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What Causes Dizziness, Belching, Burping And Diarrhea In A Person With Severe Stress?
Question: I need advice about what has happened to me lately. I call them attacks. Mt first was 10 days ago in middle of concert and then I have had in row in separate nights. Suddenly I start to feel very bad, my heart rate goes up, I feel pressure behind neck and body feels shaky. I took blood pressure and first day it was 165/88 and 15 min later 135/78. Second time my blood pressure was 178/88 and 15 min later 140/80. My blood pressure normally is 130-140. This has happened to me 3 times in last 10 days and second and third happened both night time out of sudden and 2 days in row. Also during so called attack I feel lightheaded and dizzy, I am very nervous and after attack I always have diarrhea. I also had stomach pressure on second and third time, belching, burping and diarrhea.
I am vey worried it is heart related as it starts happening too often. I am constantly nervous and think about my health. I do have a lot of stress and because of my work I do not get enough sleep. I am overweight (230 punds), have type 2 diabetes but do not use medication for it. It happens usually when I have had more to eat than usual. Also my mouth goes dry but the attack end about 15-20 min and leaves me tired and nervous after. Last time my face was flushed.
I had EKG 2 years ago and also ultrasound of heart that were ok.. though it has been 2 years. I have had history of panic attacks but haven't had them 3 years now. I don't know if it is relevant but my body aches when it is cold outside or when I have been on my feet all day - specially joints. I am worried hat it is heart related? Can you please advise me
I am vey worried it is heart related as it starts happening too often. I am constantly nervous and think about my health. I do have a lot of stress and because of my work I do not get enough sleep. I am overweight (230 punds), have type 2 diabetes but do not use medication for it. It happens usually when I have had more to eat than usual. Also my mouth goes dry but the attack end about 15-20 min and leaves me tired and nervous after. Last time my face was flushed.
I had EKG 2 years ago and also ultrasound of heart that were ok.. though it has been 2 years. I have had history of panic attacks but haven't had them 3 years now. I don't know if it is relevant but my body aches when it is cold outside or when I have been on my feet all day - specially joints. I am worried hat it is heart related? Can you please advise me
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello xxxxxxx,
Welcome on HCM!
Regarding your concern, I would like to explain that facing your clinical scenario, it is necessary to perform a comprehensive differential diagnosis:
(1) Some of your clinical complaints (like sudden bouts of palpitations, shaky feelings, nervousness, flushing, abdominal discomfort and diarrhea, etc) are suggestive of a serotoninergic syndrome, most likely carcinoid syndrome.
Coming to this point, a careful medical review should be done. If sufficient suspicions are raised in this regard, probably it would be necessary to perform some imagine studies to exclude any abdominal masses which are the most likely causes of carcinoid syndrome (abdominal ultrasound, fibrogastroscopy, colonoscopy, MRI, etc.). Some lab tests like dosing of blood and urine levels of several metabolites (serotonine, histamine, 5-hydroxiyndolacetic acid [5-HIAA], catecholamines, etc) could be helpful in ruling in/out this syndrome.
(2) Though not specific, facing your clinical symptomatology, a neurological status examination and eventually EEG (electroencephalogram) should be done to exclude a possible psycho-motor epilepsy (another potential responsible cause for your complaints).
(3) Another reason would be a pure anxiety, but we could safely conclude to this options only after we are relieved by excluding the above mentioned alternatives.
I recommend you to discuss with your attending doctor, perform a careful physical exam, all the routine tests (complete blood count, PCR, fasting blood glucose level, liver and renal function tests, etc) and also to find the opportunity to investigate about the above mentioned options.
Hope to have been helpful to you!
In case of further uncertainties, feel free to ask me again.
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello xxxxxxx,
Welcome on HCM!
Regarding your concern, I would like to explain that facing your clinical scenario, it is necessary to perform a comprehensive differential diagnosis:
(1) Some of your clinical complaints (like sudden bouts of palpitations, shaky feelings, nervousness, flushing, abdominal discomfort and diarrhea, etc) are suggestive of a serotoninergic syndrome, most likely carcinoid syndrome.
Coming to this point, a careful medical review should be done. If sufficient suspicions are raised in this regard, probably it would be necessary to perform some imagine studies to exclude any abdominal masses which are the most likely causes of carcinoid syndrome (abdominal ultrasound, fibrogastroscopy, colonoscopy, MRI, etc.). Some lab tests like dosing of blood and urine levels of several metabolites (serotonine, histamine, 5-hydroxiyndolacetic acid [5-HIAA], catecholamines, etc) could be helpful in ruling in/out this syndrome.
