[26F] With fever, chills, and gastrointestinal symptoms

Patient Description

A 26-year-old female has been experiencing fever and chills since Monday, with the fever reaching up to 102.2°F. The fever and chills come and go, typically at night, and last for about an hour or two. She has been taking ampicillin to manage the fever. Additionally, she has been dealing with moderate stomach cramps during the day, mainly after eating, which subside after a bowel movement. The cramps are exacerbated by dairy and greasy foods. Her stool is dark, and she has experienced abdominal bloating and gas. She reports nausea and occasional vomiting with certain foods, and although she feels hungry, food tastes gross to her. There is no blood in her stool, no weight loss, and no significant changes in appetite beyond the aversion to food. She has no pre-existing conditions or chronic illnesses and is not currently taking any medications other than ampicillin.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms can include fever, chills, stomach cramps, diarrhea, nausea, and vomiting. Dark stools can sometimes occur due to dietary changes or medications.

    • Treatment: Gastroenteritis typically resolves on its own within a few days. Staying hydrated, resting, and eating bland foods can help. In some cases, antibiotics may be necessary if a bacterial infection is confirmed.
  • Food Intolerance or Sensitivity: Your symptoms, especially the stomach cramps after eating dairy or greasy foods, suggest a possible food intolerance, such as lactose intolerance or sensitivity to fatty foods.

    • Treatment: Avoiding trigger foods and keeping a food diary to identify and eliminate problematic foods can help manage symptoms.
  • Peptic Ulcer Disease: This condition involves sores in the lining of the stomach or the first part of the small intestine. Symptoms can include stomach pain, bloating, dark stools, and nausea.

    • Treatment: Treatment may involve medications to reduce stomach acid and antibiotics if an infection is present. Avoiding NSAIDs and certain foods can also help.
  • Irritable Bowel Syndrome (IBS): IBS is a chronic condition that affects the large intestine, causing symptoms like cramping, abdominal pain, bloating, gas, and diarrhea.

    • Treatment: Managing IBS often involves dietary changes, stress management, and medications to relieve symptoms.

What you can do

  1. Stay Hydrated: Drink plenty of fluids, such as water, clear broths, or oral rehydration solutions, to prevent dehydration, especially if you have diarrhea.
  2. Eat Bland Foods: Stick to bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet) until your symptoms improve.
  3. Avoid Trigger Foods: Since dairy and greasy foods seem to worsen your symptoms, try to avoid them for now.
  4. Rest: Make sure to get plenty of rest to help your body recover.
  5. Monitor Your Symptoms: Keep track of your symptoms, including any changes in your stool, using the MDandMe journal. This can help you identify patterns and provide useful information to your healthcare provider.
  6. Consult a Doctor: It's important to see a healthcare professional for a formal diagnosis and treatment plan. They may recommend tests, such as stool tests, blood tests, or imaging studies, to determine the cause of your symptoms.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe Abdominal Pain: If your stomach cramps become severe or do not go away after a bowel movement.
  • Persistent High Fever: If your fever remains high (above 102°F) or does not improve with medication.
  • Blood in Stool: If you notice blood in your stool or if your stool becomes black and tarry.
  • Dehydration: Signs of dehydration include dry mouth, excessive thirst, dark urine, and dizziness.
  • Worsening Symptoms: If your symptoms worsen or do not improve after a few days.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What are the common causes of fever and chills that occur mainly at night?

Fever and chills that occur mainly at night can be caused by infections such as viral or bacterial gastroenteritis, as well as other conditions like malaria or tuberculosis. It's important to monitor other symptoms and consult a healthcare provider for a proper diagnosis.


How can I differentiate between food intolerance and a more serious gastrointestinal condition?

Food intolerance often causes symptoms like bloating, gas, and stomach cramps after consuming certain foods, whereas more serious gastrointestinal conditions like peptic ulcers or IBS may present with persistent pain, dark stools, or significant changes in bowel habits. A healthcare provider can help differentiate these through tests and evaluations.


What dietary changes can help alleviate symptoms of gastroenteritis or food intolerance?

To alleviate symptoms of gastroenteritis or food intolerance, it's recommended to follow a bland diet, such as the BRAT diet (bananas, rice, applesauce, toast), and avoid trigger foods like dairy and greasy foods. Staying hydrated and eating small, frequent meals can also help.


When should I seek medical attention for dark stools and abdominal pain?

You should seek medical attention if you experience severe abdominal pain, persistent high fever, blood in your stool, signs of dehydration, or if your symptoms worsen or do not improve after a few days. Dark stools can indicate bleeding in the gastrointestinal tract, which requires prompt evaluation by a healthcare professional.

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