[39M] Experiencing abdominal cramping, diarrhea, and hot flashes

Patient Description

A 39-year-old male presents with a 2-day history of generalized abdominal cramping rated 3/10 in severity, accompanied by nausea, diarrhea, lightheadedness, and gradual, persistent hot flashes. The patient has a medical history of idiopathic peripheral neuropathy diagnosed in 2019, anxiety, depression, PTSD since age 18, hypercholesteremia diagnosed in 2024, ADHD diagnosed at age 38, and has undergone a tonsillectomy and cholecystectomy. Current medications include Paroxetine 20 mg daily for 2 years, Vyvanse 30 mg daily for 1 year, and Pepcid Complete 10-40 mg daily for 2 years, with no reported side effects. The patient also takes a daily multivitamin gummy and has no known drug allergies but has experienced adverse reactions to Toradol, Effexor, Wellbutrin, Seroquel, and Flexeril.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a virus, bacteria, or parasites. Symptoms can include diarrhea, abdominal pain, nausea, and sometimes fever.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics may be prescribed if a bacterial cause is identified.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, diarrhea or constipation, or both.

    • Treatment typically involves long-term management of diet, lifestyle changes, and stress. Medications and counseling might be part of the treatment plan.
  • Anxiety or stress: Physical symptoms such as those you're experiencing can sometimes be related to mental health conditions like anxiety or stress. Given your history of anxiety, PTSD, and depression, this could be a contributing factor.

    • Treatment typically involves psychological therapy, medication, and lifestyle changes.

What you can do

  1. Stay hydrated: Diarrhea can cause dehydration, so it's important to drink plenty of fluids. Water is best, but you can also sip on clear broths or non-caffeinated sports drinks to help replace lost electrolytes.

  2. Rest: Your body needs energy to fight off the virus. Getting extra sleep can help.

  3. Eat light: If you can eat without vomiting, eat small amounts of bland foods like rice, applesauce, or crackers.

  4. Over-the-counter medication: Over-the-counter medication like Imodium can help with diarrhea. However, these should not be used if you have a fever or bloody stools.

  5. Seek medical attention: If your symptoms persist for more than a few days, or if they worsen, you should seek medical attention.

What you should look out for

  • Blood in your stool
  • Persistent vomiting
  • A fever over 102°F (39°C)
  • Signs of dehydration, such as dark urine, dry skin, or feeling lightheaded when standing up

Please remember that while I strive to provide accurate and helpful information, I'm not a doctor. You should seek care from a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common causes of abdominal cramping and diarrhea?

Common causes of abdominal cramping and diarrhea include infections like gastroenteritis, food intolerances, irritable bowel syndrome (IBS), and stress or anxiety. It's important to consider recent dietary changes, travel history, and stress levels when identifying the cause.


How can anxiety and stress contribute to physical symptoms like nausea and lightheadedness?

Anxiety and stress can lead to physical symptoms due to the body's 'fight or flight' response, which can affect the digestive system and cause symptoms like nausea, diarrhea, and lightheadedness. Chronic stress can exacerbate these symptoms over time.


What are the potential side effects of Paroxetine and Vyvanse that could relate to these symptoms?

Paroxetine can cause side effects such as nausea, dizziness, and gastrointestinal issues, while Vyvanse may lead to decreased appetite, nausea, and anxiety. These side effects could potentially contribute to the symptoms experienced.


When should someone with these symptoms seek medical attention?

Medical attention should be sought if symptoms persist for more than a few days, worsen, or if there are signs of severe dehydration, blood in the stool, persistent vomiting, or a high fever over 102°F (39°C).


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