[22F] Experiencing intermittent soft stools with stringy material, abdominal cramps, and bloating

Patient Description

A 22-year-old female reports intermittent soft, snake-like stools with white stringy material, abdominal cramps, and bloating. The cramps are localized to the lower abdomen, rated as 7/10 in severity, and are exacerbated by sitting down but relieved by a heating pad. The patient has been experiencing these symptoms off and on for years, along with occasional blood in the stool, upper abdominal pain that radiates and varies in intensity, and fatigue. The patient has a history of gallbladder removal but no other pre-existing conditions, allergies, or current medications.

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Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

  • 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. IBS is a chronic condition that you'll need to manage long term.

    • Treatment of IBS typically involves long-term strategies to manage symptoms, including dietary adjustments, medication, and stress management.
  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a virus, bacteria, or parasites. Symptoms can include diarrhea, abdominal pain, vomiting, headache, fever, and chills.

    • Treatment usually involves rest, hydration, and over-the-counter medications. Antibiotics may be necessary if the cause is bacterial.
  • Food intolerances or sensitivities: Certain foods might be irritating your digestive system or causing food intolerance symptoms. Common culprits include lactose, fructose, and grains.

    • Treatment generally involves avoiding the offending foods.
  • Postcholecystectomy syndrome: Some people continue to experience abdominal symptoms after gallbladder removal. These can include bloating, diarrhea, and abdominal pain.

    • Treatment can vary widely depending on the cause and may include dietary adjustments, medications, or in some cases, further surgery.

What you can do

  1. Keep a food diary: This can help you identify any foods that trigger your symptoms. You might find it helpful to work with a dietitian.
  2. Stay hydrated: Especially if you're experiencing diarrhea, it's important to drink plenty of fluids to prevent dehydration.
  3. Try over-the-counter remedies: Anti-diarrheal medications or pain relievers might help manage your symptoms. Always follow the package instructions.
  4. Exercise regularly: Regular physical activity can help reduce symptoms of IBS and other digestive conditions.

What you should look out for

  • If your symptoms persist or worsen, seek medical attention.
  • If you notice blood in your stool or if your abdominal pain becomes severe, seek immediate medical attention.
  • If you experience unexplained weight loss, persistent vomiting, or signs of anemia such as fatigue or paleness, seek medical attention.

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal 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 are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, and diarrhea or constipation. These symptoms can vary in intensity and may be triggered by certain foods or stress.


How can I manage symptoms of postcholecystectomy syndrome after gallbladder removal?

Managing postcholecystectomy syndrome often involves dietary adjustments, such as reducing fat intake, and sometimes medications to manage symptoms like diarrhea and abdominal pain. Consulting with a healthcare provider can help tailor a management plan.


What dietary changes can help with food intolerances or sensitivities?

To manage food intolerances, it's important to identify and avoid foods that trigger symptoms. Keeping a food diary can help pinpoint these foods. Common triggers include lactose, fructose, and gluten-containing grains.


When should I seek medical attention for abdominal pain and digestive issues?

You should seek medical attention if you experience persistent or worsening symptoms, blood in your stool, severe abdominal pain, unexplained weight loss, persistent vomiting, or signs of anemia such as fatigue or paleness.


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