[37F] Experiencing right-side pain, excessive sweating, and fatigue

Patient Description

A 37-year-old female presents with a 2-week history of sudden onset pain in the lower right side of the abdomen, described as both achy and sharp, with a severity of 6/10 that worsens with movement. Concurrently, she experiences excessive sweating, significant enough to saturate clothing, which began alongside the pain. This sweating occurs day and night, with temporary relief upon cooling down. She also reports extreme fatigue. The patient has a low-grade fever and intermittent diarrhea since the onset of pain. Urine is clear with unchanged frequency, and there is no blood in stool or urine. Past medical history includes endometriosis, leading to a total hysterectomy 5 years ago, and she is on Zoloft for depression/anxiety diagnosed at age 11. The patient has allergies to codeine and Vicodin and is currently taking a D-Manna supplement for frequent kidney infections. She recently stopped taking birth control for hormone replacement post-hysterectomy.

Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

Gallstones or Gallbladder Disease: The gallbladder is located on the right side of the abdomen and can cause pain in the area you described. The pain can be sharp and may worsen with movement. Gallstones can also cause fever and changes in bowel movements.
- Treatment often involves dietary changes, medications to dissolve gallstones, or in some cases, surgery to remove the gallbladder.
Kidney Stones or Kidney Infection: Given your history of frequent kidney infections, these conditions could cause pain in the side and back, changes in urine, and fever. However, you mentioned your urine is clear, which is not typical in these conditions.
- Treatment for kidney stones involves pain management and drinking lots of fluids to help pass the stone. Kidney infections typically require antibiotics.
Liver Disease: The liver is also located on the right side of the body and could cause pain in this area. However, liver disease often causes other symptoms like yellowing of the skin and eyes (jaundice), which you did not mention.
- Treatment depends on the specific type of liver disease and its severity.
Menopause Symptoms: You mentioned you are in surgical menopause and have recently stopped hormone therapy. Some of your symptoms, such as the excessive sweating and fatigue, could be related to menopause.
- Treatment often involves hormone replacement therapy or other medications to manage symptoms.

What you can do

Given the severity and duration of your symptoms, it's important to see a healthcare provider for a proper evaluation. They may order tests such as blood tests, ultrasound, or CT scan to help determine the cause of your symptoms. In the meantime, try to rest and stay hydrated. Over-the-counter pain relievers may help with the pain, but avoid taking them in excess as they can cause other health issues.