[38F] Experiencing gastrointestinal and systemic symptoms

Patient Description

A 38-year-old female presents with four days of diarrhea, occurring approximately 20 times a day, triggered by drinking fluids. The diarrhea is described as very watery, with occasional light or dark brown color, and once appearing green. The patient reports a gradual onset of nausea, exacerbated by activity and relieved by lying down with eyes closed. Additionally, she experiences abdominal bloating and a full feeling, persisting for about a year, with abdominal pain rated as 7 out of 10. The patient also reports significant foot pain and swelling, severe enough to limit footwear to Crocs, and a history of significant weight gain over the past two years. There is a history of alternating constipation and diarrhea over the past year. She reports blurry vision and a sensation of hairs in her eyes for about two years. The patient is currently taking Suboxone, with no noted changes in symptoms since starting the medication. She has been using Pepto-Bismol and Imodium AD to manage her symptoms. There is no significant family history of gastrointestinal disorders, and she has no known allergies or other chronic illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing:

  1. Gastroenteritis or Stomach Infection: The sudden onset of diarrhea, nausea, and abdominal pain could be due to a viral or bacterial infection in your gastrointestinal tract. This is often referred to as gastroenteritis. It can cause symptoms like watery diarrhea, nausea, and abdominal cramping. Treatment typically involves staying hydrated and resting, but if symptoms persist, medical evaluation is necessary.

  2. Irritable Bowel Syndrome (IBS): The alternating pattern of constipation and diarrhea over the past year, along with bloating, could suggest IBS, a common disorder affecting the large intestine. IBS can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation. Management often includes dietary changes, stress management, and sometimes medication.

  3. Fluid Retention and Edema: The swelling in your legs and feet, along with weight gain, could be due to fluid retention, which might be related to various conditions, including heart, liver, or kidney issues. It's important to have this evaluated by a healthcare provider to determine the underlying cause.

  4. Vision Changes: Blurry vision and the sensation of something in your eyes could be related to dry eyes or other eye conditions. An eye examination by an optometrist or ophthalmologist would be beneficial to determine the cause.

What you can do

For Diarrhea and Nausea:

  • Stay hydrated by drinking clear fluids like water, broth, or an oral rehydration solution.
  • Avoid caffeine, alcohol, and dairy products, which can worsen diarrhea.
  • Eat bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet).
  • Consider using MDandMe to journal your symptoms and track any changes or patterns.

For Bloating and Abdominal Pain:

  • Try to eat smaller, more frequent meals rather than large meals.
  • Avoid foods that can increase bloating, such as beans, cabbage, and carbonated drinks.
  • Gentle exercise, like walking, can help reduce bloating.

For Leg and Foot Swelling:

  • Elevate your legs when sitting or lying down to help reduce swelling.
  • Wear compression stockings to help manage swelling.
  • Limit salt intake, as it can contribute to fluid retention.

For Vision Changes:

  • Schedule an eye exam to determine the cause of your blurry vision and eye discomfort.
  • Use artificial tears or lubricating eye drops if dry eyes are a concern.

What you should look out for

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

  • Severe or persistent abdominal pain
  • Signs of dehydration, such as dizziness, dry mouth, or decreased urination
  • Blood in your stool or black, tarry stools
  • Significant weight loss without trying
  • Worsening leg or foot swelling, or if it becomes painful or red

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

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

People Also Ask


What could be causing my sudden onset of diarrhea and nausea?

The sudden onset of diarrhea and nausea could be due to gastroenteritis, which is an infection of the gastrointestinal tract caused by viruses or bacteria. It typically involves symptoms like watery diarrhea, nausea, and abdominal cramping. Staying hydrated and resting are important, but if symptoms persist, a medical evaluation is necessary.


How can I manage the alternating constipation and diarrhea associated with IBS?

To manage IBS, which can cause alternating constipation and diarrhea, consider dietary changes such as increasing fiber intake, managing stress, and possibly using medications prescribed by a healthcare provider. Keeping a symptom journal can help identify triggers and patterns.


What might be causing the swelling in my legs and feet?

Swelling in the legs and feet, known as edema, could be due to fluid retention. This might be related to various conditions, including heart, liver, or kidney issues. It's important to have this evaluated by a healthcare provider to determine the underlying cause and appropriate treatment.


What should I do about my blurry vision and sensation of hairs in my eyes?

Blurry vision and the sensation of something in your eyes could be related to dry eyes or other eye conditions. Scheduling an eye exam with an optometrist or ophthalmologist is recommended to determine the cause. In the meantime, using artificial tears or lubricating eye drops may help alleviate discomfort.


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