[28F] Experiencing persistent bloating and gastrointestinal symptoms

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Patient Description

A 28-year-old female has been experiencing bloating in the lower middle stomach for almost two months, with a sensation of pressure on the bladder and lower back. The bloating occurs almost daily, especially after lunch or dinner, lasting through the night. The patient reports excess bowel movements, nausea, vomiting, dry heaving, constipation, and increased urinary frequency. Vomiting was frequent in August and September, now occurring once or twice a week. Weight fluctuates between 120 and 125 pounds, with a loss of 7 pounds in August due to vomiting. Stool is very dark, and bowel movements increased to 49 in August, 53 in September, and 27 so far in October. The patient urinates up to 15 times during an 8-hour shift. Nausea is often worse in the mornings. Abdominal pain accompanies bloating, described as a dull, full pressure. No blood in stool or vomit. The patient started taking vitamin C (1000 mg), vitamin D (10,000 IU), and zinc (30 mg) nightly. Medications include Adderall (20 mg, 3-4 times a week) and valacyclovir (1000 mg daily). No recent medical evaluations, family history of gastrointestinal issues, or recent travel. No pre-existing conditions.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

Irritable Bowel Syndrome (IBS): This condition can cause bloating, changes in bowel habits, and abdominal pain. Stress and certain foods can trigger symptoms.
- Treatment often involves dietary changes, stress management, and sometimes medication.
Gastroenteritis or Infection: An infection could cause nausea, vomiting, and changes in bowel habits. Dark green stool can sometimes be due to bile moving quickly through the intestines.
- Treatment may include hydration and rest. If bacterial, antibiotics might be needed.
Medication Side Effects: Adderall and valacyclovir can sometimes cause gastrointestinal symptoms.
- Discussing with your doctor about possible side effects or alternatives might be helpful.
Food Intolerances or Sensitivities: These can cause bloating, nausea, and changes in bowel habits.
- Identifying and avoiding trigger foods can help manage symptoms.

What you can do

Dietary Adjustments: Keep a food diary to track what you eat and any symptoms that follow. This can help identify triggers.
Hydration: Ensure you stay well-hydrated, especially if experiencing vomiting or diarrhea.
Consult a Doctor: It's important to see a healthcare provider for a formal diagnosis and to discuss your symptoms and medications.
Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your provider.

What you should look out for

Seek Immediate Care If:
- You experience severe abdominal pain.
- You notice blood in your stool or vomit.
- You have a high fever or persistent vomiting.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation.

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3 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines