[23F] Experiencing stomach discomfort, acid reflux, and diarrhea

Patient Description

A 23-year-old female presents with a month-long history of stomach discomfort described as cramping and sharp pain in both the lower and upper stomach areas. The patient also reports daily acid reflux, which occurs regardless of food intake and worsens at night, rating the severity as 7 out of 10. Additionally, the patient has experienced diarrhea starting today, characterized by very soft stools and excessive gas. Difficulty swallowing and a sensation of food being stuck in the throat have been noted. The patient is currently taking Famotidine 40 mg at bedtime for acid reflux and uses Pepto-Bismol and Tums every other day for acid reflux and upset stomach. The patient has a known allergy to Benadryl and a family history of ulcerative colitis and esophagitis (father). No recent travel, fever, chills, vomiting, weight loss, or correlation with meals or stress was reported. No other chronic illnesses or medication allergies were mentioned.

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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 acid reflux and difficulty swallowing.

    • Treatment typically involves lifestyle modifications and over-the-counter medications. In severe cases, prescription medications or even surgery may be required.
  • Gastritis: This is an inflammation of the stomach lining. It can cause abdominal pain and discomfort, as well as acid reflux.

    • Treatment usually involves taking antacids and other drugs to reduce stomach acid, which helps relieve gastritis symptoms and promotes healing.
  • Peptic Ulcer Disease: 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, though some people may experience acid reflux and difficulty swallowing.

    • Treatment usually involves medications to decrease stomach acid. If an ulcer is caused by a bacterial infection, antibiotics may be prescribed.
  • 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 of IBS is aimed at relieving symptoms and often includes dietary adjustments, medication, and stress management.

Please note that these are potential explanations for your symptoms, and it's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Maintain a healthy diet: Avoid foods and drinks that trigger your symptoms. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.

  2. Eat smaller meals: Eating large meals can cause your stomach to produce too much acid. Try eating smaller meals more frequently throughout the day.

  3. Don't lie down after a meal: Wait at least three hours after eating before lying down or going to bed.

  4. Elevate the head of your bed: If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.

  5. Don't smoke: Smoking decreases the lower esophageal sphincter's ability to function properly.

What you should look out for

Reasons to see a doctor more urgently:

  • If you notice blood in your stool or vomit
  • If you have severe abdominal pain
  • If you have difficulty swallowing
  • If your symptoms persist despite over-the-counter treatments

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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9 mo ago


People Also Ask


What are common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include frequent heartburn, acid reflux, difficulty swallowing, regurgitation of food or sour liquid, and a sensation of a lump in the throat.


How can lifestyle changes help manage acid reflux symptoms?

Lifestyle changes such as avoiding trigger foods, eating smaller meals, not lying down after eating, elevating the head of the bed, and quitting smoking can help reduce acid reflux symptoms.


What are the potential causes of difficulty swallowing?

Difficulty swallowing can be caused by conditions such as GERD, esophagitis, peptic ulcers, or structural abnormalities in the esophagus. It is important to consult a healthcare provider for an accurate diagnosis.


What dietary adjustments can help alleviate symptoms of Irritable Bowel Syndrome (IBS)?

Dietary adjustments for IBS may include increasing fiber intake, avoiding trigger foods like caffeine and alcohol, eating smaller meals, and staying hydrated. Keeping a food diary can help identify specific triggers.

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