[40F] Experiencing severe abdominal pain, vomiting, and dark urine

Patient Description

A 40-year-old female presents with a 3-day history of severe, sharp, shooting abdominal pain localized centrally and to the left, which is constant and exacerbated by movement. The pain is rated 8/10 in severity and radiates up the left side. Accompanying symptoms include vomiting when attempting to eat or drink, dark yellow and thick urine, and the presence of deep red blood in the stool. The patient also reports dizziness but no shortness of breath or chest pain. The patient has a medical history of Crohn's disease and endometriosis, diagnosed at age 17, and is currently taking Gabapentin (800mg three times daily) and Clonidine (0.2mg twice daily). The patient has allergies to NSAIDs, Levaquin, Tramadol, and Toradol. No recent use of NSAIDs or blood thinners was reported. The patient has a family history of Crohn's disease.

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Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

  • Gastroenteritis: This is an inflammation of the digestive tract, typically caused by a virus, bacteria, or parasites. Symptoms can include abdominal pain, vomiting, and diarrhea. The presence of blood in your stool could suggest a more severe form of gastroenteritis.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics or antiparasitics may be needed if a specific organism is identified.

  • Crohn's Disease Flare: Given your history of Crohn's disease, your symptoms could be due to a flare of this condition. Crohn's disease is a type of inflammatory bowel disease that can cause abdominal pain, diarrhea, weight loss, anemia, and fatigue.

    • Treatment typically involves medications to reduce inflammation and manage symptoms. In severe cases, surgery may be needed.

  • Diverticulitis: This is an inflammation or infection of small pouches that can form in your digestive system, particularly in the lower part of your colon. Symptoms can include abdominal pain (usually on the left side), fever, and changes in bowel habits.

    • Treatment typically involves antibiotics, pain relievers, and a temporary change to a liquid diet. More serious cases may require hospitalization or surgery.

  • Urinary Tract Infection (UTI): Your dark urine and decreased frequency of urination could be signs of a UTI. UTIs can cause abdominal discomfort, changes in urination, and fever.

    • Treatment typically involves antibiotics to clear the infection.

What you can do

  1. Seek immediate medical attention. Your symptoms, especially the severe abdominal pain and blood in your stool, are concerning and warrant urgent evaluation by a healthcare professional.
  2. Stay hydrated. With frequent vomiting and decreased urination, there's a risk of dehydration. Try to sip small amounts of water or suck on ice chips.
  3. Avoid eating solid food until vomiting stops. Then try small amounts of mild foods such as rice, applesauce, or crackers.

What you should look out for

Seek immediate medical attention if you experience:

  • Increased intensity of abdominal pain
  • Persistent vomiting or inability to keep liquids down
  • Blood in your vomit
  • High fever (temperature over 100.4°F)
  • Signs of dehydration, such as extreme thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness

Please note that while I strive to provide accurate information, I am an AI and this advice should not replace a consultation with a healthcare professional.

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9 mo ago

People Also Ask

What are the common symptoms of a Crohn's disease flare-up?

Common symptoms of a Crohn's disease flare-up include abdominal pain, diarrhea, weight loss, fatigue, and sometimes blood in the stool. Patients may also experience fever and a feeling of fullness or bloating.

How can I differentiate between a Crohn's disease flare and diverticulitis?

While both conditions can cause abdominal pain, Crohn's disease flares often come with diarrhea and systemic symptoms like weight loss and fatigue. Diverticulitis typically causes localized pain, often on the left side, and may be accompanied by fever and changes in bowel habits. A healthcare provider can perform tests to differentiate between the two.

What are the potential causes of blood in the stool?

Blood in the stool can be caused by several conditions, including hemorrhoids, anal fissures, diverticulitis, inflammatory bowel diseases like Crohn's disease, infections, or more serious conditions like colorectal cancer. It's important to consult a healthcare provider for an accurate diagnosis.

How can I manage severe abdominal pain at home before seeing a doctor?

To manage severe abdominal pain at home, try resting and avoiding solid foods until vomiting subsides. Stay hydrated by sipping water or sucking on ice chips. Over-the-counter pain relievers may help, but avoid NSAIDs if you have allergies. Seek medical attention if the pain worsens or is accompanied by other severe symptoms.

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