[20F] With abdominal pain and bloating

Patient Description

A 20-year-old female reports experiencing abdominal pain and bloating, which has worsened over the past two days. The pain is described as dull and cramping, located under the belly button on the right side, and is rated 4 out of 10 in severity. It worsens with activities such as carrying heavy objects, bending down, twisting, and standing, but is relieved by lying down. The patient also reports a lump under the belly button, present for about a year and slightly increasing in size. Currently on her period, she notes increased bloating, especially in the center above the belly button. She experiences nausea in certain positions but no vomiting, and has some constipation. There are no changes in urination, fever, or chills. Family history includes hernias in both parents and gastritis in a sister. The patient takes ashwagandha gummies daily without side effects and has no known allergies or chronic illnesses.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possibilities:

  1. Hernia: The lump under your belly button, especially if it has grown, could suggest a hernia. Hernias can cause pain and discomfort, especially when lifting or bending. A doctor can confirm this with a physical exam or imaging.

  2. Gastrointestinal Issues: The bloating and cramping could be related to digestive issues, possibly influenced by your menstrual cycle. Conditions like irritable bowel syndrome (IBS) or gastritis (considering your family history) might be contributing.

  3. Menstrual Cycle: Increased bloating and discomfort during your period can be normal, but if it's more severe than usual, it might be worth discussing with a healthcare provider.

What you can do

For the lump and pain:

  • Avoid heavy lifting and activities that worsen the pain.
  • Consider seeing a healthcare provider to evaluate the lump, especially if it continues to grow or causes significant discomfort.

For bloating and cramping:

  • Try over-the-counter remedies like simethicone for bloating.
  • Apply a warm compress to your abdomen to help relieve cramping.
  • Stay hydrated and consider a light, balanced diet to ease digestive symptoms.

General tips:

  • Keep a symptom journal using MDandMe to track your symptoms, diet, and activities. This can help identify triggers and provide useful information for your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening pain.
  • Nausea or vomiting that doesn't go away.
  • Changes in bowel habits that persist.
  • Any signs of infection, such as fever or chills.

Remember, it's important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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3 mo ago

People Also Ask


What are the common symptoms of a hernia?

Common symptoms of a hernia include a noticeable lump or bulge in the abdomen or groin, pain or discomfort especially when bending over, coughing, or lifting, and sometimes a feeling of heaviness or pressure in the abdomen.


How can menstrual cycles affect bloating and abdominal pain?

Menstrual cycles can lead to hormonal changes that cause the body to retain more water and salt, leading to bloating. Prostaglandins released during menstruation can also cause the uterus to contract, leading to cramping and abdominal pain.


What lifestyle changes can help manage symptoms of gastrointestinal issues like IBS?

Lifestyle changes that can help manage IBS symptoms include eating a balanced diet rich in fiber, avoiding trigger foods, staying hydrated, exercising regularly, and managing stress through techniques like yoga or meditation.


When should I seek medical attention for abdominal pain and bloating?

You should seek medical attention if you experience severe or worsening abdominal pain, persistent nausea or vomiting, significant changes in bowel habits, or any signs of infection such as fever or chills.


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