[23F] Experiencing severe upper right abdominal pain with extreme gas and hunger

Patient Description

A 23-year-old female presents with severe upper right abdominal pain described as a sharp, sudden pain that necessitates pausing activity. The pain has been present for two months and rates an 8.5 out of 10 in intensity. The pain is associated with eating and extreme hunger, but the patient has not identified specific food triggers. Accompanying symptoms include extreme gas, frequent hunger pangs, and intermittent nausea without vomiting. The patient also reports occasional bluish discoloration in the whites of the eyes but no jaundice. Bowel movements are described as 'little nuggets,' suggesting possible constipation. There is no reported fever, chills, or significant weight loss. The patient has not kept a food diary and is unaware of any family history of gallbladder disease. No changes in diet or weight have been noted. The patient has taken some unspecified medications that provide minimal relief.

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Arora's Assessment

What might be happening

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

  • Gallstones: These are hard deposits in your gallbladder, a small organ under the liver. You might not even know you have them until they block a bile duct, causing pain that you need to get treated right away.

    • Typical treatments include lifestyle changes such as a healthier diet, pain medications, and sometimes surgery if the gallstones keep coming back.

  • Peptic Ulcer: These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.

    • Peptic ulcers are usually treated with medication to decrease stomach acid. In some cases, surgery may be needed.

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is particularly common and is also known as the stomach 'flu'.

    • This condition often resolves without treatment. However, it's important to stay hydrated as the diarrhea and vomiting can cause dehydration.

What you can do

  1. Keep a food diary to track what you eat and how you feel afterwards. This could help identify any food-related triggers.
  2. Stay hydrated and eat a balanced diet. Avoid foods that seem to trigger your symptoms.
  3. Over-the-counter antacids may provide temporary relief from your symptoms.
  4. Consult with a healthcare provider for a formal diagnosis and treatment plan.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool or vomit
  • Unexplained weight loss
  • Yellowing of the skin and eyes (jaundice)

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 accurate information.

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9 mo ago

People Also Ask

What are the common symptoms of gallstones?

Common symptoms of gallstones include sudden and intense pain in the upper right abdomen, pain between the shoulder blades, nausea, and vomiting. The pain may occur after eating a fatty meal.

How can a peptic ulcer be diagnosed and treated?

A peptic ulcer can be diagnosed through tests such as an endoscopy, barium swallow, or testing for H. pylori infection. Treatment typically involves medications to reduce stomach acid, antibiotics if H. pylori is present, and lifestyle changes. In severe cases, surgery may be necessary.

What dietary changes can help manage symptoms of gastrointestinal issues?

Dietary changes that can help manage gastrointestinal symptoms include eating smaller, more frequent meals, avoiding spicy and fatty foods, staying hydrated, and keeping a food diary to identify and avoid triggers.

When should I seek immediate medical attention for abdominal pain?

You should seek immediate medical attention for abdominal pain if it is severe and sudden, if you have blood in your stool or vomit, if you experience unexplained weight loss, or if you notice yellowing of the skin and eyes, which could indicate jaundice.

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