[21M] Experiencing chest and abdominal pain with frequent bowel movements

Patient Description

A 21-year-old male reports a week and a half history of intermittent chest pain, described as a dull or stinging sensation that sometimes radiates to the shoulders and shoulder blades, particularly when breathing. The pain varies in intensity and does not seem to be consistently related to meals, though it can occur after eating large amounts. Stretching and changing posture sometimes provide minor relief. Additionally, the patient experiences crampy to dull abdominal pain on the right side, middle region, after eating or drinking anything. This pain tends to subside after some time. The patient has altered his diet to include fruits and easily digestible foods, which has slightly alleviated the symptoms. He also reports frequent, loose bowel movements, approximately 3-4 times daily, without blood or changes in color. No fever, chills, shortness of breath, or palpitations are present. The patient frequently uses weed vapes but has no known allergies, pre-existing conditions, chronic illnesses, or current medications.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Gastroesophageal Reflux Disease (GERD): This condition occurs when 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, causing symptoms such as chest pain and heartburn. Overeating can trigger these symptoms.
- Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
Gastritis: This is an inflammation of the stomach lining. The symptoms can include upper abdominal pain, nausea, and sometimes vomiting. The pain is often described as a gnawing or burning pain, and it may be relieved by eating.
- Treatment usually involves taking antacids and other drugs to reduce stomach acid, which helps relieve gastritis symptoms and promote healing.
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 burning abdominal pain that extends from the navel to the chest.
- Treatment usually involves medications to decrease stomach acid. If an H. pylori infection is present, antibiotics will also be required.
Gallstones: These are hardened deposits in the gallbladder that can cause abdominal pain. The pain is often severe and located in the upper right part of the abdomen.
- Treatment may involve surgery to remove the gallbladder or medications to dissolve the gallstones.
Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.
- Treatment usually focuses on relieving symptoms. Lifestyle changes, including diet and managing stress, may help.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

Lifestyle changes: Try to avoid foods and drinks that trigger your symptoms, eat smaller meals, avoid lying down after a meal, maintain a healthy weight, and manage stress.
Over-the-counter medications: Antacids can neutralize stomach acid and provide temporary relief. Medications to reduce acid production (H-2-receptor blockers) or block acid production and heal the esophagus (proton pump inhibitors) can also be helpful.
Stop smoking: Smoking can increase stomach acid and make your symptoms worse.

What you should look out for

Seek immediate medical attention if you:

Vomit blood or have blood in your stool (your stool may appear black)
Have chest pain accompanied by pain in the arm or jaw, or difficulty breathing (these could be signs of a heart attack)
Have severe abdominal pain or discomfort that doesn't go away within a few hours

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines