[18F] Experiencing severe pelvic pain, diarrhea, and nausea

Patient Description

An 18-year-old female presents with severe pelvic and lower stomach pain that comes in waves, accompanied by diarrhea and severe nausea without vomiting. The pain is described as dull but sharp, worsening postprandially, and is alleviated by sleep. The patient's bowel movements are green/brown and solid but watery, occurring just today. She reports no fever, chills, or blood in the stool. The patient has a history of painful menstruation, particularly in the last 2-3 cycles. She is a type one diabetic and experiences lightheadedness and an increased heartbeat when her sugar drops during episodes of severe pain. Her medical history includes eosinophilic esophagitis and type one diabetes, diagnosed at ages 13 and 12, respectively. She has multiple food allergies but no known drug allergies. Current medications include Omeprazole (40mg AM, 20mg PM), Vitamin D (5000 units), insulin (Lispro on a 1:45 carb ratio), multivitamin, Zofran (as needed on Saturdays and Sundays), Dupixent, Claritin, and allergy shots (twice weekly), with an unspecified inhaled medication to coat the throat. The patient's mother has a history of PCOS, which may be relevant to the patient's symptoms.

Show More

Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the U.S. It causes diarrhea and can also cause symptoms such as abdominal cramps, nausea, and vomiting. Treatment usually involves rest, hydration, and electrolyte repletion.

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

  • Gynecological conditions: Given your severe pelvic pain and recent painful periods, conditions like endometriosis or ovarian cysts could be possible. Both conditions can cause severe pelvic pain and changes in menstrual cycle.

  • Diabetic Gastroparesis: This is a condition in which your stomach cannot empty itself of food in a normal fashion. It is caused by damage to the vagus nerve, which regulates the digestive system. A damaged vagus nerve prevents the muscles in the stomach and intestine from functioning, preventing food from moving through the digestive system properly.

  • Eosinophilic gastroenteritis: Given your history of eosinophilic esophagitis, it's possible that eosinophils may be affecting other parts of your gastrointestinal tract.

What you can do

  1. Stay hydrated: Make sure you're drinking plenty of fluids to replace what you lose through diarrhea. Water is good, but adding broth, juice or sports drinks to your diet may be beneficial as they can help replenish your electrolyte levels.

  2. Rest: Your body needs energy to fight off the virus. Getting extra sleep can give your body the rest it needs.

  3. Over-the-counter help: Over-the-counter anti-diarrheal medications like loperamide (Imodium) can help with diarrhea, but they should not be used if you have a high fever or bloody stools.

  4. Monitor your blood sugar levels: As a diabetic, it's important to monitor your blood sugar levels and keep them under control. If your blood sugar levels get too low or too high, seek medical attention.

What you should look out for

  • If your symptoms persist for more than a few days, you should seek medical attention.
  • If you notice blood or mucus in your stool.
  • If you have persistent vomiting and can't keep fluids down.
  • If you have a high fever (over 101.5 F, measured orally).
  • If you have signs of dehydration, such as a dry mouth and throat, feeling dizzy when you stand up, or producing less urine.

Please remember, while I strive to provide accurate information, I'm not a doctor. It's important to consult with a healthcare provider who can take a full history, examine you, and access your medical records.

Show More

1
 Hugs
0
 Comments

Save

10 mo ago

People Also Ask


What are the common symptoms of gastroenteritis and how is it treated?

Common symptoms of gastroenteritis include diarrhea, abdominal cramps, nausea, and sometimes vomiting. Treatment typically involves rest, staying hydrated, and replenishing electrolytes. In some cases, over-the-counter medications may be used to alleviate symptoms.


How can Irritable Bowel Syndrome (IBS) be managed long-term?

Irritable Bowel Syndrome (IBS) can be managed long-term through dietary changes, stress management, regular exercise, and sometimes medications prescribed by a healthcare provider. Identifying and avoiding trigger foods is also important.


What are the signs and symptoms of endometriosis and how is it diagnosed?

Endometriosis can cause severe pelvic pain, especially during menstruation, as well as pain during intercourse, heavy periods, and infertility. It is diagnosed through a combination of pelvic exams, imaging tests, and sometimes laparoscopy.


How does diabetic gastroparesis affect digestion and what are its symptoms?

Diabetic gastroparesis affects digestion by slowing or stopping the movement of food from the stomach to the small intestine. Symptoms include nausea, vomiting, feeling full quickly, bloating, and abdominal pain. It is often managed by dietary changes, medications, and blood sugar control.


Preview

Post

No comments yet

Be the first one to comment

Share your feedback