[31F] With right lower rib pain and bloating

Patient Description

A 31-year-old female presents with discomfort in the right lower ribs extending into the back, accompanied by bloating in the abdomen. The discomfort is constant, with episodes of sharp pain rated at 4 out of 10 in intensity. These symptoms have been present for the past 3 days. The patient also reports increased frequency of bowel movements, occurring almost every other hour, and episodes of nausea with regurgitation. There is no change in the color of urine or stool. The patient denies fever, chills, recent dietary changes, stress, physical activity, or travel. She experiences hot flashes at work but no yellowing of the skin or eyes. The patient has no fallopian tubes and is concerned about the possibility of pregnancy. She is currently taking Omeprazole and an allergy medication, with no recent changes in medication. There is no family history of gastrointestinal disorders.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Gastrointestinal Issues: The combination of right-sided abdominal pain, bloating, and increased bowel movements could suggest a gastrointestinal issue such as gastritis, peptic ulcer disease, or gallbladder problems. Omeprazole, which you are taking, is often used to treat acid-related stomach issues, but if symptoms persist, further evaluation might be needed.

    • Testing and Treatment: A healthcare provider might recommend an abdominal ultrasound or endoscopy to investigate further. Treatment could involve dietary changes, medications to reduce stomach acid, or other interventions depending on the diagnosis.
  • Irritable Bowel Syndrome (IBS): IBS can cause abdominal pain, bloating, and changes in bowel habits. Stress and diet can often exacerbate symptoms.

    • Testing and Treatment: Diagnosis is typically based on symptoms and ruling out other conditions. Management includes dietary modifications, stress management, and sometimes medications.
  • Hormonal Changes: Breast tenderness and hot flashes could be related to hormonal fluctuations, which might also contribute to gastrointestinal symptoms.

    • Testing and Treatment: If hormonal changes are suspected, a healthcare provider might suggest blood tests to check hormone levels.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis, here are some steps you can take in the meantime:

  1. Dietary Adjustments: Try to identify any foods that might be triggering your symptoms. Keeping a food diary can help track what you eat and how it affects your symptoms.
  2. Hydration: Ensure you stay well-hydrated, especially with increased bowel movements.
  3. Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can provide valuable insights into potential triggers and the effectiveness of any interventions you try.
  4. Stress Management: Practice stress-reducing techniques such as deep breathing, meditation, or gentle exercise, as stress can exacerbate gastrointestinal symptoms.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or vomit
  • Persistent vomiting or inability to keep fluids down
  • Signs of dehydration, such as dizziness, dry mouth, or decreased urination
  • Any new or concerning symptoms

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a thorough evaluation and personalized advice.

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1 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What could be causing the discomfort in the right lower ribs and back?

The discomfort in the right lower ribs and back could be due to gastrointestinal issues such as gastritis, peptic ulcer disease, or gallbladder problems. An abdominal ultrasound or endoscopy might be needed for further investigation.


How can increased bowel movements and bloating be managed?

Increased bowel movements and bloating can be managed by identifying and avoiding trigger foods, staying hydrated, and possibly using medications to reduce stomach acid. Keeping a food diary and consulting with a healthcare provider can help tailor the management plan.


Are hot flashes and gastrointestinal symptoms related?

Hot flashes and gastrointestinal symptoms might be related to hormonal changes. Hormonal fluctuations can affect both the gastrointestinal system and cause symptoms like hot flashes. Blood tests can help determine if hormonal changes are contributing to these symptoms.


Is it possible to be pregnant without fallopian tubes?

Pregnancy is not possible without fallopian tubes, as they are necessary for the egg to travel from the ovaries to the uterus. If there are concerns about pregnancy, a healthcare provider can offer more information and reassurance.


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