[35F] With lower abdominal and back pain, bloating, and history of colitis

Patient Description

A 35-year-old female has been experiencing cramping and twitching pain in her lower stomach and lower back all day, rated as a 6 out of 10 in severity. She also reports bloating above her belly button. The pain started upon waking up and has persisted throughout the day. She had a small, round bowel movement this morning. Last month, she was diagnosed with inflammation in the left side of her colon and was prescribed a 10-day course of antibiotics. Three days after completing the antibiotics, she vomited and her stomach issues recurred. She has not experienced fever, chills, blood in stool, changes in stool color, nausea, vomiting, unintentional weight loss, or mucus in stool. Her appetite has slightly decreased, possibly due to taking Wegovy for weight loss, but she has not experienced side effects from the medication. She notes possible slight constipation. Her medical history includes possible colitis, asthma, calcific tendinitis in both shoulders, arthritis in her spine, anxiety, and depression. She is allergic to contrast dye used in CT scans. Current medications include Wegovy 1mg once a week, Tylenol 500mg twice a day, muscle relaxer 5mg daily, spironolactone 50mg daily, duloxetine 30mg daily, and ondansetron 4mg as needed. She also takes a protein and fiber powder supplement. Her menstrual periods are regular, with the last one occurring in mid-August.

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS): IBS is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. The fact that your symptoms come and go and are associated with bloating and cramping could suggest IBS.

    • Treatment: Management of IBS often includes dietary changes, stress management, and sometimes medications to manage symptoms. A healthcare provider might recommend a low-FODMAP diet or other dietary adjustments.
  • Colitis: Given your recent diagnosis of inflammation in the left side of your colon, it's possible that your symptoms are related to colitis. Colitis can cause abdominal pain, cramping, and changes in bowel habits.

    • Treatment: Treatment for colitis often involves anti-inflammatory medications, antibiotics, and sometimes dietary changes. It's important to follow up with your healthcare provider to ensure proper management.
  • Side Effects of Medications: The antibiotics you took could have disrupted your gut flora, leading to gastrointestinal symptoms like cramping, bloating, and changes in bowel habits. Additionally, medications like Wegovy can sometimes cause gastrointestinal side effects.

    • Treatment: Probiotics or dietary adjustments might help restore gut balance. Discussing your symptoms with your healthcare provider is crucial to determine if any medication adjustments are needed.

What you can do

While you wait to see a healthcare provider, here are some steps you can take to help manage your symptoms:

  1. Dietary Adjustments: Try to eat small, frequent meals and avoid foods that can trigger bloating and cramping, such as high-fat foods, spicy foods, and carbonated beverages. A low-FODMAP diet might be beneficial.
  2. Stay Hydrated: Drink plenty of water to help with digestion and prevent constipation.
  3. Probiotics: Consider taking a probiotic supplement to help restore the balance of good bacteria in your gut.
  4. Over-the-Counter Remedies: Over-the-counter medications like simethicone (for bloating) or antispasmodics (for cramping) might provide some relief.
  5. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share longitudinal medical notes with your provider. This can help identify patterns and triggers.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe Abdominal Pain: If your pain becomes severe or unbearable, seek medical attention immediately.
  • Blood in Stool: If you notice any blood in your stool, contact your healthcare provider.
  • Persistent Vomiting: If you continue to experience vomiting, especially if you can't keep fluids down, seek medical care.
  • Fever or Chills: If you develop a fever (temperature over 100.4°F) or chills, it could indicate an infection or other serious condition.
  • Unintentional Weight Loss: If you notice significant weight loss without trying, consult your healthcare provider.

Remember, while these suggestions can help manage your symptoms, it's important to consult with a healthcare provider for a formal diagnosis and appropriate treatment.

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4 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, and diarrhea or constipation. Symptoms can vary in intensity and may come and go over time.


How can colitis affect bowel habits and what are its symptoms?

Colitis can cause symptoms such as abdominal pain, cramping, and changes in bowel habits, including diarrhea or constipation. It may also lead to bloating and discomfort.


Can antibiotics cause gastrointestinal issues and how can they be managed?

Yes, antibiotics can disrupt gut flora, leading to gastrointestinal issues like cramping, bloating, and changes in bowel habits. Managing these issues may involve taking probiotics to restore gut balance and discussing any necessary medication adjustments with a healthcare provider.


What dietary changes can help manage symptoms of IBS or colitis?

Dietary changes that can help manage symptoms of IBS or colitis include following a low-FODMAP diet, eating small and frequent meals, avoiding high-fat and spicy foods, and staying hydrated. These adjustments can help reduce bloating and cramping.


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