[20F] With abdominal pain, cognitive impairment, and lightheadedness

Patient Description

A 20-year-old female presents with a constellation of symptoms including abdominal pain, constipation, cognitive impairment, lightheadedness, and chest heaviness. The cognitive impairment, characterized by tiredness, dissociation, and trouble focusing, began suddenly two weeks ago concurrent with the onset of stomach pain. These symptoms are exacerbated by light and standing, impacting her ability to focus at work and causing brain fog and loss of interest in activities. Constipation has been present for one week, with the patient able to pass only small amounts of stool, which is dark brown and slimy. She reports a weight loss of 10 pounds over the past three weeks. Stomach swelling and severe bloating have been present for three days. Lightheadedness, described as dizziness, occurs primarily when walking or being outside and has been present for two weeks. Chest heaviness and sharp intermittent chest pain have also been present for two weeks. The patient reports blurred vision and fatigue. She has a history of kidney, stomach, UTI, and yeast infections diagnosed two weeks ago. She experienced suicidal thoughts, severe body pain, and anxiety attacks while taking Bactrim but is not currently on any medications.

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS): IBS can cause abdominal pain, bloating, and changes in bowel habits, including constipation. Stress and anxiety can exacerbate IBS symptoms, which might explain your cognitive impairment and lightheadedness.

    • Treatment: IBS is managed through dietary changes, stress management, and sometimes medications to relieve symptoms.
  • Gastrointestinal Infections: Given your recent history of kidney, stomach, UTI, and yeast infections, it's possible that an ongoing or residual infection could be contributing to your symptoms.

    • Treatment: This would require antibiotics or antifungal medications as prescribed by a doctor, along with supportive care like hydration and rest.
  • Hypothyroidism: This condition can cause fatigue, cognitive impairment, constipation, and bloating. It can also lead to weight gain or difficulty losing weight.

    • Treatment: Hypothyroidism is typically treated with thyroid hormone replacement therapy.
  • Electrolyte Imbalance: Electrolyte imbalances can cause symptoms like dizziness, lightheadedness, and cognitive impairment. This could be related to your recent infections or changes in diet and hydration.

    • Treatment: This would involve correcting the imbalance through dietary adjustments or supplements.
  • Anxiety and Depression: These mental health conditions can cause cognitive impairment, fatigue, and physical symptoms like chest heaviness and stomach pain.

    • Treatment: Treatment options include therapy, medications, and lifestyle changes.

What you can do

  1. Consult a Doctor: It's important to see a healthcare professional for a thorough evaluation. They can order tests to identify any underlying conditions and provide appropriate treatment.
  2. Stay Hydrated: Drink plenty of fluids to help manage constipation and prevent dehydration, which can contribute to dizziness and lightheadedness.
  3. Dietary Adjustments: Consider a high-fiber diet to help with constipation. Avoid foods that may exacerbate bloating and stomach pain, such as dairy or high-fat foods.
  4. Stress Management: Practice stress-relieving techniques like deep breathing, meditation, or gentle exercise to help manage anxiety and cognitive impairment.
  5. Monitor Symptoms: Keep a symptom diary to track what you eat, your bowel movements, and any other symptoms. This can help your doctor identify patterns and potential triggers.

What you should look out for

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

  • Severe or worsening abdominal pain
  • Blood in your stool
  • Persistent vomiting or inability to keep fluids down
  • Severe chest pain or difficulty breathing
  • Sudden, severe headache or vision changes
  • Suicidal thoughts or severe anxiety attacks

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please consult with a healthcare provider for a formal diagnosis and appropriate treatment.

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9 mo ago

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People Also Ask


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

Common symptoms of IBS include abdominal pain, bloating, gas, diarrhea, constipation, and changes in bowel habits. Stress and certain foods can trigger or worsen these symptoms.


How can electrolyte imbalances affect the body?

Electrolyte imbalances can cause symptoms such as dizziness, lightheadedness, fatigue, muscle cramps, and cognitive impairment. Severe imbalances can lead to more serious health issues.


What are the signs of hypothyroidism?

Signs of hypothyroidism include fatigue, weight gain, constipation, dry skin, hair loss, sensitivity to cold, and cognitive impairment. It can also cause bloating and changes in mood.


How can anxiety and depression manifest physically?

Anxiety and depression can cause physical symptoms such as chest heaviness, stomach pain, fatigue, headaches, and muscle tension. They can also lead to cognitive issues like difficulty concentrating and memory problems.


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