[20F] Experiencing gastrointestinal and systemic symptoms

Patient Description

A 20-year-old female reports a constellation of symptoms including bloating, diarrhea, stomach pains, fatigue, anxiety, irritability, memory fog, hair loss, water retention, and extreme menstrual cramps. She has been unable to gain weight despite efforts to increase protein intake and has noted her stool to be of unusual colors. Her symptoms have been persistent for approximately a year to a year and a half. She has been managing acid reflux with a daily pill prescribed by a doctor, and she has attempted dietary changes such as reducing dairy and gluten intake without significant improvement. She experiences loose diarrhea 3 to 5 times a day, severe abdominal pain rated 8 out of 10, and hair loss that is noticeable during brushing or showering. The patient has not been diagnosed with anxiety but has been experiencing it for a couple of years, alongside irritability. She has no known family history of autoimmune diseases, no known allergies or adverse reactions to medications, and no pre-existing conditions or chronic illnesses. She consumes alcohol weekly and has not traveled out of the country since 2015.

Arora's Assessment

What might be happening

Based on the symptoms you've described, a few possibilities could be contributing to your condition:

Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms like bloating, abdominal pain, and alternating diarrhea and constipation. It's usually a chronic condition that needs to be managed long term.
- Treatment often includes dietary changes, medication, and managing stress.
Food Intolerance or Allergy: Certain foods might be causing your digestive symptoms. Common culprits include lactose, fructose, and gluten.
- Treatment usually involves avoiding the offending foods.
Hormonal Imbalance: Symptoms like hair loss, irritability, extreme menstrual cramps, and difficulty gaining weight could be signs of a hormonal imbalance, such as Polycystic Ovary Syndrome (PCOS) or thyroid disorders.
- Treatment often involves medication to help regulate hormone levels.
Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms like heartburn and indigestion.
- Treatment often includes lifestyle changes and over-the-counter or prescribed medications.

Please note that these are possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions that might help alleviate your symptoms:

Maintain a food diary: Keep track of what you eat and how you feel afterwards. This can help identify any food triggers.
Eat smaller, more frequent meals: Instead of three large meals, try eating smaller amounts more frequently throughout the day.
Stay hydrated: Drink plenty of fluids, especially water, to help prevent dehydration from diarrhea.
Try a low FODMAP diet: This type of diet can help manage symptoms in some people with IBS.
Practice stress management techniques: Stress and anxiety can exacerbate many of the symptoms you're experiencing. Techniques such as deep breathing, yoga, and meditation may help.