[29F] Experiencing severe stomach cramping and bloody diarrhea

Patient Description

A 29-year-old female presents with severe stomach cramping, bloody diarrhea, and nausea. The cramping, which has been ongoing for 12 hours, is described as sharp and throbbing, rated 7 out of 10 in severity, and worsens upon consumption of any food or drink. The patient also reports liquid bright red blood in the stool, occurring 4 times in 8 hours, which is a new symptom for her. She is experiencing signs of dehydration, including lightheadedness, dry mouth, excessive thirst, and reduced urination. The patient's medical history includes migraines, occipital neuralgia, depression, and anxiety, with a diagnosis at ages 21, 25, and 15, respectively. She is currently taking Trazadone, Gabapentin, Prazosin, and Cymbalta, and has a known allergy to latex. There are no reports of fever, chills, dizziness, or fainting. The patient has not found any relief measures for her stomach cramping.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the U.S. It causes diarrhea and vomiting and is often called the "stomach flu."

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be necessary if the cause is bacterial.
  • Peptic Ulcers: These are sores that develop on the lining of your stomach, upper small intestine or esophagus. The most common symptom of a peptic ulcer is stomach pain, but they can also cause bloody or dark stool.

    • Treatment typically involves medications to decrease stomach acid. If the cause is the bacteria H. pylori, antibiotics will be necessary.
  • Colitis: This is an inflammation of the colon. Colitis can cause abdominal pain, urgency, bloody diarrhea, and it can be a chronic condition.

    • Treatment depends on the cause of the colitis but can include changes in diet, antibiotics, and anti-inflammatory drugs.
  • Diverticulosis/Diverticulitis: Diverticulosis is a condition where small, bulging pouches (diverticula) develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis. This can cause severe abdominal pain, fever, nausea, and a marked change in your bowel movements.

    • Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require surgery.

Please note that these are possible diagnoses based on the information you've provided, and actual diagnosis should be made by a healthcare professional.

What you can do

Given the severity of your symptoms, especially the bloody diarrhea, it is important to seek medical attention immediately. In the meantime, try to stay as hydrated as possible. Dehydration can exacerbate your symptoms and make you feel worse.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Increased intensity or frequency of abdominal pain
  • High fever
  • Persistent vomiting
  • Signs of shock, such as rapid heartbeat, dizziness or fainting, or excessive sweating
  • Blood in your vomit or stool that is black and tarry

Remember, it's important to consult with a healthcare professional who can evaluate your condition and provide a formal diagnosis.

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11 mo ago

People Also Ask


What are the common causes of bloody diarrhea?

Bloody diarrhea can be caused by infections (bacterial, viral, or parasitic), inflammatory bowel diseases like ulcerative colitis or Crohn's disease, diverticulitis, or peptic ulcers. It's important to consult a healthcare professional for an accurate diagnosis.


How can dehydration be managed at home?

To manage dehydration at home, increase fluid intake with water, oral rehydration solutions, or clear broths. Avoid caffeinated or alcoholic beverages. If symptoms of dehydration persist, seek medical attention.


What are the potential side effects of the medications the patient is taking?

Trazadone can cause dizziness, dry mouth, and nausea. Gabapentin may cause drowsiness and dizziness. Prazosin can lead to dizziness and headaches. Cymbalta might cause nausea, dry mouth, and fatigue. It's important to discuss any side effects with a healthcare provider.


When should someone with severe stomach cramping and bloody diarrhea seek medical attention?

Immediate medical attention is necessary if there is an increase in the intensity or frequency of abdominal pain, high fever, persistent vomiting, signs of shock, or if the blood in the stool is black and tarry.


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