[28F] With crampy stomach pain and diarrhea

Patient Description

A 28-year-old female has been experiencing crampy stomach pain and light brown diarrhea for the past three days. The stomach pain subsides after bowel movements and occurs 1-2 times a day. These episodes happen about once a month and typically last for a day. Certain foods like Subway and peanut butter seem to trigger the symptoms, but recently, anything eaten has caused issues. The symptoms appeared suddenly, and there is no recent travel history. The patient has not experienced fever or blood in the stool recently, although bright red blood was present in the past. There is some nausea but no vomiting, and the patient reports bloating. There is no unintentional weight loss. The patient consumes some caffeine and has not taken any new medications or supplements recently. Menstrual periods are regular but have become shorter in duration. The patient has a history of rheumatoid arthritis diagnosed a year ago, a sulfa reaction, and is currently taking Ativan (1mg once a day) and Advil (200mg once a day).

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS): IBS is a common condition that affects the large intestine and can cause crampy stomach pain, bloating, and diarrhea. Symptoms often improve after a bowel movement. IBS can be triggered by certain foods, stress, and hormonal changes.

    • Treatment: Management of IBS typically involves dietary changes, stress management, and sometimes medications to relieve symptoms. Common dietary changes include avoiding trigger foods, eating smaller meals, and increasing fiber intake.
  • Food Intolerances: Intolerances to certain foods, such as lactose or gluten, can cause symptoms like diarrhea, stomach pain, and bloating. Your mention of Subway and peanut butter as potential triggers suggests that certain foods might be causing your symptoms.

    • Treatment: Identifying and avoiding trigger foods is key. Keeping a food diary can help you pinpoint which foods cause symptoms.
  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. It can cause sudden onset of diarrhea, stomach pain, nausea, and sometimes headache.

    • Treatment: Gastroenteritis usually resolves on its own within a few days. Staying hydrated and resting are important. Over-the-counter medications can help manage symptoms.
  • Stress and Anxiety: Stress and anxiety can have a significant impact on your digestive system, leading to symptoms like stomach pain, diarrhea, and headaches.

    • Treatment: Stress management techniques such as mindfulness, relaxation exercises, and counseling can be beneficial.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Dietary Changes: Try to identify and avoid foods that trigger your symptoms. Keeping a food diary can help you track what you eat and how it affects your symptoms.
  2. Stay Hydrated: Drink plenty of fluids, especially if you are experiencing diarrhea. Oral rehydration solutions can help replace lost electrolytes.
  3. Over-the-Counter Medications: Medications like loperamide (Imodium) can help manage diarrhea, and antacids or simethicone can help with bloating and gas.
  4. Stress Management: Practice relaxation techniques such as deep breathing, meditation, or yoga to help manage stress and anxiety.
  5. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or persistent abdominal pain
  • Blood in your stool (especially if it is dark or tarry)
  • High fever (temperature over 100.4°F) or chills
  • Unintentional weight loss
  • Symptoms that do not improve or worsen over time

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago

People Also Ask


What are common triggers for Irritable Bowel Syndrome (IBS) and how can they be managed?

Common triggers for IBS include certain foods (like fatty or spicy foods), stress, and hormonal changes. Management involves identifying and avoiding these triggers, eating smaller meals, increasing fiber intake, and practicing stress management techniques.


How can I differentiate between food intolerance and IBS?

Food intolerance typically causes symptoms like diarrhea, bloating, and stomach pain after consuming specific foods, whereas IBS can be triggered by a broader range of factors including stress. Keeping a food diary can help identify specific food intolerances.


What are the best dietary changes to manage symptoms like diarrhea and bloating?

To manage symptoms like diarrhea and bloating, consider avoiding trigger foods, eating smaller and more frequent meals, increasing fiber intake gradually, and staying hydrated. Probiotics and low-FODMAP diets may also be beneficial.


When should I seek medical attention for gastrointestinal symptoms?

Seek medical attention if you experience severe or persistent abdominal pain, blood in your stool, high fever, unintentional weight loss, or if symptoms do not improve or worsen over time.


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