(2) Though not specific, facing your clinical symptomatology, a neurological status examination and eventually EEG (electroencephalogram) should be done to exclude a possible psycho-motor epilepsy (another potential responsible cause for your complaints).
(3) Another reason would be a pure anxiety, but we could safely conclude to this options only after we are relieved by excluding the above mentioned alternatives.
I recommend you to discuss with your attending doctor, perform a careful physical exam, all the routine tests (complete blood count, PCR, fasting blood glucose level, liver and renal function tests, etc) and also to find the opportunity to investigate about the above mentioned options.
Hope to have been helpful to you!
In case of further uncertainties, feel free to ask me again.
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer. I see that you do not seem to think that those episodes are heart related. My episodes start all of the sudden and end between 15-20 min after what blood pressure and heart rate normalizes. Flushing is not there all the time just sometimes and like said I have had 3 episodes last 10 days.
Just to clear off.. I had all tests 2 years ago- including abdominal ultrasound, gynecology exam, Camera in GI tract - I have chronic gastritis but everything else was fine. I also had MRI of brain 2 years ago. I understand that it has been 2 years but just wanted to mention it because I read that carcinoid syndrome happens after cancer or tumor has been there a long time. Is this correct?
I do get anxious a lot and even reading your letter made me stressed - I am not blaming just describing symptoms.
I also wanted to mention that after my attack yesterday my chest was burning and had a lot of gas and belching.. chest burning slowly seems to resolve.
My fasting blood sugar has been more lately and I will see doctor about it but I measured my sugar during both of these attacks and it was fine - not too high or low.
I also have had back pain last 5 days, specially flank pain on left side but no other symptoms of kidney problems - urine normal, no swelling. The pain has been slowly better every day.
Are there any other possibilities than those that you suggested. I am planning to do all tests but because of insurance I have to wait a month or so
Just to clear off.. I had all tests 2 years ago- including abdominal ultrasound, gynecology exam, Camera in GI tract - I have chronic gastritis but everything else was fine. I also had MRI of brain 2 years ago. I understand that it has been 2 years but just wanted to mention it because I read that carcinoid syndrome happens after cancer or tumor has been there a long time. Is this correct?
I do get anxious a lot and even reading your letter made me stressed - I am not blaming just describing symptoms.
I also wanted to mention that after my attack yesterday my chest was burning and had a lot of gas and belching.. chest burning slowly seems to resolve.
My fasting blood sugar has been more lately and I will see doctor about it but I measured my sugar during both of these attacks and it was fine - not too high or low.
I also have had back pain last 5 days, specially flank pain on left side but no other symptoms of kidney problems - urine normal, no swelling. The pain has been slowly better every day.
Are there any other possibilities than those that you suggested. I am planning to do all tests but because of insurance I have to wait a month or so
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
I understand your concern, and would like to reassure you that I didn't mean to make your more anxious.
I would exclude any cardiac disorders related to this symptomatology.
As a doctor, my duty is to give a professional opinion, based on a certain symptomatology.
As I explained before this symptomatology could be related to the above mentioned disorders.
Your normal performed tests do not exclude these disorders.
Why did you perform those tests?
Regarding carcinoid syndrome, you should know that sometimes the tumor is not even found, even though the symptoms are present. So it is not related for sure to an old tumor. But you should also know that even though a tumor may be the cause of this clinical situation, most of the time they are benign and not life threatening.
Are you taking any medications?
Regarding your chest pain and belching, it may be just a gastroesophageal reflux or an irritable bowel syndrome, induced by anxiety.
Nevertheless I recommend performing an abdominal ultrasound, a fibrogastroscopy and some blood lab tests to be sure that everything is OK.
Hope you will find this answer helpful!
Best regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
I understand your concern, and would like to reassure you that I didn't mean to make your more anxious.
I would exclude any cardiac disorders related to this symptomatology.
As a doctor, my duty is to give a professional opinion, based on a certain symptomatology.
As I explained before this symptomatology could be related to the above mentioned disorders.
Your normal performed tests do not exclude these disorders.
Why did you perform those tests?
Regarding carcinoid syndrome, you should know that sometimes the tumor is not even found, even though the symptoms are present. So it is not related for sure to an old tumor. But you should also know that even though a tumor may be the cause of this clinical situation, most of the time they are benign and not life threatening.
Are you taking any medications?
Regarding your chest pain and belching, it may be just a gastroesophageal reflux or an irritable bowel syndrome, induced by anxiety.
Nevertheless I recommend performing an abdominal ultrasound, a fibrogastroscopy and some blood lab tests to be sure that everything is OK.
Hope you will find this answer helpful!
Best regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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