[20F] Experiencing abdominal pain, chest pain, constipation, and dark urine

Patient Description

A 20-year-old female has been experiencing a range of concerning symptoms for several months, including upper right abdominal and side pains, chest pains, constipation, and dark urine. The abdominal pain, described as sometimes sharp and sudden or continuous and full, has been present for about 3-4 months and varies in severity. Chest pains have been described as indigestion-like with pinpoint discomfort, worsening when sitting up or laying down, and have been occurring for 1-2 months. The patient reports having less than 1-2 bowel movements a week, with stools often being soft and straining required, indicating constipation for about a year. Additionally, there has been a significant weight loss from 250lbs in January 2023 to 165lbs in April 2024. The patient also reports experiencing fatigue, dark circles under the eyes, pain under the ribs and pelvic area, and has noticed some yellowing of the skin. The patient has a history of lupus diagnosed 2 years ago and is allergic to penicillin. Currently, the patient is not on any medications.

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Arora's Assessment

What might be happening

Based on your symptoms, the following conditions could be possible:

  • Gallbladder Disease: Your upper right abdominal pain, dark urine, and yellowing skin suggest a problem with your gallbladder, such as gallstones or cholecystitis (inflammation of the gallbladder). These conditions can cause bile to build up in your system, leading to dark urine and yellowing skin.

    • Diagnostic tests for gallbladder disease often include an ultrasound or a HIDA scan. Treatment can range from dietary changes to medications to surgery, depending on the severity and cause of the gallbladder disease.
  • Malnutrition: Your significant weight loss, poor eating habits, and constipation could be signs of malnutrition. This can occur when your body doesn't get enough nutrients from the food you eat.

    • Treatment for malnutrition typically involves dietary changes and sometimes nutritional supplements. It's important to seek help from a healthcare professional to ensure you're getting the nutrients you need.
  • Lupus Flare: Given your history of lupus, it's possible that some of your symptoms (such as fatigue, chest pain, and abdominal pain) could be due to a lupus flare. Lupus is a chronic autoimmune disease that can affect many parts of the body and cause a wide range of symptoms.

    • Treatment for lupus flares often involves medications to reduce inflammation and manage symptoms. It's important to discuss your symptoms with your healthcare provider, as they may need to adjust your treatment plan.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis. It's important to seek medical attention to get a proper diagnosis and treatment.

What you can do

  1. Seek immediate medical attention: Given the severity and duration of your symptoms, it's important to seek medical help as soon as possible. This is especially important because of your chest pain, which can be a sign of a serious condition.

  2. Keep a symptom diary: Write down when your symptoms occur, what they feel like, and anything that makes them better or worse. This can help your healthcare provider diagnose your condition.

  3. Stay hydrated and try to eat nutritious foods: Even if you're not feeling hungry, try to eat small amounts of nutrient-dense foods throughout the day. Drink plenty of fluids to stay hydrated, especially if you're experiencing constipation.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Chest pain that is severe, lasts longer than a few minutes, or is accompanied by other symptoms such as shortness of breath, dizziness, or nausea
  • Yellowing of the eyes
  • Blood in your stool or dark, tarry stools
  • Vomiting blood or a substance that looks like coffee grounds

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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8 mo ago

People Also Ask


What could cause upper right abdominal pain and dark urine?

Upper right abdominal pain and dark urine can be caused by gallbladder disease, such as gallstones or cholecystitis. These conditions can lead to bile buildup, resulting in dark urine and possibly yellowing of the skin.


How can lupus affect the body and what are common symptoms of a lupus flare?

Lupus is a chronic autoimmune disease that can affect many parts of the body, causing symptoms like fatigue, joint pain, skin rashes, and organ inflammation. A lupus flare can exacerbate these symptoms and may require medication adjustments to manage inflammation and symptoms.


What are the potential causes of significant weight loss and constipation?

Significant weight loss and constipation can be signs of malnutrition, which occurs when the body doesn't receive enough nutrients. Other potential causes include dietary issues, gastrointestinal disorders, or metabolic conditions.


What should I do if I experience chest pain and yellowing of the skin?

If you experience chest pain and yellowing of the skin, it's important to seek immediate medical attention. These symptoms could indicate serious conditions such as gallbladder disease or cardiac issues, and require prompt evaluation by a healthcare professional.


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1 Comments


Leo#3962

8 mo ago

Please try to go to a hospital as soon as you can to get imaging of your abdomen. Your symptoms sound like something is wrong with your liver and you need to get treated soon. I have seen many people go to the hospital too late! Also, significant unexplained weight loss can sometimes be a sign of an underlying cancer, which again you want to catch early.

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