[19F] Experiencing back pain, abdominal pain, headaches, vision changes, and urinary discomfort

Patient Description

A 19-year-old female presents with a constellation of symptoms including lower back pain, sharp lower abdominal pain, frequent headaches, worsening vision, fatigue, and uncomfortable urination. The abdominal pain, which has been present for 1-2 weeks, is sharp, located in the lower abdomen, and radiates around the area. It is somewhat alleviated when the patient assumes a fetal position. The patient has a history of IBS-C, with the most recent bowel movement being difficult and resulting in small soft pebbles. Additionally, the patient experiences hot flashes, has had a recent increase in the severity of migraines triggered by smells, and reports blurry vision that has developed over the past week. Urine is darker yellow with an unusual odor; however, tests for UTI, yeast infection, and STDs were negative. The patient has a loss of appetite but no nausea or vomiting. The patient also has Raynaud’s phenomenon, diagnosed in 2019, and is currently taking Adderall (10mg daily), Accutane, and has a Nexplanon implant. The patient uses a vaping product and is managing Accutane side effects, which include dry skin, acne, and back pain, with Epiceram. No known drug allergies or family history of similar symptoms were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Irritable Bowel Syndrome (IBS): You've mentioned that you have a history of IBS-C (constipation predominant). The abdominal pain and changes in bowel habits you're experiencing could be related to this condition. IBS can also cause a feeling of incomplete evacuation and bloating.

    • Treatment for IBS often involves dietary modifications, stress management, and sometimes medications to manage symptoms.
  • Side effects of medications: Both Adderall and Accutane can cause various side effects. Adderall can cause headaches, fatigue, and changes in vision. Accutane can cause back pain, changes in vision, and fatigue. The Nexplanon implant can cause changes in menstrual cycle, which might contribute to abdominal pain.

    • If you suspect your symptoms are due to side effects of your medications, it's important to discuss this with your doctor. Do not stop taking your medications without consulting your doctor first.
  • Urinary Tract Infection (UTI): Even though your recent tests were negative, UTIs can cause lower abdominal pain and changes in urination. They can also cause fatigue.

    • UTIs are typically treated with antibiotics.
  • Migraines: You've mentioned that you have a history of migraines. Migraines can cause severe headaches, changes in vision (like blurriness), and can be triggered by certain smells. They can also cause nausea and light sensitivity.

    • Migraines are typically treated with a combination of lifestyle changes and medications.

What you can do

  1. Consult your doctor: Given the variety and severity of your symptoms, it's important to consult your doctor for a proper evaluation. They may want to adjust your medications or perform additional tests.

  2. Monitor your symptoms: Keep track of when your symptoms occur, their severity, and any potential triggers. This can help your doctor in diagnosing and treating your condition.

  3. Stay hydrated and maintain a balanced diet: This can help with managing IBS and preventing UTIs.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool or urine
  • Sudden, severe headache
  • Sudden worsening of your vision
  • Signs of a severe allergic reaction, like difficulty breathing or swelling of your face, lips, tongue, or throat

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


Can IBS cause sharp lower abdominal pain and changes in bowel habits?

Yes, IBS can cause sharp lower abdominal pain and changes in bowel habits, including constipation and a feeling of incomplete evacuation. Managing IBS often involves dietary changes and stress management.


What are common side effects of Adderall and Accutane that might relate to my symptoms?

Adderall can cause headaches, fatigue, and changes in vision, while Accutane can lead to back pain, changes in vision, and fatigue. It's important to discuss any side effects with your doctor.


Is it possible to have a UTI even if the tests are negative?

Yes, it is possible to have a UTI even if initial tests are negative. Symptoms like lower abdominal pain and changes in urination can still suggest a UTI, and further testing or evaluation may be needed.


How can migraines affect vision and what are common triggers?

Migraines can cause changes in vision, such as blurriness, and are often triggered by smells, stress, or certain foods. Managing migraines typically involves lifestyle changes and medications.


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