[21F] Experiencing severe lower back pain and gastrointestinal symptoms

Patient Description

A 21-year-old female presents with severe, constant lower back pain that is sharp and aching, rated 7 out of 10 in severity. The pain is exacerbated by walking, sitting, and standing, with no relief reported. Additionally, she experiences intermittent, mild headaches located at the front and sides of the head, which have been ongoing for weeks. The patient also reports severe diarrhea, described as almost black and jelly-like in texture, occurring intermittently for weeks, with three episodes today. Anal bleeding has been noted three times a week, associated with constipation and diarrhea, but no blood was observed in the stool today. Stomach cramps, described as intermittent and painful with a severity of 6 out of 10, have also been present for weeks. The patient reports fatigue but no unexplained weight loss, persistent vomiting, dizziness, lightheadedness, fainting, or shortness of breath. There is no history of recent travel or known triggers for the diarrhea. No recent injuries to the back were reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Gastroenteritis: This is an inflammation of the digestive tract, typically resulting from a viral, bacterial, or parasitic infection. Symptoms can include diarrhea, stomach cramps, and sometimes fever or vomiting.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics or antiparasitics may be needed if a specific organism is identified.
  • 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.

    • Treatment typically involves long-term management of diet, lifestyle changes, and stress. In some cases, medication or counseling might be suggested.
  • Inflammatory Bowel Disease (IBD): This is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract, such as Crohn's disease and ulcerative colitis. Symptoms often include diarrhea, abdominal pain, fatigue, and weight loss.

    • Treatment usually involves drug therapy or, in severe cases, surgery.
  • Peptic Ulcers: These are sores that develop on the lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is stomach pain, but they can also cause dark or black stool or vomit, or unexplained weight loss.

    • Treatment typically involves antibiotics and medications to reduce stomach acid.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history more thoroughly.

What you can do

  1. Keep a symptom diary: Note down when your symptoms occur and what you're doing when they happen. This can help identify potential triggers or patterns.
  2. Stay hydrated: Diarrhea and vomiting can cause dehydration, so make sure to drink plenty of fluids. Avoid alcohol, caffeine, and sugary drinks, as they can make dehydration worse.
  3. Eat small, light meals: If you're experiencing stomach cramps or diarrhea, you may find it helpful to eat smaller, lighter meals and to avoid fatty, spicy or heavy foods.
  4. Rest: Your body needs energy to fight off the virus. Getting enough sleep can help your body recover.

What you should look out for

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

  • Severe abdominal or rectal pain
  • Blood in your stool or black, tarry stools
  • High fever (above 101.3°F)
  • Signs of dehydration, such as dark-colored urine, dry skin, thirst, less frequent urination, or dizziness when standing up
  • Persistent vomiting
  • Unexplained weight loss

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

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What could cause severe, constant lower back pain in a young adult?

Severe, constant lower back pain in a young adult could be caused by a variety of factors including muscle strain, herniated discs, kidney infections, or more systemic issues like inflammatory bowel disease. It's important to consult a healthcare professional for a proper diagnosis.


What are the possible reasons for experiencing black, jelly-like diarrhea?

Black, jelly-like diarrhea can be indicative of bleeding in the upper gastrointestinal tract, which might be due to conditions like peptic ulcers or gastritis. It is important to seek medical attention to determine the exact cause.


How can one differentiate between IBS and IBD based on symptoms?

IBS and IBD can have overlapping symptoms such as abdominal pain and changes in bowel habits. However, IBD often involves more severe symptoms like blood in the stool, weight loss, and inflammation visible on medical imaging, whereas IBS is typically diagnosed based on symptoms and the exclusion of other conditions.


What are the potential complications of untreated peptic ulcers?

Untreated peptic ulcers can lead to serious complications such as bleeding, perforation of the stomach or intestinal wall, and gastric obstruction. These conditions require immediate medical attention to prevent further health issues.


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