[20F] Experiencing chronic abdominal pain and bloating

Patient Description

A 20-year-old female presents with a 1-2 year history of bloating and stomach pain, which has worsened over the past 7 months. The pain is sharp, crampy, and predominantly located in the lower abdomen, radiating up the right side. Pain severity is rated 7 out of 10 and is exacerbated postprandially and with physical activity. Bloating is described as extreme pressure, occurring daily, and is severe enough to visibly distend the abdomen. Stool changes include darkening, occasional constipation, thinning, and the presence of stringy parts and white spots. The patient has a history of gallbladder removal 5 years ago, is allergic to nickel, and is not currently on any medications. No vomiting or significant weight loss reported, but there has been some weight loss. The patient has experienced a sudden onset of severe pain differing from her usual symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and changes in bowel habits. The exact cause of IBS isn't known, but several factors appear to play a role, such as muscle contractions in the intestine, abnormalities in the nerves in your digestive system, inflammation in the intestines, severe infection, or changes in bacteria in the gut.

    • Treatment for IBS is usually focused on relieving symptoms and can include dietary changes, medication, and stress management.
  • Gastroenteritis: This is an inflammation of the digestive tract, usually caused by a virus or bacteria, and can cause diarrhea, abdominal pain, and vomiting. However, you did not mention having diarrhea or vomiting, which are common symptoms of gastroenteritis.

    • Treatment for gastroenteritis usually involves rest, hydration, and over-the-counter medication to help with symptoms.
  • Gastritis: This is an inflammation of the stomach lining and can cause abdominal pain and bloating. However, gastritis usually causes upper abdominal pain, not lower abdominal pain.

    • Treatment for gastritis usually involves medication to decrease stomach acid.
  • Appendicitis: This is an inflammation of the appendix, a small pouch attached to the large intestine on the lower right side of the abdomen. Appendicitis can cause severe pain in the lower right side of the abdomen, but it usually comes on suddenly and gets worse over time, which doesn't quite match your symptoms.

    • Treatment for appendicitis is usually surgical removal of the appendix.

Please note that these are potential diagnoses based on the symptoms you've described, and you should seek care from a healthcare professional to receive a formal diagnosis and treatment.

What you can do

  1. Try to identify any triggers for your symptoms, such as certain foods or stress, and avoid them if possible.
  2. Maintain a balanced diet and drink plenty of water.
  3. Over-the-counter medications, such as antacids or gas relief drugs, may help with some of your symptoms. However, you should consult with a healthcare professional before starting any new medication.
  4. Regular exercise can help regulate bowel movements and reduce stress, which may help with some of your symptoms.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool
  • Persistent vomiting
  • Unexplained weight loss
  • Fever or chills

Remember, this advice is meant 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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10 mo ago

People Also Ask


What are common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea or constipation. Symptoms can vary in intensity and may be triggered by certain foods or stress.


How can dietary changes help manage IBS symptoms?

Dietary changes can help manage IBS symptoms by identifying and avoiding trigger foods, increasing fiber intake, and maintaining a balanced diet. Some people find relief by following a low FODMAP diet, which involves reducing certain carbohydrates that are difficult to digest.


What are the typical signs of appendicitis?

Typical signs of appendicitis include sudden pain that begins on the right side of the lower abdomen, pain that worsens with movement, nausea, vomiting, loss of appetite, and sometimes fever. The pain often starts near the navel and then moves.


When should I seek immediate medical attention for abdominal pain?

You should seek immediate medical attention for abdominal pain if it is severe or worsening, if you experience blood in your stool, persistent vomiting, unexplained weight loss, or if you have a fever or chills. These could be signs of a serious condition that requires prompt evaluation.


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