[33F] Experiencing severe abdominal pain and gastrointestinal symptoms

Patient Description

A 33-year-old female is experiencing sharp, radiating abdominal pain around the belly button area, rated 8/10 in severity, which is alleviated by the use of a heating pad or after a bowel movement. The pain has been present for a couple of hours and is more frequent after eating, with increased episodes over the last two weeks. The patient has a long-term history of constipation, with bowel movements occurring approximately once a week, and describes the stool as pebble-like. Additionally, the patient reports bloating after most meals, nausea rated 5/10 with a recent episode of vomiting, and chills. The patient has a history of Erythema nodosum diagnosed at age 13 and a congenital heart murmur. She underwent a hysterectomy due to extreme pain and bleeding. The patient is currently taking Lithium, Wellbutrin, Focalin, and various supplements, with no noted side effects. She has a penicillin allergy and a family history of unspecified gastrointestinal problems. The patient also mentions joint pain and a change in bladder sensation, no longer feeling full when needing to urinate. The patient has experienced a recent weight loss of 5 pounds.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possibilities:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

  • Gastroenteritis: Also known as stomach flu, this condition causes inflammation in your stomach and intestines. This can result in severe abdominal pain, nausea, vomiting, and diarrhea.

  • Gallstones: These are hard deposits in your gallbladder, a small organ under the liver. They can cause sharp, intense pain in the upper right part of the abdomen.

  • Gastritis: This is an inflammation of the stomach lining. It can cause severe upper stomach pain, nausea, and vomiting.

  • Peptic Ulcer: An open sore in the lining of your stomach, upper small intestine or esophagus. This can cause abdominal pain, bloating, nausea, and a feeling of fullness.

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

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. In the meantime, here are some things you can do:

  1. Keep a symptom diary: Note down when your symptoms occur, what you're doing when they happen, and what foods you've eaten.

  2. Stay hydrated: Drink plenty of fluids to replace any lost through vomiting or diarrhea.

  3. Eat small, light meals: If you can eat, stick to bland foods like rice, crackers, or bananas.

  4. Rest: Your body needs energy to fight off the virus. Getting extra sleep can help.

What you should look out for

Seek immediate medical attention if you:

  • Have severe abdominal pain
  • Are unable to keep down fluids
  • Have blood in your stool or vomit
  • Have a fever over 100.4°F (38°C)
  • Have signs of dehydration, such as excessive thirst, dry mouth, deep yellow urine, little or no urine, and severe weakness, dizziness or lightheadedness

Remember, this advice is intended to be general in nature, and specific causes may need different management. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 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. Symptoms can vary in intensity and may be triggered by certain foods or stress.


How can constipation be managed effectively?

Constipation can be managed by increasing fiber intake through fruits, vegetables, and whole grains, staying hydrated, exercising regularly, and possibly using over-the-counter laxatives as recommended by a healthcare provider.


What dietary changes can help alleviate bloating and abdominal pain?

To alleviate bloating and abdominal pain, it is recommended to eat smaller, more frequent meals, avoid gas-producing foods like beans and carbonated drinks, and consider a low-FODMAP diet. Keeping a food diary can help identify specific triggers.


When should someone with abdominal pain seek immediate medical attention?

Immediate medical attention should be sought if there is severe abdominal pain, inability to keep down fluids, blood in stool or vomit, a high fever, or signs of dehydration such as excessive thirst, dry mouth, or severe weakness.


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