[27M] Experiencing unexplained weight loss, abdominal pain, and bowel movement changes

Patient Description

A 27-year-old male presents with a 30-pound unexplained weight loss over two months, intermittent abdominal pain rated 5/10 in severity, nausea rated 6-7/10, and changes in bowel movements including constipation and presence of bright red blood in stool on one occasion. The abdominal pain is described as random, sometimes sharp or cramping, occurring near the belly button or on the left or right side, and can worsen with movement or bending over. The patient has been experiencing these symptoms for approximately 4 weeks, with constipation lasting 1.5 months and bowel movement changes for 6 weeks. The patient also reports fatigue starting two weeks ago and sharp lower back pain on the left side at night. The patient has a family history of colon cancer and is scheduled for a colonoscopy in the next two weeks. The patient has Gastroesophageal Reflux Disease (GERD) diagnosed post-surgery and is currently taking Vyvanse (40mg daily for 7 years) and Propranolol (40mg once daily). No known drug allergies. No other medications or supplements reported.

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Arora's Assessment

What might be happening

Based on the information provided, here are some possible explanations for your symptoms:

  • Colon Cancer: Given your family history, unexplained weight loss, changes in bowel movements, and presence of blood in stool, this is a possibility that should be ruled out. Colon cancer often presents with these symptoms, and your risk is increased due to your family history.

    • Colonoscopy is the gold standard for diagnosis. Treatment typically involves surgery, chemotherapy, and/or radiation therapy.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, changes in bowel habits, and blood in the stool. Fatigue and weight loss can also be associated with these conditions.

    • Diagnosis is usually made with a combination of imaging, endoscopy, and biopsy. Treatment typically involves medications to reduce inflammation and manage symptoms.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause abdominal pain, bloating, gas, diarrhea or constipation, and mucus in the stool. However, IBS does not typically cause weight loss or blood in the stool.

    • Diagnosis is usually made based on symptoms and ruling out other conditions. Treatment focuses on long-term management of symptoms.
  • Gastroesophageal Reflux Disease (GERD): While you have a history of GERD, it typically causes heartburn and acid regurgitation. It's less likely to be the cause of your current symptoms, but severe cases can sometimes present with atypical symptoms.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis. You should consult with a healthcare provider for a formal evaluation.

What you can do

  1. Keep your upcoming colonoscopy appointment. This test will provide valuable information about your colon health and can help rule out certain conditions like colon cancer.
  2. Monitor your symptoms closely and note any changes or patterns. This information can be helpful for your healthcare provider.
  3. Maintain a balanced diet and stay hydrated, especially if you're experiencing changes in bowel movements.
  4. Try to rest and take care of your overall health. Chronic conditions can often cause fatigue, and taking care of your general health can help manage this symptom.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Vomiting blood or having black, tarry stools
  • High fever (temperature over 100.4°F)
  • Signs of dehydration, such as dry mouth, extreme thirst, little to no urination, severe weakness, dizziness, or lightheadedness
  • Any other symptoms that are severe or concerning to you

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

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People Also Ask


What are the common symptoms of colon cancer?

Common symptoms of colon cancer include unexplained weight loss, changes in bowel habits (such as diarrhea or constipation), blood in the stool, abdominal pain, and fatigue. A family history of colon cancer can increase the risk.


How is Inflammatory Bowel Disease (IBD) diagnosed and treated?

Inflammatory Bowel Disease (IBD), which includes Crohn's disease and ulcerative colitis, is diagnosed through a combination of imaging tests, endoscopy, and biopsy. Treatment typically involves medications to reduce inflammation and manage symptoms, and in some cases, surgery may be necessary.


Can Irritable Bowel Syndrome (IBS) cause weight loss and blood in the stool?

Irritable Bowel Syndrome (IBS) typically does not cause weight loss or blood in the stool. It is characterized by abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea or constipation. If you experience weight loss or blood in the stool, it is important to rule out other conditions.


What should I do if I experience severe abdominal pain or other concerning symptoms?

If you experience severe abdominal pain, vomiting blood, black or tarry stools, high fever, or signs of dehydration, you should seek immediate medical attention. These symptoms could indicate a serious condition that requires prompt evaluation and treatment.


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