[35F] Experiencing acute abdominal swelling and sharp back pain with diarrhea

Patient Description

A 35-year-old female presented with a sudden onset of swelling under the left breast on the stomach, described as tight and painful, persisting for approximately 4 hours. The patient also reports sharp back pain behind the swelling, which is exacerbated by sitting and somewhat alleviated by heat. The pain is severe enough to cause discomfort when taking deep breaths. Additionally, the patient has been experiencing watery diarrhea more than 10 times per day for a few days. The patient has a medical history of diabetes diagnosed 2 years ago and is currently on a regimen of Monjaro once a week, Singulair, birth control, and Allegra, all taken once daily. There is no recent travel history, no known allergies or adverse reactions to medications, and no family history of abdominal or gastrointestinal diseases. The patient denies any recent alcohol consumption, fever, chills, chest pain, or shortness of breath but does feel somewhat dizzy or lightheaded.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Symptoms include diarrhea, abdominal pain, and sometimes nausea and vomiting.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be needed if the cause is bacterial.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.

    • Treatment often includes diet changes, medication, and stress management.
  • Pancreatitis: This is inflammation of the pancreas. It can cause severe abdominal pain and diarrhea.

    • Treatment usually involves hospitalization, pain management, IV fluids, and sometimes surgery.
  • Gallstones: Although you've mentioned that you don't have a gallbladder, it's possible to have a stone in the bile ducts that was left behind after gallbladder surgery. This can cause abdominal pain and swelling.

    • Treatment usually involves surgery to remove the stone.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. Stay hydrated: Diarrhea can cause dehydration, so it's important to drink plenty of fluids. Try to drink water, broth or rehydration drinks.

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

  3. Over-the-counter medication: Over-the-counter anti-diarrheal medication might help reduce the frequency of your stools.

  4. Diet: Try to eat when you feel up to it, but stick to light, low-fat foods such as rice, crackers and bananas.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe pain in your abdomen or rectum
  • Bloody or black stools
  • High fever (above 101.3°F)
  • Signs of dehydration, such as excessive thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness
  • Persistent vomiting
  • Diarrhea that lasts more than three days

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional who can evaluate your symptoms in person.

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10 mo ago

People Also Ask


What are the common causes of sudden abdominal swelling and pain?

Common causes of sudden abdominal swelling and pain include gastrointestinal infections, pancreatitis, gallstones, and sometimes conditions like irritable bowel syndrome. It's important to consult a healthcare provider for an accurate diagnosis.


How can diabetes affect gastrointestinal symptoms like diarrhea?

Diabetes can affect gastrointestinal symptoms by causing nerve damage that affects the digestive tract, leading to conditions like gastroparesis or diabetic diarrhea. It's important for diabetic patients to monitor their symptoms closely and consult with their healthcare provider.


What are the signs that diarrhea might be caused by a more serious condition?

Signs that diarrhea might be caused by a more serious condition include severe abdominal pain, bloody or black stools, high fever, signs of dehydration, persistent vomiting, and diarrhea lasting more than three days. These symptoms warrant immediate medical attention.


How can one differentiate between gastroenteritis and irritable bowel syndrome (IBS)?

Gastroenteritis is typically caused by an infection and presents with symptoms like diarrhea, abdominal pain, nausea, and vomiting. IBS is a chronic condition characterized by abdominal pain, bloating, and changes in bowel habits without an underlying infection. A healthcare provider can help differentiate between the two based on symptoms and medical history.


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