[29F] With severe abdominal pain and systemic symptoms

Patient Description

A 29-year-old female presents with severe abdominal pain, nausea, and a tingling sensation throughout the body, including the forehead. These episodes have occurred twice in the past two weeks, each lasting about 20-30 minutes. The pain is located from a few inches above the belly button down to the belly button, and folding into different positions provides temporary relief. There is occasional spotting of blood when wiping after bowel movements, and constipation is frequent. During episodes, the patient experiences confusion, lightheadedness, difficulty speaking, and a sensation of breathlessness due to pain. Vomiting occurred during the first episode but not the second. A fever was noted 3-4 weeks ago. Since starting phentermine, the patient has experienced decreased appetite and a weight loss of approximately 35 pounds. Increased urination is noted, likely due to dry mouth from phentermine. The patient has asthma, diagnosed at age 3-4, and no known allergies, although doxycycline caused adverse effects in the past. Current medications include phentermine, estradiol, women's multivitamin gummies, and calcium with vitamin D. There is no direct correlation between phentermine and the episodes, and these symptoms have not yet been discussed with a healthcare provider.

Arora's Assessment

What might be happening

Your symptoms could be related to several potential issues:

Gastrointestinal Issues: The severe abdominal pain and nausea might be related to gastrointestinal problems such as gastritis, ulcers, or even gallbladder issues. The blood when wiping could indicate hemorrhoids or another issue in the lower digestive tract.
Side Effects of Phentermine: Phentermine can cause side effects like dry mouth, increased heart rate, and possibly the tingling sensation. It might also contribute to your dizziness and lightheadedness.
Hormonal Changes: Since you've had a hysterectomy and are on estradiol, hormonal changes could be affecting your body, potentially contributing to symptoms like hair thinning and chills.
Nutritional Deficiencies: The weight loss and reduced appetite might lead to deficiencies that could cause symptoms like dizziness and tingling.

What you can do

Abdominal Pain and Nausea:

Consider keeping a food diary to identify any potential triggers.
Eat smaller, more frequent meals to avoid long periods without food.
Stay hydrated, especially if you're experiencing constipation.

Tingling and Dizziness:

Ensure you're getting enough nutrients, possibly by consulting a nutritionist.
Rise slowly from sitting or lying positions to reduce dizziness.

General Health:

Schedule a follow-up with your healthcare provider to discuss these symptoms and any potential side effects of your medications.
Use MDandMe to journal your symptoms and track any patterns or triggers.

What you should look out for

Seek medical attention if you experience:

Severe or worsening abdominal pain.
Persistent vomiting or blood in your stool.
Fainting or severe dizziness.
Any new or concerning symptoms.

Remember, it's important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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2 mo ago

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[29F] With severe abdominal pain and systemic symptoms

What might be happening

What you can do

What you should look out for

Experiencing symptoms?