[36F] Experiencing abdominal pain, diarrhea, and unexplained weight loss

Patient Description

A 36-year-old female presents with a 5-month history of frequent diarrhea, loose bowel movements, and pain in the abdomen, back, and sides. The abdominal pain is described as a dull ache that varies in location and is most pronounced after eating, but it is somewhat alleviated by bowel movements. The patient reports stools that are thin, soft, light brown, and not compact, occurring 4-8 times per week. Additionally, the patient experiences episodes of feeling hot and sweating followed by chills and shivering. There has been a recent unexplained weight loss of 10 pounds within the last week and occasional lightheadedness. The patient also mentions fatigue and intermittent aches around the rib cage. No recent injuries, blood in stool, persistent vomiting, or fever have been reported. The patient has not taken any medications and has no known allergies or pre-existing conditions. She has a history of travel to Panama in 2022.

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS): This condition can cause symptoms like abdominal pain, bloating, and changes in bowel habits. The pain is often relieved by a bowel movement and can be triggered by eating. However, IBS doesn't typically cause weight loss.

    • Treatment for IBS often involves dietary changes, stress management, and sometimes medications to manage symptoms.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, diarrhea, and weight loss. However, these conditions often cause other symptoms like bloody stools or fever, which you haven't reported.

    • Treatment for IBD often involves medications to reduce inflammation and control symptoms.
  • Gastroenteritis: This is an inflammation of the stomach and intestines, typically resulting from a viral or bacterial infection. It can cause diarrhea, abdominal pain, and sometimes fever. However, gastroenteritis usually resolves on its own within a week or two.

    • Treatment usually involves rest, hydration, and eating a bland diet until symptoms improve.
  • Celiac Disease: This is an immune reaction to eating gluten, a protein found in wheat, barley, and rye. Symptoms can include diarrhea, abdominal pain, and unintentional weight loss. However, symptoms usually improve with a gluten-free diet.

    • Treatment involves a strict gluten-free diet for life.
  • Gallstones: These are hard deposits in the gallbladder that can cause abdominal pain, particularly after eating. However, gallstones often cause severe, sharp pain rather than a dull ache.

    • Treatment can involve medications to dissolve the stones or surgery to remove the gallbladder.

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

What you can do

Given the duration and severity of your symptoms, it's important to seek medical attention. Your healthcare provider can perform a physical examination and may order tests such as blood tests, stool tests, or imaging studies to help determine the cause of your symptoms.

In the meantime, try to maintain a balanced diet and stay hydrated. Avoid foods that seem to worsen your symptoms. Over-the-counter medications may help manage some of your symptoms, but you should check with a healthcare provider before starting any new medication.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe or worsening abdominal pain
  • Blood in your stool or dark, tarry stools
  • Persistent vomiting
  • Signs of dehydration, such as dizziness, dry mouth, or producing very little urine
  • High fever (temperature over 100.4°F)

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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1 yr 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 abdominal pain or cramping, bloating, gas, diarrhea, constipation, or alternating between the two. The pain is often relieved by a bowel movement and can be triggered by eating.


How can Inflammatory Bowel Disease (IBD) be distinguished from other gastrointestinal conditions?

IBD, which includes Crohn's disease and ulcerative colitis, can be distinguished by symptoms such as persistent diarrhea, abdominal pain, weight loss, and fatigue. Unlike IBS, IBD often causes inflammation visible on imaging or endoscopy and may include symptoms like bloody stools or fever.


What dietary changes can help manage symptoms of Celiac Disease?

For managing Celiac Disease, a strict gluten-free diet is essential. This means avoiding all foods containing wheat, barley, and rye. Many people find relief from symptoms by substituting gluten-containing foods with gluten-free alternatives like rice, corn, and quinoa.


What are the warning signs that require immediate medical attention for gastrointestinal issues?

Warning signs that require immediate medical attention include severe or worsening abdominal pain, blood in the stool or dark, tarry stools, persistent vomiting, signs of dehydration such as dizziness or dry mouth, and a high fever over 100.4°F.


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