[27F] With severe constipation and abdominal pain

Patient Description

A 27-year-old female has been experiencing severe constipation for the past two weeks, with no bowel movements during this time. The last bowel movement was nearly two weeks ago and was characterized by oily and loose diarrhea. The patient reports significant abdominal pain around the belly button, described as sharp, cramping, and pressure-like, with an intensity of 7 out of 10. This pain has been present since the onset of constipation. Additional symptoms include severe bloating, fatigue, lack of appetite, nausea (without vomiting), and chills. There have been no changes in urination and no recent use of substances such as alcohol, tobacco, or recreational drugs. The patient has a family history of bowel obstructions in her grandmother and mother. She has no pre-existing conditions or chronic illnesses and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several serious conditions that could be causing your symptoms:

  1. Bowel Obstruction: Given your family history and the severity of your symptoms, a bowel obstruction is a significant concern. This condition occurs when there is a blockage in the intestines, preventing the normal passage of contents. Symptoms can include severe abdominal pain, bloating, constipation, and nausea. This is a medical emergency and requires immediate attention.

  2. Severe Constipation: Chronic constipation can lead to a condition called fecal impaction, where stool becomes hard and difficult to pass. This can cause severe abdominal pain, bloating, and a lack of bowel movements.

  3. Ileus: This is a condition where the intestines do not work properly, leading to a buildup of food material and gas. It can cause symptoms similar to a bowel obstruction, including severe abdominal pain, bloating, and constipation.

  4. Gastrointestinal Infection: Although less likely given the duration of your symptoms, a severe gastrointestinal infection could cause similar symptoms, including abdominal pain, bloating, and changes in bowel habits.

What you can do

Given the severity of your symptoms and the potential for a serious condition like a bowel obstruction, it is crucial that you seek immediate medical attention. Here are the steps you should take:

  1. Go to the Emergency Room: You need to be evaluated by a healthcare professional as soon as possible. If you are unable to get to the hospital yourself, please call 911 or have someone drive you there immediately.

  2. Do Not Delay: Conditions like bowel obstructions can worsen quickly and may require urgent treatment, including surgery. The sooner you get medical help, the better your chances of a positive outcome.

  3. Stay Hydrated: While waiting for medical help, try to stay hydrated. However, avoid eating or drinking large amounts until you have been evaluated by a healthcare professional.

  4. Monitor Your Symptoms: If you experience worsening pain, vomiting, or any new symptoms, inform the medical staff immediately.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Please take your symptoms seriously and get the help you need right away.

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6 mo ago

People Also Ask


What are the common symptoms of a bowel obstruction?

Common symptoms of a bowel obstruction include severe abdominal pain, bloating, constipation, nausea, vomiting, and an inability to pass gas or have a bowel movement. It is a serious condition that requires immediate medical attention.


How is severe constipation different from a bowel obstruction?

Severe constipation involves difficulty in passing stool and can lead to fecal impaction, causing abdominal pain and bloating. A bowel obstruction, however, is a blockage in the intestines that prevents the passage of contents entirely, often requiring urgent medical intervention.


What is an ileus and how does it differ from a bowel obstruction?

An ileus is a condition where the intestines do not function properly, leading to a buildup of food material and gas, causing symptoms similar to a bowel obstruction such as pain and bloating. Unlike a mechanical obstruction, an ileus is due to a lack of intestinal movement.


When should someone with severe constipation seek emergency medical attention?

Someone with severe constipation should seek emergency medical attention if they experience severe abdominal pain, bloating, nausea, vomiting, or if they have not had a bowel movement for an extended period, as these could be signs of a more serious condition like a bowel obstruction.


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