[37F] With abdominal pain, bloating, and blood in stool

Patient Description

A 37-year-old female reports experiencing abdominal pain and bloating. The upper abdomen pain is described as a dull, constant ache, while the lower abdomen pain is sharp and occurs before bowel movements. She has noticed bright red blood in her stool a few times a year, with two episodes in the last week. There are no changes in stool color to black or tarry, and she is not taking NSAIDs or blood thinners. The patient is highly stressed, eating less, and experiencing increased gas and intermittent pressure. She reports daily nausea and weekly vomiting, along with dizziness and extreme fatigue. There has been a weight loss of 20 lbs over the last four months. She has experienced chills but is unsure about having a fever. There is no recent travel history. Family history includes H. pylori, though she has not been tested. She has no known allergies or chronic conditions and is not currently taking any medications, though she occasionally uses garlic, multivitamins, and iron supplements.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Gastrointestinal Bleeding: The presence of bright red blood in your stool suggests bleeding in the lower gastrointestinal tract, possibly from hemorrhoids or an anal fissure, especially if associated with sharp pain. However, given your other symptoms, further evaluation is needed.

  • Peptic Ulcer Disease or Gastritis: These conditions can cause abdominal pain, bloating, nausea, and vomiting. They may be related to H. pylori infection, which is common in your family history. Testing for H. pylori might be recommended.

  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, weight loss, fatigue, and blood in the stool. These require medical evaluation and specific treatments.

  • Irritable Bowel Syndrome (IBS): While IBS can cause abdominal pain and changes in bowel habits, it typically doesn't cause blood in the stool. Stress can exacerbate symptoms.

Typical treatments or tests might include blood tests, stool tests, endoscopy, or colonoscopy to determine the cause of your symptoms.

What you can do

  1. Consult a Doctor: It's important to see a healthcare provider for a formal diagnosis and appropriate testing.

  2. Dietary Adjustments: Keep a food diary to track what you eat and any symptoms that follow. This can help identify potential triggers.

  3. Stress Management: Consider stress-reduction techniques like meditation, yoga, or deep-breathing exercises.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Increased or severe abdominal pain
  • Persistent or worsening symptoms
  • Fever or chills
  • Significant weight loss or fatigue

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation.

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1 mo ago


People Also Ask


What could be causing the bright red blood in my stool?

Bright red blood in the stool often indicates bleeding in the lower gastrointestinal tract, which could be due to hemorrhoids or an anal fissure. However, it is important to consult a healthcare provider for a proper diagnosis, as other conditions like inflammatory bowel disease could also be a cause.


How can stress affect my gastrointestinal symptoms?

Stress can exacerbate gastrointestinal symptoms by affecting gut motility and increasing sensitivity to pain. It can also contribute to conditions like irritable bowel syndrome (IBS), which can cause abdominal pain and changes in bowel habits.


What are the potential causes of my abdominal pain and bloating?

Abdominal pain and bloating can be caused by a variety of conditions, including peptic ulcer disease, gastritis, inflammatory bowel disease, or irritable bowel syndrome. A healthcare provider can help determine the cause through appropriate tests and evaluations.


Should I be concerned about my recent weight loss and fatigue?

Unintentional weight loss and fatigue can be concerning and may indicate an underlying health issue such as inflammatory bowel disease or another gastrointestinal condition. It is important to seek medical evaluation to determine the cause and receive appropriate treatment.

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