[24F] With severe diarrhea and abdominal pain

Patient Description

A 24-year-old female presents with severe diarrhea and intense stomach and intestinal pain, describing the sensation as if her stomach and intestines are being twisted from the inside. The diarrhea started first, initially brown and somewhat normal but quickly becoming brighter in color and more watery, now either bright green or bright yellow. This change occurred about a day after the diarrhea began. She estimates having around 15 to 20 watery bowel movements per day. Eating or drinking anything, including water, exacerbates her symptoms, leading to immediate trips to the bathroom. The diarrhea began suddenly and has persisted for 4 days. She experienced a fever the first night, followed by constant chills and cold sweats. The abdominal pain started 3 days ago and is rated at an 8 out of 10 in severity. Small amounts of blood have been noticed in her stool occasionally. Aloe Vera water drink provides some relief. She has not traveled recently, had any dietary changes, or started new medications. The last bowel movement was at 2:00 AM.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms typically include diarrhea, abdominal pain, nausea, vomiting, fever, and chills. The sudden onset and the nature of your symptoms suggest this could be a likely cause.

    • Treatment: Gastroenteritis usually resolves on its own within a few days. Treatment focuses on staying hydrated and managing symptoms. In some cases, antibiotics may be needed if a bacterial infection is confirmed.
  • Food Poisoning: This occurs when you consume contaminated food or water. Symptoms can include severe diarrhea, abdominal pain, nausea, vomiting, and sometimes fever. The rapid onset of symptoms after eating or drinking suggests this could be a possibility.

    • Treatment: Similar to gastroenteritis, the primary treatment is staying hydrated and resting. Over-the-counter medications can help manage symptoms, but it's important to avoid anti-diarrheal medications unless advised by a doctor.
  • Irritable Bowel Syndrome (IBS): While IBS is typically a chronic condition, it can sometimes present with acute episodes of severe symptoms, including diarrhea and abdominal pain. However, the sudden onset and severity of your symptoms make this less likely.

    • Treatment: Managing IBS often involves dietary changes, stress management, and sometimes medication. Keeping a food diary can help identify triggers.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms in the meantime:

  1. Stay Hydrated: Drink plenty of fluids, such as water, oral rehydration solutions, or clear broths. Avoid caffeinated, alcoholic, or sugary drinks, as they can worsen dehydration.
  2. Rest: Give your body time to recover by getting plenty of rest.
  3. Eat Bland Foods: If you can tolerate eating, stick to bland foods like bananas, rice, applesauce, and toast (the BRAT diet). Avoid dairy, fatty, spicy, or high-fiber foods until your symptoms improve.
  4. Monitor Symptoms: Keep track of your symptoms, including the frequency and nature of your bowel movements, any changes in pain, and any new symptoms that arise. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
  5. Avoid Anti-Diarrheal Medications: Unless advised by a healthcare professional, avoid taking anti-diarrheal medications, as they can sometimes worsen the underlying condition.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe Dehydration: Signs include excessive thirst, dry mouth, little or no urination, dark-colored urine, and dizziness or lightheadedness.
  • Persistent or Worsening Symptoms: If your symptoms do not improve after a few days or if they worsen, it's important to see a doctor.
  • Blood in Stool: While you mentioned a small amount of blood, if you notice a significant increase or if it becomes more frequent, seek medical attention.
  • High Fever: If your fever returns or becomes very high (over 100.4°F), it could indicate a more serious infection.
  • Severe Abdominal Pain: If the pain becomes unbearable or is accompanied by other concerning symptoms, seek immediate medical attention.

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare professional for a proper diagnosis and treatment plan. Take care, Emillee, and I hope you feel better soon!

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4 mo ago


People Also Ask


What are the common causes of sudden severe diarrhea and abdominal pain?

Common causes of sudden severe diarrhea and abdominal pain include viral or bacterial infections (gastroenteritis), food poisoning, and sometimes conditions like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).


How can I tell if my diarrhea is due to food poisoning or gastroenteritis?

Food poisoning often occurs after consuming contaminated food or water and can cause symptoms like diarrhea, vomiting, and abdominal pain within hours. Gastroenteritis, which can be viral or bacterial, also causes similar symptoms but may not be linked to a specific meal. A healthcare provider can help determine the cause based on symptoms and possibly stool tests.


What are the signs of dehydration I should watch for with severe diarrhea?

Signs of dehydration include excessive thirst, dry mouth, little or no urination, dark-colored urine, dizziness, and lightheadedness. It's important to stay hydrated by drinking fluids like water or oral rehydration solutions.


When should I seek medical attention for diarrhea and abdominal pain?

You should seek medical attention if you experience severe dehydration, persistent or worsening symptoms, significant blood in your stool, a high fever, or unbearable abdominal pain. These could indicate a more serious condition that requires medical evaluation.

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