[39F] With diarrhea, blood in stool, and night sweats

Patient Description

A 39-year-old female presents with diarrhea accompanied by blood in the stool for the past two weeks. The symptoms began suddenly and occur several times a day, often immediately after eating. The patient also reports experiencing night sweats and fatigue. She has a history of anemia and gastritis, diagnosed in 2014. She experiences cramping pain in the lower abdomen but denies any recent changes in weight or appetite. There is no recent travel history, and she does not consume alcohol or use tobacco products. The patient is currently taking Celexa (40 mg daily) and tirzepatide (5 mg weekly) and has no known family history of inflammatory bowel disease. She is allergic to erythromycin and has not started any new medications or supplements recently.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis, which can cause diarrhea with blood, abdominal cramping, and fatigue. Night sweats and anemia can also be associated with these conditions due to chronic inflammation and blood loss.

    • Typical Testing and Treatment: Diagnosis often involves a combination of blood tests, stool tests, colonoscopy, and imaging studies. Treatment may include medications to reduce inflammation, immune system suppressors, and dietary changes.
  2. Gastrointestinal Infection: Although you haven't traveled recently, certain infections can cause sudden onset of bloody diarrhea and cramping. These can sometimes lead to dehydration and anemia.

    • Typical Testing and Treatment: Stool tests can identify infections. Treatment may involve antibiotics or antiparasitic medications, depending on the cause.
  3. Diverticulitis: This condition involves inflammation or infection of small pouches in the digestive tract, which can cause abdominal pain, changes in bowel habits, and sometimes blood in the stool.

    • Typical Testing and Treatment: Diagnosis is often confirmed with a CT scan. Treatment usually involves antibiotics and dietary modifications.
  4. Colorectal Issues: Conditions such as hemorrhoids or anal fissures can cause blood in the stool, though they are less likely to cause night sweats or anemia.

    • Typical Testing and Treatment: A physical examination and possibly a colonoscopy can help diagnose these issues. Treatment may include topical treatments or dietary changes.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

  1. Stay Hydrated: Ensure you drink plenty of fluids to prevent dehydration, especially with frequent diarrhea.
  2. Monitor Your Diet: Keep a food diary to track what you eat and any symptoms that follow. This can help identify potential triggers.
  3. Rest and Manage Stress: Ensure you get adequate rest and try stress-reducing activities, as stress can exacerbate gastrointestinal symptoms.
  4. Use MDandMe: Consider using the MDandMe app to journal your symptoms, track your progress, and share detailed notes with your healthcare provider.

What you should look out for

Seek medical attention promptly if you experience any of the following:

  • Increased frequency or severity of symptoms
  • High fever or chills
  • Severe abdominal pain
  • Significant weight loss
  • Persistent or worsening anemia

Remember, while this information can help guide you, it's crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

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People Also Ask


What are the common symptoms of Inflammatory Bowel Disease (IBD)?

Common symptoms of Inflammatory Bowel Disease (IBD) include diarrhea, often with blood, abdominal pain and cramping, fatigue, weight loss, and sometimes fever. Night sweats and anemia can also occur due to chronic inflammation and blood loss.


How can gastrointestinal infections be diagnosed and treated?

Gastrointestinal infections can be diagnosed through stool tests that identify bacteria, viruses, or parasites. Treatment depends on the cause and may involve antibiotics for bacterial infections or antiparasitic medications for parasitic infections.


What is diverticulitis and how is it typically managed?

Diverticulitis is the inflammation or infection of small pouches in the digestive tract. It is typically managed with antibiotics, dietary modifications, and sometimes pain relief medications. In severe cases, hospitalization or surgery may be required.


What are some potential causes of blood in the stool?

Blood in the stool can be caused by several conditions, including hemorrhoids, anal fissures, diverticulitis, inflammatory bowel disease, and gastrointestinal infections. It is important to consult a healthcare provider for an accurate diagnosis.


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