[19F] Experiencing severe abdominal pain and a constellation of distressing symptoms

Patient Description

A 19-year-old female presents with a complex array of symptoms, including severe, episodic lower abdominal pain described as a stabbing and searing sensation, predominantly on the right side. Accompanying symptoms include nausea, vomiting, headaches with blurry vision, hot flashes with clamminess, fever, constipation with infrequent bowel movements (every 1.5 to 2 weeks), sleep disturbances due to pain, vivid dreams, anxiety attacks, and intense sharp pains in the lower abdomen. The abdominal pain is exacerbated by coughing or palpation. The patient has a history of constipation and severe, long-standing headaches that sometimes impair vision. No relief from abdominal pain has been found with ibuprofen, and the patient denies any recent changes in weight. The patient's fever began the day before the encounter, and they have not been tested for Covid-19.

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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 stomach and intestines, usually due to a viral or bacterial infection. It can cause symptoms like severe abdominal pain, nausea, vomiting, and diarrhea. Fever and chills can also occur.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics may be needed if the cause is bacterial.
  • Appendicitis: This is an inflammation of the appendix, a small pouch attached to the large intestine. It typically causes severe pain in the lower right abdomen, nausea, vomiting, and fever.

    • This is a medical emergency and requires immediate medical attention. Treatment usually involves surgery to remove the appendix.
  • Migraines: These are severe headaches that can cause throbbing pain, usually on one side of the head. They can also cause nausea, vomiting, and sensitivity to light and sound.

    • Treatment usually involves medications to relieve symptoms and prevent future attacks.
  • Anxiety: This can cause a variety of physical symptoms, including stomach pain, headaches, and hot flashes. It can also cause difficulty sleeping and frequent vivid dreams.

    • Treatment usually involves a combination of therapy, medication, and lifestyle changes.

What you can do

Given the severity of your symptoms, you should seek immediate medical attention. In the meantime, try to stay hydrated and rest as much as possible.

What you should look out for

If your symptoms worsen or you develop new symptoms, such as blood in your stool, severe vomiting, or an inability to keep down fluids, seek medical attention immediately.

Remember, while I strive to provide accurate information, I am not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of appendicitis and how urgent is it to seek medical attention?

Common symptoms of appendicitis include severe pain in the lower right abdomen, nausea, vomiting, and fever. It is a medical emergency and requires immediate medical attention, often involving surgery to remove the appendix.


Can anxiety cause physical symptoms like abdominal pain and headaches?

Yes, anxiety can cause a variety of physical symptoms, including abdominal pain, headaches, hot flashes, and sleep disturbances. It can also lead to vivid dreams and anxiety attacks.


What are the typical treatments for migraines and how can they be managed?

Typical treatments for migraines include medications to relieve symptoms, such as pain relievers and anti-nausea drugs, as well as preventive medications to reduce the frequency and severity of attacks. Lifestyle changes and stress management can also help manage migraines.


How can constipation be managed and what are the potential complications if left untreated?

Constipation can be managed with dietary changes, such as increasing fiber and fluid intake, regular exercise, and over-the-counter laxatives if necessary. If left untreated, constipation can lead to complications like hemorrhoids, anal fissures, or fecal impaction.


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