A 43-year-old man has sought further evaluation for persistent gastrointestinal (GI) symptoms, which have been troubling him for the past year. The patient, an emergency medicine physician, reports experiencing recurrent episodes of hives, nausea, vomiting, cramping epigastric pain, and watery, nonbloody loose stools. He is unable to pinpoint specific triggers for these episodes but suspects a potential link to his diet. Notably, he finds no relief from his symptoms through methods such as hot showers or the use of proton pump inhibitors. Periodically, his symptoms abate for about a week, during which he describes feeling normal.
However, the patient denies experiencing voice changes, throat swelling, bloating, greasy or floating stools, shortness of breath, wheezing, chest pain, melena, hematochezia, or recent use of antibiotics.
In terms of lifestyle factors, the patient acknowledges recreational marijuana use (approximately one joint per week) and occasional alcohol consumption. He maintains a regular exercise regimen, enjoying activities such as hiking in his Connecticut locale. To manage exercise-related soreness, he occasionally turns to nonsteroidal anti-inflammatory drugs (NSAIDs). Additionally, he cites the stress of his occupation as an emergency medicine physician, which often disrupts his sleep patterns, limiting him to around 6 hours of sleep per night.
This case underscores the complexity of gastrointestinal symptoms and their potential interplay with lifestyle factors, occupational stress, and recreational habits. Further evaluation and management are warranted to address the patient’s ongoing discomfort and optimize his overall well-being.
