[27F] With persistent bloating, frequent urination, and other symptoms

Patient Description

A 27-year-old female presents with persistent bloating and abdominal distension, particularly in the lower abdomen and around the belly button, which has been worsening over the past week and is present 24/7. The patient reports frequent urination, up to 27 times a day, with a slight burning sensation during urination. She also experiences changes in bowel movements, with some days having frequent bowel movements and other days only once, but no blood in the stool. Additional symptoms include slight chest pain, a skin rash, headaches, weight gain of 6 pounds in one day, loss of appetite, and chills, but no fever. The patient has not noticed any changes in symptoms after eating certain foods and has not found relief with medications, walks, or stretches. She recently traveled to Germany and Austria and consumed local food and water. Her past medical history includes anorexia, diagnosed in 2018. She is currently taking Keflex (500mg twice a day) and has no known allergies to medications or other substances.

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Arora's Assessment

What might be happening

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

  1. Urinary Tract Infection (UTI):

    • Rationale: Frequent urination, slight burning sensation during urination, and chills can be indicative of a UTI.
    • Typical Treatments/Testing: A urine test to confirm the infection, followed by a course of antibiotics.
  2. Gastrointestinal Issues:

    • Rationale: Bloating, abdominal distension, and changes in bowel movements could be related to gastrointestinal issues such as Irritable Bowel Syndrome (IBS) or a gastrointestinal infection.
    • Typical Treatments/Testing: Stool tests, blood tests, and possibly imaging studies to identify any underlying issues. Treatment may include dietary changes, medications to manage symptoms, and probiotics.
  3. Hormonal Imbalance:

    • Rationale: Sudden weight gain, loss of appetite, and bloating can sometimes be related to hormonal imbalances, such as those seen in thyroid disorders.
    • Typical Treatments/Testing: Blood tests to check hormone levels, followed by appropriate treatment based on the findings.
  4. Allergic Reaction or Skin Condition:

    • Rationale: The presence of a skin rash could indicate an allergic reaction or a dermatological condition.
    • Typical Treatments/Testing: A physical examination of the rash, possibly followed by allergy testing or a referral to a dermatologist.

What you can do

For Bloating and Abdominal Distension:

  • See a doctor: Given the severity and persistence of your symptoms, it's important to consult a healthcare provider. They may recommend tests to identify the cause of your bloating.
  • Dietary changes: Avoid foods that are known to cause gas and bloating, such as beans, carbonated drinks, and certain vegetables like broccoli and cabbage.
  • Hydration: Drink plenty of water to help with digestion and reduce bloating.
  • Probiotics: Consider taking probiotics to support gut health.

For Frequent Urination and Burning Sensation:

  • See a doctor: A urine test can help diagnose a UTI or other urinary issues. Early treatment with antibiotics can prevent complications.
  • Stay hydrated: Drink plenty of water to help flush out any potential infection.

For Skin Rash:

  • See a doctor: A healthcare provider can examine the rash and determine if it's an allergic reaction or another skin condition.
  • Avoid irritants: Try to identify and avoid any potential irritants that may be causing the rash.

For General Symptoms (Weight Gain, Loss of Appetite, Chills):

  • See a doctor: These symptoms could be related to a variety of conditions, including hormonal imbalances or infections. Blood tests and a thorough examination can help identify the cause.
  • Monitor symptoms: Keep track of your symptoms using the MDandMe journal to provide detailed information to your healthcare provider.

What you should look out for

Given the severity and combination of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe abdominal pain: This could indicate a more serious condition that requires immediate attention.
  • High fever: A high fever along with chills could indicate a serious infection.
  • Blood in urine or stool: This could be a sign of a more serious underlying condition.
  • Severe chest pain: This could indicate a cardiac issue and should be evaluated immediately.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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6 mo ago

People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include frequent urination, a burning sensation during urination, cloudy or strong-smelling urine, and sometimes pelvic pain. Chills and fever can also occur if the infection spreads.


How can gastrointestinal issues like IBS be diagnosed?

Gastrointestinal issues like IBS can be diagnosed through a combination of symptom assessment, stool tests, blood tests, and sometimes imaging studies. A healthcare provider may also recommend a colonoscopy to rule out other conditions.


What could cause sudden weight gain and loss of appetite?

Sudden weight gain and loss of appetite can be caused by hormonal imbalances, such as thyroid disorders, fluid retention, or certain medications. It's important to consult a healthcare provider for blood tests to check hormone levels.


How can I identify if a skin rash is due to an allergic reaction?

A skin rash due to an allergic reaction often appears suddenly and may be accompanied by itching, redness, and swelling. Allergy testing or a consultation with a dermatologist can help identify the cause of the rash.


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