[31F] Experiencing constant stomach pain with rectal and vaginal bleeding

Patient Description

A 31-year-old female presents with persistent stomach pain described as a sensation of pressure at the top middle of the abdomen. The pain is constant throughout the day, with some relief upon gentle massage. The patient experiences frequent bowel movements that are often runny or resemble diarrhea. Additionally, there is a report of fresh blood from the rectum and vagina upon straining, which is not mixed with the stool and resolves later in the day. Occasional presence of stringy mucus in the stool has been noted. The patient has a known history of high blood pressure and is on Metformin, Atorvastatin, and Olmesartan. There is no reported weight loss, fever, chills, dizziness, lightheadedness, or shortness of breath. No known allergies or adverse reactions to medications have been identified.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms such as cramping, abdominal pain, bloating, and changes in bowel habits. The exact cause of IBS is not known, but several factors may play a role, including muscle contractions in the intestine, abnormalities in the nervous system, inflammation in the intestines, severe infection, or changes in bacteria in the gut.

    • Treatment of IBS typically involves lifestyle changes, dietary changes, and medication to manage symptoms.
  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria, or parasites. Symptoms can include diarrhea, abdominal pain, and vomiting.

    • Treatment of gastroenteritis usually involves rest, hydration, and over-the-counter medications to manage symptoms.
  • Hemorrhoids: These are swollen veins in your lower rectum. Straining during bowel movements can worsen hemorrhoids, leading to pain, inflammation, and bleeding.

    • Treatment of hemorrhoids often involves over-the-counter creams, good hygiene, and avoiding straining during bowel movements.
  • Gynecological conditions: Various conditions, such as uterine fibroids or endometriosis, can cause vaginal bleeding and abdominal pain.

    • Treatment of these conditions often involves medication or, in some cases, surgery.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms.

What you can do

It's important to seek medical attention to get a proper diagnosis and treatment. Here are some steps you can take:

  1. Schedule an appointment with your primary care doctor. They can perform a physical examination and may order tests such as blood tests, stool tests, or imaging studies to help determine the cause of your symptoms.
  2. Keep a symptom diary. Note down when your symptoms occur, what you're doing when they occur, and what foods you've eaten. This can help identify any patterns or triggers.
  3. Try to maintain a balanced diet and stay hydrated, especially if you're experiencing diarrhea.
  4. Avoid straining during bowel movements to prevent worsening of hemorrhoids.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool or heavy vaginal bleeding
  • Unintentional weight loss
  • Persistent vomiting
  • Signs of dehydration, such as extreme thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness.

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea or constipation. The symptoms can vary in intensity and may be triggered by certain foods or stress.


How can hemorrhoids cause bleeding during bowel movements?

Hemorrhoids are swollen veins in the lower rectum or anus. Straining during bowel movements can cause these veins to become irritated and bleed, leading to fresh blood on the toilet paper or in the toilet bowl.


What dietary changes can help manage symptoms of IBS?

Dietary changes that can help manage IBS symptoms include increasing fiber intake, avoiding trigger foods such as caffeine, alcohol, and fatty foods, eating smaller meals, and staying hydrated. Keeping a food diary can help identify specific triggers.


When should I seek immediate medical attention for abdominal pain?

You should seek immediate medical attention for abdominal pain if it is severe, accompanied by blood in your stool or heavy vaginal bleeding, if you experience unintentional weight loss, persistent vomiting, or signs of dehydration such as extreme thirst, dry mouth, or dizziness.


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