[25F] Experiencing gastrointestinal and psychological symptoms

Patient Description

A 25-year-old female has been experiencing frequent and daily abdominal cramping, diarrhea, nausea, and bloating for the last one to two months. The abdominal cramping is severe, rated an 8 out of 10 in intensity, and occurs mostly an hour after eating, without specific food triggers. Diarrhea is a daily occurrence, with stool consistency being soft or liquid, and varying in color, including green, dark, nearly black, and occasionally red. The patient has also noticed blood in the stool. Bloating is prominent in the lower abdomen and causes a sensation of fullness. The patient has lost 8 pounds in two weeks unintentionally and reports constant fatigue and feelings of sadness. She has a long-standing history of bipolar disorder, anxiety, depression, and was diagnosed with Borderline Personality Disorder at age 21. She is currently on Lithium and Seroquel for her psychological symptoms and reports no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. IBS is a chronic condition that you'll need to manage long term.

    • Treatment of IBS typically involves long-term strategies to manage symptoms, including dietary adjustments, medication, and stress management.
  • Inflammatory Bowel Disease (IBD): This is a term for two conditions (Crohn's disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. The inflammation can lead to erosion of the lining of the GI tract, leading to symptoms such as diarrhea, abdominal pain, fatigue, and weight loss.

    • Treatment of IBD typically involves medication to reduce inflammation and prevent flare-ups. In severe cases, surgery may be necessary.
  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is particularly common and highly infectious. Gastroenteritis can cause diarrhea, abdominal pain, vomiting, headache, fever and chills.

    • Most cases of gastroenteritis resolve within a few days without treatment. It's important to stay hydrated by drinking plenty of fluids, preferably an oral rehydration solution that contains water, salt and sugar.
  • Food Intolerance: This occurs when your body cannot properly digest certain foods. Lactose intolerance and gluten intolerance are common types. Symptoms can include bloating, diarrhea, and abdominal pain.

    • Treatment usually involves avoiding the foods that cause symptoms. A dietitian can help you identify which foods are causing problems and make sure you're still getting all the nutrients you need.
  • Anxiety and Depression: These mental health disorders can cause physical symptoms such as fatigue, weight loss, and gastrointestinal problems. You mentioned that you have been diagnosed with these conditions and are currently taking medication for them.

    • Treatment typically involves a combination of medication, psychotherapy, lifestyle changes, and social support.

Please note that this is not an exhaustive list and other diagnoses are also possible. It's important to discuss these symptoms with your doctor or a healthcare professional who can provide a definitive diagnosis.

What you can do

  1. Keep a symptom diary: Write down what you eat and drink, and note when your symptoms occur. This could help you identify triggers for your symptoms.
  2. Stay hydrated: Diarrhea can cause you to lose fluids quickly, so it's important to drink plenty of water. Avoid alcohol and caffeine, as these can make diarrhea worse.
  3. Eat small meals: If you feel full quickly, try eating smaller meals more often.
  4. Exercise regularly: Physical activity can often help reduce feelings of anxiety and improve mood.
  5. Seek support: Consider reaching out to a mental health professional who can provide strategies to manage anxiety and depression.

What you should look out for

Seek immediate medical attention if you:

  • See a lot of blood in your stool
  • Have severe abdominal pain
  • Have symptoms of dehydration, such as a dry mouth, thirst, reduced urination, and dizziness
  • Have a fever over 100.4°F (38°C)
  • Continue to lose weight without trying

Remember, while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, diarrhea, and constipation. These symptoms can vary in intensity and may be triggered by certain foods or stress.


How can Inflammatory Bowel Disease (IBD) be managed?

IBD management typically involves medication to reduce inflammation and prevent flare-ups. In some cases, dietary changes and surgery may be necessary. Regular monitoring by a healthcare professional is important.


What should I do if I notice blood in my stool?

If you notice blood in your stool, it's important to seek medical attention promptly. This could be a sign of a serious condition such as IBD or gastrointestinal bleeding, and a healthcare professional can provide a proper diagnosis and treatment plan.


Can anxiety and depression cause physical symptoms like gastrointestinal issues?

Yes, anxiety and depression can manifest as physical symptoms, including gastrointestinal issues like nausea, diarrhea, and abdominal pain. These symptoms can be managed with a combination of medication, therapy, and lifestyle changes.


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