[26F] With hypothermia and lower abdominal pain

Patient Description

A 26-year-old female presents with hypothermia and lower abdominal pain that started this morning. The pain is described as sharp and crampy, with a severity of 6 out of 10, and has been constant. The patient has not found any relief from the pain, even after taking Tylenol. She reports frequent bowel movements, persistent hunger regardless of food intake, nausea, and chills. There is no fever, blood in stool or vomit, or recent exposure to sick individuals or contaminated food or water. The patient has a history of asthma, which has worsened since having children, and mental disorders diagnosed in her teenage years. She has food allergies and a latex allergy. She underwent gastric sleeve surgery without complications. The patient uses marijuana once a day. Her menstrual periods are regular, with the last period occurring five days ago and lasting four days. No other medications are currently being taken.

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Arora's Assessment

What might be happening

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

Hypothermia and Chills

  • Hypothermia: This is a condition where your body temperature drops below the normal range. It can be caused by prolonged exposure to cold temperatures, but it can also be a sign of an underlying medical condition.
  • Infection: Chills can be a sign of an infection, even if you don't have a fever. Infections can sometimes cause your body temperature to drop.

Lower Abdominal Pain

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms can include nausea, diarrhea, and abdominal pain.
  • Irritable Bowel Syndrome (IBS): This is a chronic condition that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea.
  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs and can cause lower abdominal pain, fever, and unusual discharge.
  • Appendicitis: This is an inflammation of the appendix and can cause sharp pain in the lower right abdomen, nausea, and vomiting.

Unifying Diagnoses

  • Gastrointestinal Infection: Given your symptoms of nausea, diarrhea, and abdominal pain, a gastrointestinal infection could be a unifying diagnosis. This could also explain your chills and constant hunger.
  • Metabolic or Endocrine Disorders: Conditions like thyroid dysfunction or adrenal insufficiency can cause a range of symptoms, including hypothermia, chills, and gastrointestinal issues.

What you can do

Hypothermia and Chills

  • Seek Immediate Medical Attention: Hypothermia can be serious. If you suspect you have hypothermia, seek medical attention immediately.
  • Stay Warm: Use blankets and warm clothing to help raise your body temperature. Avoid further exposure to cold.

Lower Abdominal Pain

  • Consult a Doctor: Given the severity and persistence of your pain, it's important to consult a healthcare provider for a thorough evaluation. They may recommend tests like blood work, imaging studies, or a physical exam.
  • Stay Hydrated: Drink plenty of fluids, especially if you are experiencing diarrhea. Oral rehydration solutions can help maintain electrolyte balance.
  • Dietary Adjustments: Stick to bland foods like bananas, rice, applesauce, and toast (the BRAT diet) until your symptoms improve.

General Tips

  • Monitor Symptoms: Keep track of your symptoms, including their severity and any triggers. This information can be helpful for your healthcare provider.
  • Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider.

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:

  • Severe or Worsening Pain: If your abdominal pain becomes more severe or spreads.
  • Signs of Severe Infection: Such as high fever, rapid heart rate, or confusion.
  • Dehydration: Signs include dry mouth, dark urine, and dizziness.
  • Persistent Vomiting: If you are unable to keep fluids down.

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

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4 mo ago

People Also Ask

What are the common causes of hypothermia in young adults?

Common causes of hypothermia in young adults include prolonged exposure to cold environments, certain medical conditions like hypothyroidism, infections, and the use of substances that impair the body's ability to regulate temperature.

How can I differentiate between gastroenteritis and irritable bowel syndrome (IBS)?

Gastroenteritis typically presents with sudden onset of symptoms like nausea, vomiting, diarrhea, and abdominal pain, often following exposure to contaminated food or water. IBS, on the other hand, is a chronic condition characterized by recurrent abdominal pain, bloating, and changes in bowel habits without an identifiable infectious cause.

What are the symptoms of pelvic inflammatory disease (PID) that I should be aware of?

Symptoms of pelvic inflammatory disease (PID) include lower abdominal pain, fever, unusual vaginal discharge with an unpleasant odor, painful urination, and pain during intercourse. It's important to seek medical attention if you suspect PID, as it can lead to serious complications if untreated.

How does marijuana use affect gastrointestinal symptoms like nausea and abdominal pain?

Marijuana use can affect gastrointestinal symptoms in various ways. It may provide relief from nausea for some individuals, but in others, it can exacerbate symptoms like abdominal pain and nausea, particularly in conditions like cannabinoid hyperemesis syndrome. It's important to discuss your marijuana use with your healthcare provider to understand its impact on your symptoms.

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