[31M] With chronic lower back pain and gastrointestinal symptoms

Patient Description

A 31-year-old male has been experiencing lower back pain for the past two years, which worsens with sitting and is somewhat relieved by massage and chiropractic care. Additionally, he reports dull abdominal pain for seven months, rated 8 out of 10 in severity, accompanied by significant blood in the stool, constipation, and a feeling of bloating centered below the belly button for the last three months. These symptoms are new and concerning, with no prior history of blood in the stool. There have been no recent dietary changes, new supplements, or travel history. The patient has a medical history of depression (diagnosed in 2008), anxiety (2016), asthma (2017), and a back injury (2019). He is not currently taking any medications and has no known allergies.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Gastrointestinal Bleeding: The presence of a lot of blood in your stool is concerning and could indicate bleeding in your digestive tract. This can be caused by conditions like hemorrhoids, diverticulosis, or more serious issues like ulcers or tumors.

  2. Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD): The combination of abdominal pain, bloating, and changes in bowel habits could suggest IBS or IBD, such as Crohn's disease or ulcerative colitis.

  3. Back Injury Complications: Chronic back pain and abdominal symptoms might be related if there's nerve involvement or other complications from your back injury.

It's important to seek medical attention promptly to determine the exact cause and receive appropriate treatment. Testing might include blood tests, imaging studies, or a colonoscopy.

What you can do

  • Seek Immediate Medical Care: Given the severity of your symptoms, especially the significant blood in your stool, it's crucial to see a healthcare provider as soon as possible. Consider visiting an emergency room or urgent care.

  • Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, more frequent bleeding, or new symptoms like fever.

  • Avoid Certain Medications: Until you see a doctor, avoid NSAIDs or other medications that might worsen bleeding.

  • Stay Hydrated: Blood loss can lead to dehydration, so ensure you're drinking plenty of fluids.

Please remember, this information is not a substitute for professional medical advice. Contact a healthcare provider immediately to get a proper diagnosis and treatment. If your symptoms worsen or you feel light-headed, call 911 or have someone take you to the hospital.

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3 mo ago

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People Also Ask


What could cause significant blood in the stool?

Significant blood in the stool can be caused by various conditions, including hemorrhoids, diverticulosis, gastrointestinal ulcers, or more serious issues like tumors or inflammatory bowel diseases. It's important to seek medical evaluation to determine the exact cause.


How are lower back pain and abdominal symptoms related?

Lower back pain and abdominal symptoms can be related if there is nerve involvement or complications from a back injury that affect the abdominal area. Additionally, some gastrointestinal conditions can cause referred pain to the back.


What are the differences between IBS and IBD?

IBS (Irritable Bowel Syndrome) is a functional disorder characterized by abdominal pain and changes in bowel habits without visible signs of damage in the digestive tract. IBD (Inflammatory Bowel Disease), such as Crohn's disease or ulcerative colitis, involves chronic inflammation and can cause visible damage to the digestive tract.


What immediate steps should be taken if experiencing severe abdominal pain and blood in the stool?

If experiencing severe abdominal pain and blood in the stool, it's crucial to seek immediate medical care. This may involve visiting an emergency room or urgent care. Avoid medications like NSAIDs that could worsen bleeding, stay hydrated, and monitor symptoms closely.


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