[30F] Experiencing severe abdominal pain, random bruising, and hair loss

Patient Description

A 30-year-old female reports experiencing sharp pain in the upper right side under her ribs for the past 3 days, with a 13-year history of similar pain without diagnosis. Accompanying symptoms include random bruising in small purple spots on her legs, arms, stomach, and hands, spreading into larger, brownish spots over 2 months, and noticeable hair thinning, particularly around the temples, over the past month. The patient describes her stool as watery, light brown, and yellow, occurring less than an hour ago. She denies fever or chills and has not identified any relief for her abdominal pain. The patient also reports unexpected weight loss and nausea but no vomiting. There is no recent history of injuries, infections, or contact with sick individuals. The patient has not noticed any yellowing of the skin or eyes, but there have been changes in the color of her urine or stool.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Gallstones: These are hard deposits in your gallbladder, a small organ under the liver. They can cause sharp pain in the upper right part of your abdomen. The pain can start suddenly and quickly become very severe.

    • Treatment usually involves surgery to remove the gallbladder. In some cases, medications may be used to dissolve the gallstones.
  • Liver disease: This can include a variety of conditions that affect liver function. Symptoms can include abdominal pain, yellowing of the skin or eyes (jaundice), and changes in stool color. However, you mentioned that you have not noticed any yellowing of your skin or eyes.

    • Treatment depends on the specific type of liver disease and may include lifestyle changes, medications, or in severe cases, a liver transplant.
  • Thrombocytopenia: This is a condition characterized by low platelet count, which can lead to easy bruising. It can be caused by many conditions, including liver disease.

    • Treatment depends on the underlying cause and how severe the condition is. It may include medications, blood or platelet transfusions, or procedures to remove the spleen.
  • Alopecia areata: This is a condition that causes hair to fall out in small patches. It's caused by the immune system attacking the hair follicles. It can result in hair loss anywhere on the body, but most commonly affects the scalp.

    • Treatment usually involves medications to help hair regrow more quickly.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis. You should consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Seek medical attention: Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. A healthcare provider can perform tests to determine the cause of your symptoms and recommend appropriate treatment.

  2. Keep a symptom diary: Note down when your symptoms occur, their severity, and any potential triggers. This can be helpful information for your healthcare provider.

  3. Stay hydrated and maintain a balanced diet: This can help manage your symptoms and support overall health.

What you should look out for

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

  • Severe abdominal pain
  • Blood in your stool or dark, tarry stools
  • Yellowing of your skin or eyes
  • Persistent vomiting or inability to keep down fluids
  • Sudden or severe hair loss

Remember, it's important to consult with a healthcare provider for a formal diagnosis and treatment.

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8 mo ago


People Also Ask


What could be causing sharp pain in the upper right side under the ribs?

Sharp pain in the upper right side under the ribs could be caused by gallstones, which are hard deposits in the gallbladder. Other possibilities include liver disease or other abdominal issues. It's important to consult a healthcare provider for an accurate diagnosis.


What might be the reason for random bruising and changes in bruise color?

Random bruising and changes in bruise color could be due to thrombocytopenia, a condition characterized by a low platelet count. This can lead to easy bruising and may be associated with other conditions like liver disease. A medical evaluation is necessary to determine the cause.


Why am I experiencing hair thinning, particularly around the temples?

Hair thinning, especially around the temples, could be due to alopecia areata, an autoimmune condition where the immune system attacks hair follicles. Other potential causes include nutritional deficiencies or hormonal changes. A healthcare provider can help identify the cause and suggest treatment options.


What could cause watery, light brown, and yellow stool?

Watery, light brown, and yellow stool could be related to digestive issues, such as those caused by gallstones or liver disease. Changes in stool color can indicate a problem with bile production or absorption. It's important to seek medical advice to determine the underlying cause.


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3 Comments


Leo#3962

8 mo ago

Im sorry to hear that you've been dealing with the pain for 13 years! How many doctors have you seen for it and what do they think it is? The random bruising is pretty indicative of a blood clotting problem. Have you gotten bloodwork done recently, especially looking at platelets, clotting time, and clotting factors?

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Anonymous#8048

8 mo ago

I have seen countless doctors. When I was 17, I had my gallbladder removed, but the pain still persists. I have had several CT scans, 2 upper GI endoscopies, an endoscoping ultrasound, and several ultrasounds. Not to mention going and checking my lipase, amylase, etc via bloodwork every time I had pain. (Daily, in some cases.) Everything came back as "fine" except for the EUS- the doctor who performed it told me that I had 5 out of the 9 changes of chronic pancreatitis present. But when going to my consultation the next morning to discuss the results with the doctor who ordered the test, he said I'm fine, nothing is wrong with me. After visiting with that doctor, no other doctor will see me kr work with me on this issue because "he's the best in the area for this kind of issue, so what he says is going to be the best opinion you can get." 🤦🏻‍♀️ Since getting that kind of treatment, I haven't bothered going to do anything further. I have wound up in the ER after all of this, I passed out from the pain and my husband (then, boyfriend) had seen this only for the first time and didn't know what to do... so he called 911. They did bloodwork and a CT scan and said I just had an upset stomach. But I was expecting that. Lol. My most recent bloodwork was taken 9 days ago, and it was just a CBC with PLT and it came back with everything looking normal. I am 4 months post partum, and did have to take iron due to low RBCs, hemoglobin, and hematocrit levels. But obviously, they have since leveled out.l, and I have not been taking iron for about 3 months. I also considered that being the problem with my hairless, but this is my second child and it wasn't this bad after having her.

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Leo#3962

8 mo ago

Wow, that sounds so frustrating. Im not sure about the pain since it seems like you've had tons of workup on that but the bruising sounds like a certain type called petechiae. Some common causes include:

  1. low platelets (which it sounds like isn't the case)
  2. Vasculitis: Conditions like Henoch-Schönlein purpura also called IgA vasculitis which can also cause various types of abdominal pain. Laboratory tests are often in-range but a skin biopsy can be diagnostic. However, this condition is more common in children and usually resolves on its own
  3. Vitamin K or vitamin C deficiency because these are involved in clotting pathways
  4. Deficiency of specific clotting factors
  5. Connective tissue disorders like Ehlers-Danlos syndrome which can lead to increased skin fragility
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