) This Tuesday afternoon, I began to feel a headache and body aches.
When I took my temperature, it was nearly 38 degrees Celsius.
I put on a mask, thought I would rest for the night, and didn't think much of it.

(3) By Wednesday, I went to the clinic to get medication.
I asked the doctor if I needed a rapid flu test, but he said there was no sore throat, cough, or runny nose, so it didn’t seem like a cold, and therefore it wasn't necessary.
I took the medication and went home.
After taking a dose at noon, I felt a bit of a fever reduction and thought I was fine.
However, my temperature was still slightly elevated (around 37.5 degrees), but I was concerned about taking more medication affecting my stomach, so I stopped.
Unexpectedly, Wednesday night I felt chills and had a high fever of about 39.5 degrees, so I quickly took acetaminophen, which brought it down to around 37.5 degrees.
(4) On Thursday, my temperature stayed around 37.5 to 38 degrees (without taking acetaminophen).
However, in the evening, I started to feel feverish again, so I went to the hospital for a check-up.
The doctor ordered blood tests, X-rays, urine tests, and an abdominal ultrasound.
The results were as follows: the chest X-ray was normal, the gallbladder appeared not enlarged, and the blood tests were generally acceptable, with only a slightly elevated white blood cell count of about 13,000.
The doctor mentioned that this could indicate some inflammation.
The urine test showed 1+ proteinuria, but the doctor said that fever could also cause protein in the urine.
Ultimately, he suggested it might just be a simple viral infection and prescribed acetaminophen for home use.
(5) On Friday, I still had a mild fever (around 37.5 degrees), so I went to a larger hospital.
This time, the doctor performed an abdominal X-ray and blood tests.
The white blood cell count had decreased to 12,000, and most other indicators were normal.
There was no sign of pancreatic inflammation, and the X-ray looked fine, so he suggested it could be gastroenteritis (though I haven't had diarrhea).
I asked if I needed antibiotics, and the doctor said no, as the white blood cell count was not indicative of a bacterial infection, but rather seemed viral.
(6) After seeing the doctor on Friday, I diligently took the prescribed medications for fever and stomach issues three times a day.
This morning (Saturday), when I woke up, my temperature was around 37 degrees, and I was very happy, thinking I could stop taking the fever medication.
However, by noon, I started to feel feverish again.
Now it is Saturday afternoon, and my temperature is 38 degrees (measured with an ear thermometer).
I would like to ask the following questions:
1.
My symptoms include stomach pain, headache, and fever.
What could be the possible causes? (I haven't had much diarrhea, only once each on Friday and Saturday morning, which I believe was due to taking too much stomach medication.
My gastrointestinal tract still feels somewhat active, but I don't feel like I have diarrhea, just some gas.)
2.
Since I've had a fever from Tuesday afternoon until today (Saturday), and blood tests and X-rays are mostly normal, what further tests should I undergo?
3.
Can simple gastritis or a viral infection cause a fever lasting this many days?
4.
Today, the stomach pain has decreased, but why does my temperature remain elevated if I don't take fever-reducing medication?
5.
How many more days might it take for me to improve? Should I continue taking the fever-reducing medication?
I greatly appreciate your assistance with these five points.

Xiao Ke, 30~39 year old female. Ask Date: 2012/11/24

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Please be aware of gastrointestinal symptoms that may be caused by a cold (viral infection).
It is advisable to seek medical attention for a proper evaluation by a physician, who can arrange appropriate tests.
Antipyretic and analgesic medications can help reduce fever and, when used moderately and in conjunction with gastric medications, should not pose significant risks.
Additionally, the relief from symptoms and the effectiveness of medications may take a few days, depending on individual immunity and the severity of the infection.
If symptoms persist, it is important to seek medical care promptly for appropriate evaluation and treatment.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2012/11/24

More Info

Hello! Thank you for your detailed description of your symptoms and medical history. Based on the information you've provided, let's break down your situation regarding abdominal pain, headaches, and fever, and explore possible causes and solutions.

1. Possible Causes of Your Symptoms
Your symptoms of abdominal pain, headaches, and fever could be attributed to several factors. Given your recent diagnosis of a gastric ulcer and the subsequent dietary choices, it's possible that your abdominal pain is related to irritation of the stomach lining, especially after consuming hot foods and beverages. This could lead to gastritis or a flare-up of your ulcer, which might explain the pain shortly after eating.

The fever and body aches you experienced could suggest a viral infection, particularly since your blood tests indicated elevated white blood cell counts, which often signal inflammation or infection. The absence of respiratory symptoms like a sore throat or cough makes a typical respiratory infection less likely. Instead, a viral gastroenteritis or a systemic viral infection could be at play, which can sometimes present with fever and generalized body aches without significant gastrointestinal symptoms like diarrhea.

2. Further Investigations
Given that your blood tests and X-rays have returned mostly normal, further investigations might include:
- Stool Tests: To check for any viral or bacterial pathogens that could be causing your gastrointestinal symptoms.

- Ultrasound or CT Scan: If abdominal pain persists, imaging studies can help rule out other conditions such as appendicitis or pancreatitis.

- Endoscopy: If symptoms continue or worsen, a repeat endoscopy may be warranted to evaluate the status of your gastric ulcer and rule out any complications.

3. Duration of Symptoms
It is indeed possible for a simple case of gastritis or a viral infection to cause prolonged fever. Viral infections can sometimes last several days to weeks, depending on the virus and the individual's immune response. Gastritis or ulcer flare-ups can also lead to persistent discomfort and systemic symptoms like fever.

4. Fever Management
The fact that your fever persists even when not taking antipyretics (fever-reducing medications) suggests that your body is still fighting an underlying issue. It's not uncommon for fevers to fluctuate, and they can remain elevated as long as there is inflammation or infection present. Continuing to monitor your temperature and symptoms is crucial. If the fever remains high or worsens, it would be advisable to consult your healthcare provider again.

5. Recovery Timeline
Recovery from viral infections can vary widely. Generally, if your symptoms are improving, you may expect gradual resolution over the next few days to a week. However, if your fever persists beyond a week or if you experience worsening symptoms, it would be prudent to seek further medical evaluation.

Conclusion
In summary, your symptoms of abdominal pain, headaches, and fever could be linked to a combination of gastric irritation and a possible viral infection. It's essential to continue monitoring your symptoms and maintain communication with your healthcare provider. If your condition does not improve or worsens, further investigations may be necessary to ensure appropriate treatment. In the meantime, continue taking your medications as prescribed, stay hydrated, and rest as much as possible. If you have any further questions or concerns, feel free to reach out!

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