[21F] Experiencing gastrointestinal and menstrual symptoms

Patient Description

A 21-year-old female reports experiencing cramping in the lower and upper abdomen, diarrhea, gas, hot flashes, and blood in stool, along with light spotting over the last couple of days, which is a new occurrence for her. The abdominal cramps are rated as a 5/10 in severity, tend to occur after eating, and are somewhat alleviated by using the restroom, drinking water, or waiting. Diarrhea has been present on and off for a few weeks, occurring 1-3 times a day, with normal bowel movements in between episodes. The patient suspects bread and soda as possible triggers for the diarrhea. Additionally, she experiences chills often and sometimes cold sweats, with the cramps mainly occurring before bowel movements. The hot flashes, which have been happening for a few weeks, are sudden but not too intense, usually occurring later in the day after 12:00 pm. The patient also reports feeling bloated and experiencing excessive gas and burping after eating or upon waking in the morning. The last bowel movement was 2 hours ago and was described as very runny. The patient has not traveled recently and has not identified any fever accompanying these symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. It's usually a chronic condition, but many people can control their symptoms by managing diet, lifestyle, and stress.

    • Treatment typically involves changes in diet and lifestyle, as well as managing stress. In some cases, medication or counseling might be suggested.
  • Food Intolerance: This occurs when your body can't properly digest and convert the foods you eat into the necessary nutrients that fuel your system. This can cause gas, bloating, diarrhea, and stomach cramps. Common food intolerances include lactose and gluten.

    • Treatment generally involves avoiding the foods that cause symptoms.
  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria, or parasites. Symptoms include diarrhea, abdominal cramps, nausea, and sometimes fever and vomiting.

    • Treatment usually involves rest, hydration, and over-the-counter remedies.
  • Inflammatory Bowel Disease (IBD): This is a term for two conditions (Crohn's disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. Symptoms can include diarrhea, abdominal pain, weight loss, and blood in the stool.

    • Treatment typically involves medication to reduce inflammation and prevent flare-ups.

Please note that these are potential explanations for your symptoms, but other conditions could also be responsible. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Keep a food diary: Note what you eat and when you experience symptoms to see if there's a correlation. This can help you identify potential food intolerances or triggers for IBS.

  2. Stay hydrated: Especially if you're experiencing diarrhea, it's important to replace lost fluids and electrolytes.

  3. Try over-the-counter remedies: For gas and bloating, over-the-counter medications containing simethicone might provide relief.

  4. Rest and avoid stress: Both can help alleviate symptoms of IBS and gastroenteritis.

What you should look out for

If your symptoms persist or worsen, or if you notice new symptoms such as severe abdominal pain, high fever, persistent vomiting, or signs of dehydration (such as dry mouth, decreased urination, or feeling lightheaded), seek medical attention promptly.

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


What are common triggers for Irritable Bowel Syndrome (IBS) symptoms?

Common triggers for IBS symptoms include certain foods (such as dairy, gluten, and fatty foods), stress, hormonal changes, and certain medications. Keeping a food diary can help identify specific triggers.


How can I identify if I have a food intolerance?

To identify a food intolerance, keep a detailed food diary noting what you eat and any symptoms that occur afterward. An elimination diet, where you remove suspected foods and gradually reintroduce them, can also help pinpoint intolerances.


What are the main differences between IBS and Inflammatory Bowel Disease (IBD)?

IBS is a functional disorder with symptoms like cramping, bloating, and diarrhea, but it doesn't cause inflammation or damage to the intestines. IBD, which includes Crohn's disease and ulcerative colitis, involves chronic inflammation and can lead to damage in the GI tract.


When should I seek medical attention for gastrointestinal symptoms?

Seek medical attention if you experience severe abdominal pain, high fever, persistent vomiting, signs of dehydration, or if your symptoms persist or worsen despite self-care measures.


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