[29F] Experiencing abdominal pain, nausea, and altered bowel habits

Patient Description

A 29-year-old female reports experiencing sharp pain in the lower right side of the abdomen, rated as 8 out of 10 in severity, occurring 4-5 times a week, typically before bowel movements, for over a year. The patient also describes chronic nausea when hungry, persisting after eating, and a sense of fullness accompanied by hunger, both present for approximately one year. Additionally, there is occasional light-headedness and headaches. The patient has observed blood after wiping post-stool and recent changes in stool color to light green. The patient has a known diagnosis of Polycystic Ovary Syndrome (PCOS) since 2013 and is currently on Metformin 500mg twice daily and Phentermine 37.5mg once daily, with no reported side effects. There are no known allergies or adverse reactions to medications. The patient's symptoms have remained consistent without sudden worsening, fever, or bloody stools.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Irritable Bowel Syndrome (IBS): This condition can cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. It's a chronic condition that needs long-term management. The exact cause of IBS isn't known, but various factors play a role.
Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria, or parasites. Viral gastroenteritis is particularly common and is highly infectious.
Gastritis: This is an inflammation of the stomach lining. Weaknesses in the mucus-lined barrier that protects your stomach wall allow your digestive juices to damage and inflame your stomach lining.
Peptic Ulcers: These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.
Gallstones: These are hardened deposits in the gallbladder that can cause abdominal pain and other digestive problems.
Gynecological issues: Given your history of PCOS, it's also possible that some of your symptoms could be related to gynecological issues.

Please note that this is not an exhaustive list and other diagnoses could also be possible.

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention. Here are some steps you can take:

Schedule an appointment with your primary care provider. If you don't have one, consider going to an urgent care clinic.
Keep a symptom diary. Note down when your symptoms occur, what you're doing when they occur, what you've eaten that day, and how severe they are. This can help your healthcare provider diagnose your condition.
Stay hydrated and try to eat small, light meals.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

Severe abdominal pain
Blood in your stool or black, tarry stools
High fever (over 101°F)
Signs of dehydration, such as excessive thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness
Unexplained weight loss
Difficulty swallowing

Remember, while I strive to provide accurate information, I'm an AI and this advice is not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis.

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11 mo ago

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