21-Year-Old Woman with Seronegative RA and Gastroparesis Experiencing Unusual Symptoms
A 21-year-old female has been diagnosed with seronegative rheumatoid arthritis and is undergoing treatment with Humiroz, a biosimilar to Humira, administered bi-weekly. Currently, there is an investigation into possible connective tissue disorders, yet no definitive diagnosis has been established as of now. For pain and fatigue management, she is prescribed Duloxetine at 30 mg, while Prazosin at 3 mg is utilized to address sleep disturbances and nightmares. To manage acid reflux, she has been given Omeprazole at 30 mg. Recently, she underwent a gastric emptying study (GES), which was terminated after four hours due to inadequate stomach movement, leading to a diagnosis of moderate gastroparesis. Despite a slight weight loss of 9 pounds — which is not significant given her already slender frame — she is coping with unexpected health challenges. One peculiar symptom she experiences is a combination of sneezing and vomiting, which she humorously refers to as "snomiting." This troubling occurrence arises approximately twice a week and is often preceded by a mild fever, usually around 100.8°F to 100.9°F, culminating in episodes over the toilet. So far, feedback from healthcare professionals regarding her sneezing and vomiting has been minimal, often reduced to comments noting the oddity of such symptoms. She is eager to understand the underlying cause of this unusual connection between her sneezing fits and vomiting, as it poses a significant inconvenience in her daily life.
Answers (1)
7/7/2025, 11:20:36 PM
OpenHealth AI
The combination of sneezing and vomiting (referred to as "snomiting") alongside mild fever and your ongoing medical conditions can understandably be concerning. Let's explore this further and determine key steps you can take.
Explanation:
Sneezing and vomiting together might indicate a reflex response from the body, potentially linked to irritation in the throat or nasal passages. In your case, the underlying factors could include:
- Gastrointestinal Issues: Your diagnosis of moderate gastroparesis could cause nausea and vomiting. Delayed gastric emptying might lead to food or acid irritating your stomach and triggering a gag reflex.
- Allergic Reactions: Sneezing often relates to allergies or environmental irritants. If you're exposed to allergens, it could exacerbate these reactions, potentially leading to nausea.
- Systemic Symptoms: The interplay between your autoimmune condition and any underlying connective tissue disorders could also manifest in unusual symptoms, including these.
Next Steps:
-
Identify Triggers: Keep a symptom diary to note when these episodes occur. Document any possible triggers, such as food, environmental allergens, or activities preceding the "snomiting." This information can be crucial for your healthcare provider.
-
Evaluate Allergies: Consider consulting an allergist or your current healthcare provider about possible allergies, especially if sneezing correlates with certain exposures (e.g., dust, pollens). Testing might clarify if allergens play a role.
-
Symptom Management: To handle nausea resulting from gastroparesis:
- Eat smaller, more frequent meals that are easier to digest.
- Avoid foods that are high in fat and fiber, as they can slow gastric emptying.
- Stay hydrated, but try to drink fluids between meals rather than during to prevent feeling overly full.
-
Monitor Fever Response: Keep an eye on the pattern of your mild fevers, especially since autoimmune conditions can sometimes manifest with systemic symptoms. If fevers persist or worsen, it’s important to document these occurrences for your provider.
-
Follow-Up with Your Provider: Since the feedback you've received has felt insufficient, make an appointment specifically to discuss these unusual symptoms in detail. Bring your symptom diary and any documented triggers or patterns to facilitate a focused discussion.
This multifaceted approach can help you gain clarity regarding your symptoms and allow for adjustments in your management plan, making daily life more comfortable. Let me know if you have any further questions or need more specific guidance!
Related Questions
Persistent Shin Discomfort
For the past year, I have been grappling with ongoing discomfort in my shins. Despite consulting multiple physiotherapists and doctors, I have yet to find a solution to my problem. My routine has included extensive strength training targeting my hips, glutes, calves, and lower leg muscles. I've also taken steps to improve my running form and have experimented with various recovery techniques, such as foam rolling and using massage devices. No matter what I try, the pain persists, specifically on the inner side of my lower legs. Initially, I suspected that I was suffering from shin splints. However, given my varied attempts at treatment and the lack of improvement, I am starting to believe that the issue might be something different. Even mundane activities, like walking around at home, have become increasingly uncomfortable, not to mention my inability to ride a stationary bike without experiencing pain. If anyone has any insights or recommendations that could assist me in alleviating this issue, I would be extremely grateful. Thank you for your help! I'm a 20-year-old male, standing at 5 feet 8 inches and weighing 70 kilograms.
