HomeAnswersInternal MedicineconstipationWhy do I have a cough, loss of appetite, and constipation?

Why do cough, nausea with occasional vomiting, loss of appetite, and constipation occur?


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Published At February 4, 2023
Reviewed AtJanuary 21, 2024

Patient's Query

Hi doctor,

I am a 32-year-old female and a mother of two children. I have a diagnosis of Hashimoto, lichen planus, and vitiligo. I have had 11 years of chronic medical stress over my 11-year-old daughter, who has CHD and had four open heart surgeries and a cancer diagnosis five years ago. Before six years, I started having strange GI symptoms, and I was so sick that I landed in the hospital on IV fluids for four days and was then released. The gastroenterologist did an endoscopy and said it was a hiatal hernia. He said that it was small and would not cause symptoms and also told me it was related to stress, and it seemed less concerning. I have dropped from 178 to 145 lbs in four months unintentionally. I will list other symptoms with descriptions. None of the doctors I have seen seem to think there is anything wrong with me.

I have a cough and thick saliva that becomes worse in the morning. It is so thick that I cannot swallow it or breathe out without gasping. It gets better but is still present throughout the day. I have a noticeable flushing redness on my face and chest without exertion. My heart flutters or feels like it is pounding really hard at rest. At the end of the day, I have nausea with occasional vomiting and loss of appetite. I feel constipated; however, the stool is soft and thin, and sometimes diarrhea. I do lots of straining, excretion feels incomplete, and I go multiple times to the bathroom yet feeling not done excreting. There is a darkening of the skin around my mouth and under my right eye. I also have random dizzy attacks feeling as though I will faint, followed by sudden nausea and tingling hands. I occasionally have sudden blurred vision and uncomfortable feelings in my kidneys. I also have pressure or fullness feeling in the pelvic floor and rectum. I have a rash on my hip that looks like ringworm, and I was treated for it for five weeks, but it did not change and did not spread. I also have complaints like excessive dry mouth and thirst. These symptoms have crept in one after the other over the past year. My thyroid function is within range, and I have had laboratory tests like endoscopy in which a hiatal hernia was found and gastric emptying slow but not paresis, Hida normal. Abdominal ultrasound was also normal, with no pancreas view. Please help.


Welcome to icliniq.com.

I thoroughly read your query and understand your concern.

Your case does not seem simple. I do not think you do not have anything wrong, especially because of your diagnosis of Hashimoto, lichen planus, and vitiligo which all are related to autoimmune diseases. First, I think your medication might be incomplete since at least you should have thyroid hormone replacement. Are you taking drugs for your diagnosis of chronic stress right now? What medications have you used for your GI (gastrointestinal) problems?

Following are my suggestions for your queries:

  • Cough and thick saliva are very commonly related to your GI symptoms and even more as you already have a documented hiatal hernia. The treatment for this is the same as for reflux, changes in diet, and the prescription of proton pump inhibitors.
  • Flushing redness. Have you noticed a relationship with sun exposure?
  • 'My heart flutters or feels like pounding.' How long does this last? What helps this feeling go away? How often do you feel it? Do you have at least one ECG (electrocardiogram)? Also, we need to check out if your hormonal replacement therapy is controlling your blood thyroid hormones. If they are high, it can explain the loss of weight, your heart pounding, and your episodes of diarrhea.
  • Your constipation with diarrhea sometimes looks like irritable bowel syndrome. We usually suggest medications such as Trimebutine, Pinaverium, or Simethicone for at least two weeks.
  • Rash and skin color changes. It would be really helpful to see a picture of these.
  • Excessive dry mouth and thirst are common in another autoimmune disease called Sjogren syndrome.

In order to delimitate your diagnosis, we need at least those pictures of your rash and skin changes and any laboratory test results and medical tests you have already. Then, we can see if you need more laboratory studies. For now, I do not get why other doctors say it is nothing, so I would like to see the big picture they saw. I mean with the information of all your medication, your laboratory tests, or other medical tests.

I hope I was helpful.

Kind regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ana Karen Pulido Ayala
Dr. Ana Karen Pulido Ayala

General Practitioner

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