[36M] Experiencing intermittent abdominal pain and gastrointestinal symptoms

Patient Description

A 36-year-old male presents with intermittent sharp pain under the bottom left ribs, front and back, and near the appendix, with symptoms persisting for about one week. The pain varies in intensity from mild to severe and is not triggered by any specific activity. The patient also experiences nausea, particularly at night, and reports strong gut movements that worsen when lying down, which are temporarily alleviated by eating. Bowel movements are described as solid, dark brown with mucus, but without blood. The patient has a history of IBS diagnosed 20 years ago and Long Covid diagnosed 4 years ago. Current medication includes a GLP-1 agonist, and the patient has allergies to penicillin, sulfa, cephalosporins, and levofloxacin. No recent weight loss, fever, chills, persistent vomiting, or sudden worsening of pain has been reported.

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS) Flare-up: Given your history of IBS, your symptoms might be a flare-up of this condition. IBS can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. Some people with IBS notice that their symptoms worsen when they eat certain foods, are stressed, or don't get enough sleep.

    • Treatment of IBS typically involves managing the symptoms. This can include changes to your diet, lifestyle adjustments, and medication.
  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis, including the type commonly referred to as stomach flu, is a common cause of severe diarrhea. Symptoms can include nausea, vomiting, and a low-grade fever.

    • Treatment of gastroenteritis usually involves rest, hydration, and over-the-counter remedies. Antibiotics may be necessary if the cause is bacterial.
  • Gastritis: This is an inflammation of the stomach lining. The symptoms you've described, such as pain in the upper left part of your abdomen and nausea, are common symptoms of gastritis.

    • Treatment of gastritis usually involves taking antacids and other drugs to reduce stomach acid, avoiding hot and spicy foods, and abstaining from alcohol and tobacco.
  • Peptic Ulcer Disease: These are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They're usually caused by inflammation caused by H. pylori bacteria. In addition, long-term use of anti-inflammatory drugs can increase the risk of ulcers.

    • Treatment of peptic ulcers depends on the cause, but may include medications to decrease stomach acid, antibiotics to kill H. pylori bacteria, and lifestyle modifications.

What you can do

While you should definitely seek care from a healthcare professional to receive a formal diagnosis and treatment, here are some things you can do in the meantime:

  1. Monitor your symptoms: Keep track of 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 avoid dehydration, especially if you've been having diarrhea.

  3. Eat a bland diet: Try to eat bland, easy to digest foods like rice, bananas, and toast. Avoid spicy, fatty, or acidic foods.

  4. Over-the-counter remedies: Over-the-counter antacids or acid reducers can sometimes help with stomach pain and nausea.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool or black, tarry stools
  • High fever (over 101°F)
  • Persistent vomiting or inability to keep fluids down
  • Signs of dehydration, such as excessive thirst, dry mouth, little to no urine, severe weakness, dizziness, or lightheadedness

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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11 mo ago

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People Also Ask


What are the common symptoms of an IBS flare-up?

Common symptoms of an IBS flare-up include cramping, abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea or constipation. Symptoms can be triggered by certain foods, stress, or lack of sleep.


How can gastritis be managed at home?

Gastritis can be managed at home by taking antacids or acid reducers, avoiding hot and spicy foods, and abstaining from alcohol and tobacco. Eating smaller, more frequent meals and avoiding lying down immediately after eating can also help.


What dietary changes can help alleviate symptoms of peptic ulcer disease?

Dietary changes for peptic ulcer disease include eating smaller, more frequent meals, avoiding spicy and acidic foods, reducing caffeine and alcohol intake, and avoiding smoking. Foods that are less likely to irritate the stomach include lean meats, non-citrus fruits, and whole grains.


When should someone with abdominal pain seek immediate medical attention?

Immediate medical attention should be sought if someone experiences severe abdominal pain, blood in stool or black, tarry stools, a high fever over 101°F, persistent vomiting, or signs of dehydration such as excessive thirst, dry mouth, little to no urine, severe weakness, dizziness, or lightheadedness.


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