[32F] With abdominal pain, yellow stool, and swollen liver

Patient Description

A 32-year-old female presents with a month and a half history of worsening right-sided abdominal pain and tenderness. The pain is described as a steady dull ache with occasional sharp pains, and it is exacerbated by touch. The patient reports a swollen abdomen from the lower right ribs to the waistline, present for the past five days. Additional symptoms include yellow, loose stools for the past week, nausea, severe heartburn, and pain in the lower right back. The patient also experiences increased sweating and difficulty discerning hunger and fullness. She has unintentionally lost a few pounds, likely due to irregular eating patterns. An ultrasound has confirmed a swollen liver.

Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

Liver Conditions: Given that you have a swollen liver and pain in the upper right abdomen, conditions such as hepatitis, fatty liver disease, or liver cirrhosis could be potential causes. These conditions can lead to symptoms like yellow stool, nausea, and abdominal swelling.
- Typical Treatments and Testing: Treatment depends on the specific liver condition. It may include lifestyle changes, medications, or other interventions. Blood tests, imaging studies like ultrasounds, and sometimes liver biopsies are used for diagnosis.
Gallbladder Issues: Pain in the upper right abdomen, especially if it radiates to the back, could indicate gallbladder problems such as gallstones or cholecystitis (inflammation of the gallbladder).
- Typical Treatments and Testing: Treatment may involve dietary changes, medications, or surgery. An ultrasound is commonly used to diagnose gallbladder issues.
Gastroesophageal Reflux Disease (GERD): Severe heartburn and nausea can be symptoms of GERD, a condition where stomach acid frequently flows back into the esophagus.
- Typical Treatments and Testing: Treatment often includes lifestyle changes, medications to reduce stomach acid, and sometimes surgery. Diagnosis is usually based on symptoms and may include an endoscopy.
Pancreatic Issues: Pain in the upper abdomen that radiates to the back, along with nausea and changes in stool color, could be related to pancreatic conditions such as pancreatitis.
- Typical Treatments and Testing: Treatment may involve hospitalization, medications, and dietary changes. Blood tests and imaging studies like CT scans are used for diagnosis.

What you can do

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

Dietary Changes: Avoid fatty, fried, and spicy foods that can exacerbate liver and gallbladder issues. Eating smaller, more frequent meals may also help.
Hydration: Ensure you stay well-hydrated, especially if you are experiencing loose stools.
Over-the-Counter Medications: Antacids or acid reducers may help alleviate heartburn symptoms.
Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share longitudinal medical notes with your healthcare provider. This can help in identifying patterns and triggers.
Rest: Ensure you get plenty of rest to help your body recover.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

Severe or worsening abdominal pain
Yellowing of the skin or eyes (jaundice)
Blood in your stool or vomit
High fever or chills
Unexplained weight loss

Remember, while this information can be helpful, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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4 mo ago

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