[24F] With severe stomach pain, diarrhea, and light vaginal bleeding

Patient Description

A 24-year-old female has been experiencing severe, sharp, and cramping stomach pain all over her abdomen for about a week. The pain started suddenly and has not been relieved by any measures. She also reports having runny diarrhea four to five times a week, with episodes lasting three to four days. This started around the same time as the stomach pain. There is no blood in the stool. The patient has not had any recent changes in diet, but symptoms worsened after consuming ramen noodles. Additionally, she feels extremely hot, suggesting a fever, although her temperature has not been measured. She has experienced light vaginal bleeding for about two weeks, which is unusual for her. Along with these symptoms, she feels like vomiting and has vomited one to two times a day. The patient has lost about 8 pounds recently but has not noticed any changes in appetite. She has not traveled recently, been exposed to anyone who is sick, or consumed any potentially contaminated food or water. There is no family history of gastrointestinal or gynecological conditions, and she has not taken any new medications or substances recently. Current medications include Aripiprazole 15 mg, Vitamin D3, Venlafaxine 37.5 ER, Krill oil 500 mg, Cetirizine 10 mg, Mili birth control, Fluticasone propionate 0.5 mg, Vraylar, Hydroxyzine 25 mg, Melatonin 5 mg, Magnesium 500 mg, Naproxen 500 mg, and Ventolin 90 mg.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential diagnoses to consider:

  1. Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms include severe stomach pain, diarrhea, vomiting, and fever. The sudden onset of your symptoms after eating ramen noodles could suggest food poisoning or a similar gastrointestinal infection.

  2. Irritable Bowel Syndrome (IBS): IBS can cause cramping, abdominal pain, bloating, gas, and diarrhea. Stress and certain foods can trigger symptoms. However, the presence of fever and vomiting makes this less likely.

  3. Pelvic Inflammatory Disease (PID): Given the light vaginal bleeding and severe abdominal pain, PID, which is an infection of the female reproductive organs, could be a possibility. This condition often causes fever and can be serious if not treated promptly.

  4. Medication Side Effects: Some of the medications you are taking, such as Venlafaxine and Aripiprazole, can cause gastrointestinal side effects, including nausea, vomiting, and diarrhea. However, the presence of fever and the sudden onset of symptoms make an infection more likely.

What you can do

Severe Stomach Pain and Diarrhea:

  • Seek medical attention immediately: Given the severity and duration of your symptoms, it's important to see a healthcare provider as soon as possible. They may perform tests such as blood work, stool tests, or imaging studies to determine the cause of your symptoms.
  • Stay hydrated: Drink plenty of fluids like water, oral rehydration solutions, or clear broths to prevent dehydration from diarrhea and vomiting.
  • Avoid certain foods: Stick to bland foods like bananas, rice, applesauce, and toast (the BRAT diet) until your symptoms improve. Avoid dairy, fatty foods, and caffeine.

Light Vaginal Bleeding:

  • Monitor the bleeding: Keep track of the amount and duration of the bleeding. If it worsens or is accompanied by severe pain, seek medical attention.
  • Avoid tampons: Use sanitary pads instead to reduce the risk of infection.

Feeling Extremely Hot (Possible Fever):

  • Take your temperature: If possible, measure your temperature to confirm if you have a fever.
  • Use fever reducers: Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) can help reduce fever and alleviate pain. Follow the dosing instructions on the package.

General Advice:

  • Document your symptoms: Use MDandMe to journal your symptoms, track your progress, and share your medical notes with your healthcare provider.
  • Rest: Ensure you get plenty of rest to help your body recover.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Persistent or worsening abdominal pain
  • High fever (above 101°F or 38.3°C)
  • Blood in your stool or vomit
  • Signs of dehydration (e.g., dry mouth, dark urine, dizziness)
  • Severe weakness or fainting

Remember, while I can provide guidance based on your symptoms, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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3 mo ago

People Also Ask

What are the common causes of severe stomach pain and diarrhea?

Severe stomach pain and diarrhea can be caused by a variety of factors, including infections like gastroenteritis, food poisoning, irritable bowel syndrome (IBS), and inflammatory bowel diseases. It's important to consider recent dietary changes, travel history, and any other symptoms like fever or vomiting.

Can certain foods trigger gastrointestinal symptoms like those described?

Yes, certain foods can trigger gastrointestinal symptoms, especially in individuals with sensitivities or conditions like IBS. Spicy, fatty, or processed foods, such as ramen noodles, can sometimes exacerbate symptoms. It's helpful to keep a food diary to identify potential triggers.

What are the potential side effects of medications like Venlafaxine and Aripiprazole?

Venlafaxine and Aripiprazole can cause gastrointestinal side effects such as nausea, vomiting, and diarrhea. These medications can also lead to other side effects like dizziness, dry mouth, and changes in appetite. It's important to discuss any concerning side effects with a healthcare provider.

What should I do if I experience light vaginal bleeding along with abdominal pain?

If you experience light vaginal bleeding along with abdominal pain, it's important to monitor the bleeding and seek medical attention if it worsens or is accompanied by severe pain. This could be a sign of conditions like pelvic inflammatory disease (PID) or other gynecological issues that require prompt evaluation and treatment.

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