[28F] Pregnant with digestive issues and abdominal pain

Patient Description

A 28-year-old female, currently 20 weeks pregnant, reports several weeks of digestive issues, including abdominal pain, diarrhea after eating, low energy, and weakness. The patient rates the abdominal pain as a 7 out of 10, describing it as cramping and constant. Diarrhea occurs 15-20 minutes after eating any food. Additionally, the patient experiences extremely dark green stools that are very foul-smelling. There is no presence of blood or mucus in the stool. The patient also notes a loss of appetite but no recent weight loss, swelling, or sudden weight gain. Past medical history includes gallbladder removal in 2014 and preeclampsia during the third pregnancy. The patient is currently taking prenatal vitamins and probiotics and has no known allergies or adverse reactions to medications. There is no family history of gastrointestinal diseases and no new medications or supplements have been introduced recently.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible diagnoses include:

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can cause diarrhea, abdominal pain, and loss of appetite.

    • Treatment typically involves rest, hydration, and over-the-counter remedies to manage symptoms. Antibiotics may be prescribed if a bacterial infection is suspected.
  • Gallbladder Disease or Post-Cholecystectomy Syndrome: Given your history of gallbladder removal, it's possible that your symptoms are related to changes in your bile flow. This can cause diarrhea, especially after meals, and abdominal pain.

    • Treatment may involve dietary changes, medications to bind bile acid, or in rare cases, further surgery.
  • Irritable Bowel Syndrome (IBS): This is a chronic condition that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation.

    • Treatment typically involves long-term management of diet, lifestyle, and stress. Medications and other therapies may also be beneficial.
  • Pregnancy-related Digestive Issues: Hormonal changes during pregnancy can slow down your digestive system, leading to constipation, bloating, and abdominal pain.

    • Treatment usually involves dietary changes, such as eating smaller, more frequent meals and avoiding trigger foods. Over-the-counter remedies may also be helpful.

What you can do

  1. Stay hydrated: Diarrhea can cause you to lose a lot of fluids and electrolytes quickly, which can lead to dehydration. Make sure you're drinking plenty of fluids, especially water.

  2. Eat a bland diet: Try eating bland, easy-to-digest foods like rice, bananas, and toast. Avoid spicy, fatty, or fried foods.

  3. Rest: Make sure you're getting plenty of rest. This can help your body recover more quickly.

  4. Over-the-counter remedies: Over-the-counter medications like loperamide (Imodium) can help manage diarrhea. However, you should check with your doctor before starting any new medications while pregnant.

  5. Consult a doctor: If your symptoms persist or worsen, you should consult a healthcare professional. They can provide a formal diagnosis and appropriate treatment.

What you should look out for

  • If your diarrhea lasts more than a few days
  • If you notice blood in your stool
  • If you become dehydrated (symptoms include extreme thirst, dry mouth, dark urine, or feeling dizzy when you stand up)
  • If you develop a fever
  • If your abdominal pain becomes severe or persistent

Please remember that while I strive to provide accurate and helpful information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common causes of diarrhea during pregnancy?

Common causes of diarrhea during pregnancy include hormonal changes, dietary changes, prenatal vitamins, and increased sensitivity to certain foods. Infections and gastrointestinal conditions can also contribute.


How can gallbladder removal affect digestion?

Gallbladder removal can lead to changes in bile flow, which may cause diarrhea, especially after eating fatty foods. This condition is known as post-cholecystectomy syndrome.


What dietary changes can help manage IBS symptoms?

To manage IBS symptoms, it is often recommended to eat a high-fiber diet, avoid trigger foods (such as caffeine, alcohol, and fatty foods), eat smaller meals, and manage stress. Keeping a food diary can help identify specific triggers.


When should I see a doctor for persistent digestive issues during pregnancy?

You should see a doctor if your digestive issues persist for more than a few days, if you experience severe abdominal pain, dehydration, blood in your stool, or if you develop a fever. These could be signs of a more serious condition that requires medical attention.


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