[24F] Experiencing abdominal pain, green diarrhea, nausea, and urgency

Patient Description

A 24-year-old female presents with a 5-month history of intermittent abdominal pain described as a mix of sharp, crampy, and dull, with a severity of 8 out of 10. The pain is located across the pelvic region and in the upper abdomen below the ribs. Accompanying symptoms include green, watery, gassy diarrhea with a frequency of 3-4 times daily for the past 3 days, nausea, and urgency to use the bathroom. The patient reports chills, a rapid heart rate at times, and lightheadedness. There is a history of black, tarry stools last week, weight fluctuations, and a known diagnosis of Duodenal diverticula. The patient is also undergoing testing for Crohn's disease and IBS. No recent travel, no known triggers for the diarrhea, and no vomiting reported. No current pregnancy, no recent changes in diet, supplements, or medications that could explain the green stool.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Gastroenteritis: This is inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing diarrhea and vomiting. The green color of your stool could be due to rapid transit of stool through the intestines, not giving bile enough time to break down.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be prescribed if a bacterial infection is suspected.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and 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 lifestyle adjustments.
  • 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 include diarrhea, abdominal pain, fatigue, and weight loss.

    • Treatment typically involves drug therapy or surgery.
  • Food poisoning: This is an illness caused by eating contaminated food. Infectious organisms — including bacteria, viruses and parasites — or their toxins are the most common causes of food poisoning.

    • Treatment typically involves rest, hydration, and over-the-counter remedies.

What you can do

  1. Stay hydrated: Diarrhea can lead to dehydration, so it's important to drink plenty of fluids. Water is good, but adding broth, juice or sports drinks to your diet may help replace lost electrolytes.

  2. Rest: Your body needs energy to fight off the virus. Getting extra sleep can help.

  3. Eat light: While you have diarrhea, eat simple and light foods like rice, crackers and bananas.

  4. Avoid certain foods: Dairy, fatty foods, high-fiber foods, or highly seasoned foods can make symptoms worse.

  5. Over-the-counter remedies: Certain over-the-counter medications may help with symptoms.

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

What you should look out for

Seek immediate medical attention if you:

  • Have severe abdominal or rectal pain
  • Have blood in your stool or black, tarry stools
  • Have a fever above 102 F (39 C)
  • Are showing signs of dehydration — excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness
  • Have had diarrhea for more than two days

Remember, this advice is intended to be general in nature, and specific causes may need different management. 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 Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What could cause green, watery diarrhea and how should it be treated?

Green, watery diarrhea can be caused by rapid transit of stool through the intestines, which doesn't allow bile to break down completely. It can also be due to infections, such as gastroenteritis. Treatment typically involves staying hydrated, resting, and possibly using over-the-counter remedies. If a bacterial infection is suspected, antibiotics may be prescribed.


What are the symptoms and treatment options for duodenal diverticula?

Duodenal diverticula are pouches that form in the duodenum, the first part of the small intestine. They are often asymptomatic but can cause abdominal pain, bloating, and nausea if inflamed or infected. Treatment may include dietary changes, antibiotics, or surgery in severe cases.


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

IBS and IBD can have overlapping symptoms like abdominal pain and diarrhea. However, IBD, which includes Crohn's disease and ulcerative colitis, often involves more severe symptoms such as weight loss, fatigue, and blood in the stool. IBS is typically managed with lifestyle changes, while IBD may require medication or surgery.


What are the potential causes of black, tarry stools and when should I seek medical attention?

Black, tarry stools can indicate bleeding in the upper gastrointestinal tract, such as from a peptic ulcer or gastritis. It's important to seek medical attention if you experience black stools, especially if accompanied by symptoms like dizziness or severe abdominal pain, as it may indicate a serious condition.


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