Seeking Guidance on Ice Treatment Post-Surgery
I’m a 34-year-old male, weighing 158 pounds and standing 5 feet 6 inches tall. I lead a non-smoking lifestyle, consume three alcoholic drinks weekly, and do not have any known allergies. I'm currently recovering from right hand and wrist surgery, which took place five weeks ago. I need some advice regarding the use of ice for my treatment, as my wrist remains quite swollen. While I understand the advantages of icing, I find the experience quite intolerable. I attempt to immerse my hand and wrist in ice water completely, but the pain is so intense that I can barely last more than 15 seconds. Is this a challenge of mental resilience where I need to push through the discomfort for the sake of a proper 10-minute soak? In the past, I worked with racehorses, and we would apply ice to their legs for 30-minute sessions, significantly accelerating their recovery. I recognize the effectiveness of this method, yet the pain from the cold is unbearable. Should I endure this discomfort for longer periods?
Rash on My Arm: Should I Be Concerned?
Hi there! I’m a 65-year-old female, and for the past four days, I’ve been dealing with a strange rash on my arm. Unfortunately, I can’t visit a healthcare professional until Monday, so I’m hoping to get some clarity in the meantime. I’ll share some images. If they don’t upload here, I’ll post them in the comments instead. The first image, taken last night, is a bit out of focus, but this morning, the rash has appeared even redder. Although it doesn’t itch now, I did experience some itching during the initial two days. As for my health history, I generally don’t have major health concerns apart from elevated cholesterol levels and a recent A1C reading of 5.9, but I do not have diabetes. I keep fairly active for my age group. During the first couple of days, there was some pus, and I managed to clean it with an alcohol wipe, which helped remove it. Could this be related to a spider bite? I noticed some small spiders (specifically daddy long legs) in my bedroom, especially near the balcony door, and I eliminated a few of them today, so that could be a possibility. Should I be wary of any serious complications from this rash? Any advice would be immensely appreciated! My ER co-payment is quite steep, and there’s no urgent care facility nearby. My only option is to request an appointment with my primary care physician next week, but I’m uncertain if it’s something that warrants immediate attention.
Navigating Recurrent Prostate Cancer: A Patient's Journey
As a 60-year-old man living in New York, I faced a challenging battle with prostate cancer approximately 4.5 years ago. My initial biopsy results indicated a Gleason score of 6. However, in September 2025, my PSA levels alarmingly soared to 27.7. To investigate the possibility of an infection, my doctor prescribed a month-long course of antibiotics. Afterward, my PSA levels showed a slight reduction, dropping to 25.5. Following another biopsy procedure, the Gleason score unexpectedly escalated to 10. This prompted serious discussions with my healthcare provider. He explained that, given the radiation treatment I had previously undergone, the surgical removal of my prostate would be quite complex, with very few surgeons willing to perform such a procedure. Consequently, I sought a second opinion from a specialist in urological cancer. The specialist echoed similar concerns, indicating that the potential complications could severely affect the urethra and rectal lining. Instead of surgery, he proposed cryoablation as a viable alternative. Simultaneously, I commenced treatment with testosterone hormone blockers. To say that this experience has been frustrating is an understatement. Most importantly, I also struggle with urination issues that complicate my daily life. I am reaching out for any insights or advice that might assist me in navigating this difficult situation.
Concerns Regarding Neurological Health
Hello! I received an epilepsy diagnosis back in 2008, and throughout this time, various MRI and CT imaging studies have indicated issues related to cerebral function and encephalopathy. Despite consulting multiple neurologists over the years, I’ve found that none of them appear worried about the encephalopathy aspect. Shouldn’t this be something to take more seriously? My cognitive abilities, including memory and vision, have noticeably deteriorated as time has passed. I’m feeling lost since my previous neurologists have not acknowledged my concerns adequately. If anyone could offer guidance or suggest resources, I would greatly appreciate it. In addition to epilepsy, my other medical conditions include Narcolepsy, Lynch Syndrome, Migraines, a mutation associated with HLA-B27, and Hashimoto's disease, along with others that escape me for the moment. Currently, I’m on a medication regimen that includes Lamictal, Xcopri, Hydroxyzine, Solifenacin, Zoloft, Wellbutrin, Sunosi, Aimovig, and Famotidine.