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:
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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.
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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.
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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.
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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.
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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!
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