[19F] With abdominal lump, bloating, and other symptoms

Patient Description

A 19-year-old female presents with a bump on the right side of her lower abdomen that has been present for about two years. Recently, the bump has become very itchy and has grown in size. The bump is soft and has changed color from skin-colored to a more pinkish and brown hue. The patient has also been experiencing bloating around the belly button and lower abdomen for a few weeks, along with constipation, nausea, and a lack of appetite. The patient's urine has appeared cloudy, but there is no pain or discomfort when pressing on the bump. The patient has a history of Ehlers-Danlos syndrome, gastroparesis, POTS, irritable bowel syndrome, anxiety, and depression. Current medications include Trazodone, Requip, Paxil, laxatives, and Hydroxyzine (all taken every night before bed), Adderall and birth control (taken every morning), and Vyvance (taken every afternoon). The patient does not use tobacco, alcohol, or recreational drugs and is up to date with vaccinations, including the HPV vaccine.

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Arora's Assessment

What might be happening

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

Bump on Lower Abdomen

  • Lipoma: A lipoma is a benign (non-cancerous) tumor made of fat tissue. They are usually soft, movable, and painless. However, they can sometimes become itchy or grow in size.
  • Cyst: A cyst is a sac filled with fluid or other material. They can become inflamed or infected, leading to changes in color and size, and can sometimes be itchy.

Bloating and Gastrointestinal Symptoms

  • Irritable Bowel Syndrome (IBS): Given your history of IBS, your bloating and constipation could be related to this condition. IBS can cause a range of gastrointestinal symptoms, including bloating, constipation, and changes in bowel habits.
  • Gastroparesis: This condition, which you have a history of, can cause delayed stomach emptying, leading to bloating, nausea, and a feeling of fullness.

Cloudy Urine

  • Dehydration: Cloudy urine can sometimes be a sign of dehydration. Ensure you are drinking enough fluids.
  • Urinary Tract Infection (UTI): Although you haven't mentioned pain during urination, a UTI can sometimes present with cloudy urine and other symptoms like nausea.

What you can do

Bump on Lower Abdomen

  • See a Doctor: It's important to have the bump evaluated by a healthcare professional, especially since it has changed in size and color. They may recommend imaging tests or a biopsy to determine the nature of the bump.
  • Avoid Scratching: Try to avoid scratching the bump to prevent irritation or infection. You can use over-the-counter anti-itch creams to help with the itching.

Bloating and Gastrointestinal Symptoms

  • Dietary Changes: Consider following a low-FODMAP diet, which can help reduce bloating and other IBS symptoms. Avoid foods that are known to cause gas and bloating, such as beans, carbonated drinks, and certain vegetables.
  • Hydration: Drink plenty of water to help with constipation and overall digestive health.
  • Medication Review: Discuss your symptoms with your doctor to see if any of your current medications might be contributing to your gastrointestinal symptoms. They may adjust your medications or suggest alternatives.

Cloudy Urine

  • Hydrate: Ensure you are drinking enough water throughout the day. Aim for at least 8 glasses of water daily.
  • Monitor Symptoms: Keep an eye on your urine color and any other symptoms. If you develop pain during urination, fever, or other concerning symptoms, see a doctor.

What you should look out for

Given the complexity of your symptoms and your medical history, it's important to seek medical care to get a comprehensive evaluation. Here are some specific reasons to seek care more urgently:

  • Rapid Growth or Pain in the Bump: If the bump continues to grow rapidly, becomes painful, or shows signs of infection (redness, warmth, pus), see a doctor immediately.
  • Severe Abdominal Pain: If you develop severe or worsening abdominal pain, seek medical attention.
  • Changes in Bowel Habits: If you experience significant changes in your bowel habits, such as severe constipation or diarrhea, see a doctor.
  • Fever or Chills: If you develop a fever or chills, it could indicate an infection and you should seek medical care.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider.

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6 mo ago


People Also Ask


What could cause a bump on the lower abdomen to become itchy and change color?

A bump on the lower abdomen that becomes itchy and changes color could be due to a lipoma or a cyst. Both are generally benign but can change in size and color, and become itchy. It's important to have it evaluated by a healthcare professional.


How can Ehlers-Danlos syndrome affect gastrointestinal symptoms like bloating and constipation?

Ehlers-Danlos syndrome can affect the gastrointestinal tract by causing issues like delayed gastric emptying (gastroparesis) and irritable bowel syndrome (IBS), leading to symptoms such as bloating, constipation, and nausea.


What are some common causes of cloudy urine without pain?

Cloudy urine without pain can be caused by dehydration, which concentrates the urine, or a urinary tract infection (UTI), even if there is no pain. It's important to stay hydrated and monitor for other symptoms.


How can medications like Trazodone, Requip, and Paxil affect gastrointestinal health?

Medications like Trazodone, Requip, and Paxil can affect gastrointestinal health by causing side effects such as nausea, constipation, or changes in appetite. It's important to discuss these symptoms with a doctor to see if medication adjustments are needed.


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