[18F] With chronic diarrhea and abdominal pain

Patient Description

An 18-year-old female presents with chronic diarrhea for almost two months, characterized by very runny stool ranging from dark brown to neon yellow, occurring at least six times a day. The episodes last about 20 minutes each. The patient reports that spicy foods exacerbate the diarrhea. There is no noticeable blood in the stool except when wiping, but there is a significant presence of mucus. The diarrhea started suddenly, and the patient was prescribed dicyclomine after it began. The patient also experiences lower abdominal cramping pain, rated 6-7 out of 10, on and off for the past seven years. Additionally, she reports nausea, body aches rated 5 out of 10, and heavy sweating, particularly during bowel movements, for the past three days. Her last recorded temperature was 99.4 degrees Fahrenheit. The patient has a decreased appetite but no recent weight loss. She has a family history of Crohn's disease and diabetes and was diagnosed with irritable bowel syndrome (IBS) four years ago. Current medications include Effexor, dicyclomine (as needed), trazodone, and Abilify, with Benadryl as an over-the-counter medication. The patient uses marijuana and nicotine daily but has not experienced any side effects from her current medications.

Show More

Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations for your condition:

Chronic Diarrhea, Nausea, and Stomach Pain

  1. Inflammatory Bowel Disease (IBD)

    • Crohn's Disease: Given your family history of Crohn's disease, it's possible that your symptoms could be related to this condition. Crohn's disease can cause chronic diarrhea, abdominal pain, and other gastrointestinal symptoms. Elevated white blood cell count can also be a sign of inflammation.
    • Ulcerative Colitis: Another form of IBD that can cause similar symptoms, including diarrhea with mucus, abdominal pain, and cramping.
  2. Irritable Bowel Syndrome (IBS)

    • Since you have a history of IBS, it's possible that your symptoms are related to this condition. However, the severity and duration of your symptoms suggest that there might be another underlying issue.
  3. Infection

    • A gastrointestinal infection could cause sudden onset of severe diarrhea, nausea, and abdominal pain. Elevated white blood cell count can indicate an infection.

Sweating and Body Aches

  1. Systemic Inflammatory Response

    • The sweating and body aches could be related to a systemic inflammatory response, possibly due to an underlying infection or inflammatory condition like IBD.
  2. Medication Side Effects

    • While you haven't experienced side effects from your current medications, it's still possible that they could be contributing to your symptoms.

What you can do

Chronic Diarrhea, Nausea, and Stomach Pain

  • Consult a Gastroenterologist: Given the severity and duration of your symptoms, it's important to see a specialist who can perform a thorough evaluation. They may recommend tests such as a colonoscopy, stool tests, or imaging studies to determine the cause of your symptoms.
  • Dietary Changes: Avoid spicy foods and other known triggers. Consider following a low-FODMAP diet, which can help manage symptoms of IBS and other gastrointestinal conditions.
  • Hydration: Ensure you stay hydrated, especially with the frequent diarrhea. Oral rehydration solutions can help maintain electrolyte balance.
  • Medication Review: Discuss your current medications with your doctor to ensure they are appropriate and not contributing to your symptoms.

Sweating and Body Aches

  • Monitor Symptoms: Keep track of your symptoms, including when they occur and their severity. This information can be helpful for your healthcare provider.
  • Rest and Hydration: Ensure you get plenty of rest and stay hydrated to help your body recover.

General Advice

  • Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider. This can help in managing your condition and providing your healthcare provider with detailed information.

What you should look out for

Given the severity of your symptoms and the possibility of underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Abdominal Pain: If your abdominal pain becomes severe or unbearable.
  • High Fever: If you develop a high fever (above 100.4 degrees Fahrenheit).
  • Blood in Stool: If you notice a significant amount of blood in your stool.
  • Severe Dehydration: Signs of severe dehydration include dizziness, rapid heartbeat, and decreased urine output.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

Show More

1
 Hugs
0
 Comments

Save

5 mo ago

People Also Ask


What are the common symptoms of Crohn's disease and how is it diagnosed?

Common symptoms of Crohn's disease include chronic diarrhea, abdominal pain, weight loss, and fatigue. Diagnosis typically involves a combination of blood tests, stool tests, endoscopic procedures like colonoscopy, and imaging studies such as MRI or CT scans to assess inflammation and damage in the digestive tract.


How can diet affect symptoms of irritable bowel syndrome (IBS) and what dietary changes might help?

Diet can significantly impact IBS symptoms. A low-FODMAP diet, which involves reducing certain carbohydrates that are poorly absorbed in the small intestine, can help alleviate symptoms. Avoiding spicy foods, caffeine, and alcohol may also reduce symptoms.


What are the potential side effects of medications like dicyclomine and how can they impact gastrointestinal symptoms?

Dicyclomine is an antispasmodic medication used to treat IBS. Potential side effects include dry mouth, dizziness, blurred vision, and constipation. It can sometimes exacerbate gastrointestinal symptoms, so it's important to discuss any adverse effects with a healthcare provider.


How can one differentiate between symptoms of an infection and those of inflammatory bowel disease (IBD)?

Symptoms of an infection often include sudden onset of diarrhea, fever, and body aches, whereas IBD symptoms are more chronic and may include blood in the stool and weight loss. Laboratory tests, such as stool cultures and blood tests, can help differentiate between the two by identifying infectious agents or markers of inflammation.


Preview

Post

No comments yet

Be the first one to comment

Share your feedback

All Stories

Experiencing symptoms?

Our AI will conduct a medical interview and assess what might be happening. You can also make a post afterwards.

Share your feedback