[25F] Experiencing constipation with subsequent diarrhea

Patient Description

A 25-year-old female reports experiencing constipation that began 5 days ago, gradually worsening over time. She had one large, lumpy, and oddly shaped bowel movement 3 days ago, which did not relieve her symptoms. Since yesterday, she has been experiencing diarrhea. Alongside these symptoms, she reports a loss of appetite, abdominal pain in the lower abdomen on both sides, bloating, and a sensation of pressure. She feels the urge to have a bowel movement, but is unable to do so. She has experienced chills but no fever, and has noted recent weight gain along with fatigue. Her medical history includes a diagnosis of sinus tachycardia made recently, and there is a possibility of lupus, though it remains unconfirmed. She is currently taking Metoprolol 12.5 mg at bedtime and occasionally takes Tylenol or ibuprofen as needed. She has allergies to penicillin, amoxicillin, augmentin, and codeine. Her menstrual periods were abnormal for a couple of months but have since returned to normal. There is no family history of gastrointestinal issues.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Irritable Bowel Syndrome (IBS): IBS is a common condition that affects the large intestine and can cause symptoms like constipation, diarrhea, bloating, and abdominal pain. The alternating pattern of constipation and diarrhea you're experiencing could be indicative of IBS. Stress, certain foods, and hormonal changes can trigger symptoms.

  2. Dietary Changes or Low Fiber Intake: A decrease in appetite and changes in diet can lead to constipation. If your diet has been low in fiber, this could contribute to your symptoms. Fiber helps regulate bowel movements by adding bulk to the stool.

  3. Medication Side Effects: Metoprolol, a medication you're taking, can sometimes cause gastrointestinal side effects, including constipation or diarrhea. It's important to discuss any potential side effects with your healthcare provider.

  4. Stress or Anxiety: Emotional stress or anxiety can impact your digestive system, leading to symptoms like constipation or diarrhea.

  5. Potential Lupus Flare: Although unconfirmed, if you have lupus, gastrointestinal symptoms can sometimes be part of a flare. It's important to monitor other symptoms and discuss them with your healthcare provider.

What you can do

  1. Increase Fiber Intake: Gradually add more fiber to your diet through fruits, vegetables, whole grains, and legumes. This can help regulate bowel movements and alleviate constipation.

  2. Stay Hydrated: Drink plenty of water throughout the day to help soften stools and prevent dehydration, especially if you're experiencing diarrhea.

  3. Exercise Regularly: Physical activity can help stimulate digestion and improve bowel regularity.

  4. Manage Stress: Practice stress-reducing techniques such as deep breathing, meditation, or yoga to help manage any stress or anxiety that may be affecting your digestive system.

  5. Monitor Symptoms: Use MDandMe to journal your symptoms, track your progress, and identify any potential triggers. This information can be valuable for your healthcare provider.

What you should look out for

  • Seek Medical Attention If:
    • You experience severe abdominal pain or persistent diarrhea.
    • You notice blood in your stool or have black, tarry stools.
    • You develop a fever or experience significant weight loss.
    • Your symptoms worsen or do not improve with dietary and lifestyle changes.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. They can provide personalized advice and may recommend further testing if necessary.

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2 mo ago

People Also Ask


What are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea, constipation, or alternating between the two. Stress and certain foods can trigger these symptoms.


Can Metoprolol cause gastrointestinal side effects?

Yes, Metoprolol can cause gastrointestinal side effects in some people, including constipation, diarrhea, nausea, and abdominal discomfort. It's important to discuss any side effects with your healthcare provider.


How can dietary changes impact bowel movements?

Dietary changes, especially those involving low fiber intake, can lead to constipation as fiber helps add bulk to stool and promote regular bowel movements. A sudden change in diet can also disrupt normal digestive processes.


What are the signs of a lupus flare affecting the gastrointestinal system?

A lupus flare affecting the gastrointestinal system can include symptoms like abdominal pain, nausea, vomiting, diarrhea, and sometimes blood in the stool. It's important to monitor these symptoms and discuss them with a healthcare provider.


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