[26F] With severe abdominal pain and constipation

Patient Description

A 26-year-old female presents with severe, sharp abdominal pain located on the right side and above the belly button, persisting constantly for three days and gradually worsening. The patient reports constipation for the past three weeks, with no bowel movements since the onset of pain. She recently began a regimen of healthier eating and increased physical activity to aid weight loss, resulting in a 5-pound loss over the past month. The patient has a significant family history of colon cancer, as her mother is affected, and she has undergone a cholecystectomy. Her medical history includes polycystic ovary syndrome (PCOS), diagnosed at 18, attention-deficit/hyperactivity disorder (ADHD) diagnosed at 8, and oppositional defiant disorder (ODD) diagnosed at 13. She has previously taken Inositol and Metformin for PCOS, prenatal vitamins and Letrozole for pregnancy-related purposes, and Ritalin for ADHD. Currently, she is not on any medications and reports no known drug allergies.

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Arora's Assessment

What might be happening

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

  1. Bowel Obstruction: Given the combination of severe abdominal pain, constipation for three weeks, and a family history of colon cancer, a bowel obstruction could be a concern. This occurs when there is a blockage in the intestines, preventing the normal movement of contents. It can be serious and requires immediate medical attention. Typical treatments may include hospitalization, imaging tests like an X-ray or CT scan, and possibly surgery.

  2. Appendicitis: Although less likely given the duration of symptoms, appendicitis is an inflammation of the appendix that can cause sharp pain in the right side of the abdomen. It usually requires surgical removal of the appendix.

  3. Irritable Bowel Syndrome (IBS) or Other Gastrointestinal Disorders: Your history of alternating constipation and diarrhea could suggest a functional bowel disorder like IBS. However, the severity and duration of your current symptoms warrant a more urgent evaluation.

  4. Complications from PCOS or Previous Gallbladder Removal: While less likely, hormonal imbalances from PCOS or changes in digestion after gallbladder removal could contribute to gastrointestinal symptoms.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and duration of your symptoms, along with your family history of colon cancer, it's crucial to seek medical care immediately. Visit an emergency room or urgent care center to get evaluated. If you feel unable to drive, please call 911 or have someone take you to the hospital.

  2. Monitor for Additional Symptoms: While waiting for medical care, keep an eye out for any new symptoms such as fever, vomiting, or changes in the severity of your pain, and report these to the healthcare provider.

  3. Avoid Self-Medication: Until you have been evaluated by a healthcare professional, avoid taking any new medications or supplements that could potentially worsen your condition.

Remember, while I can provide information based on your symptoms, only a healthcare professional can offer a formal diagnosis and appropriate treatment. Please prioritize getting medical attention as soon as possible.

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1 mo ago


People Also Ask


What are the symptoms of a bowel obstruction?

Symptoms of a bowel obstruction can include severe abdominal pain, bloating, constipation, vomiting, and inability to pass gas. It requires immediate medical attention as it can lead to serious complications.


How can a family history of colon cancer affect my health?

A family history of colon cancer can increase your risk of developing the disease. It's important to discuss this with your healthcare provider, who may recommend earlier or more frequent screenings.


What are the potential complications after gallbladder removal?

After gallbladder removal, some people may experience changes in digestion, such as diarrhea or bloating, due to the bile flowing directly into the intestines. Most people adjust over time, but dietary changes may help manage symptoms.


How does PCOS affect gastrointestinal health?

PCOS can affect gastrointestinal health through hormonal imbalances, which may contribute to symptoms like bloating or changes in bowel habits. Managing PCOS with lifestyle changes and medication can help alleviate these symptoms.

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