[41F] Experiencing gastrointestinal and systemic symptoms

Patient Description

A 41-year-old female presents with a three-month history of frequent and urgent diarrhea, occurring 1-6 times daily, accompanied by weight loss, a persistent low-grade fever, rectal pain, bloating, and crampy abdominal pain rated 6-7 out of 10, located in the middle of the lower abdomen. The patient also reports recent onset of dizziness and blurry vision. She has a history of multiple sclerosis diagnosed in 2015 and is currently managed with biannual Ocrevus infusions, the last of which was in December 2023. The patient takes a daily multivitamin and has no known drug allergies. No recent travel, substance use, or changes in diet were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Inflammatory Bowel Disease (IBD): This includes conditions like Crohn's disease and ulcerative colitis. These are chronic diseases that cause inflammation in your digestive tract and can lead to symptoms like diarrhea, abdominal pain, bloating, and rectal pain. The presence of mucus in your stool could also be a sign of IBD.

    • Treatment typically involves medications to reduce inflammation and manage symptoms. In severe cases, surgery may be needed.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea. However, IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer, unlike IBD.

    • Treatment focuses on long-term management of symptoms and may involve dietary changes, medication, and stress management.
  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria, or parasites. It can cause diarrhea, abdominal pain, and fever. However, gastroenteritis usually resolves on its own within a few days to a week, which doesn't align with your symptom duration.

    • Treatment usually involves rest, hydration, and over-the-counter remedies.
  • Side effects of Ocrevus: Ocrevus is a medication used to treat multiple sclerosis. While it's not common, it can cause side effects like fever, diarrhea, and abdominal pain in some people.

    • If this is the cause, your doctor may adjust your medication regimen.

What you can do

Given the duration and severity of your symptoms, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your healthcare provider: They can evaluate your symptoms, perform necessary tests, and provide a diagnosis and treatment plan.
  2. Keep a symptom diary: Note when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider identify patterns and make a diagnosis.
  3. Stay hydrated and maintain a balanced diet: Diarrhea can lead to dehydration and nutrient loss. Drink plenty of fluids and eat a balanced diet to help your body recover.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal or rectal pain
  • Blood in your stool
  • Persistent vomiting
  • Signs of dehydration, such as extreme thirst, dry mouth, little to no urination, severe weakness, dizziness, or lightheadedness
  • A fever over 102°F

Please remember that while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


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

Common symptoms of Inflammatory Bowel Disease (IBD) include frequent diarrhea, abdominal pain, bloating, rectal pain, weight loss, and sometimes blood or mucus in the stool. It can also cause fatigue and fever.


How can Irritable Bowel Syndrome (IBS) be managed effectively?

Irritable Bowel Syndrome (IBS) can be managed through dietary changes, such as increasing fiber intake or avoiding trigger foods, stress management techniques, regular exercise, and medications to relieve symptoms like diarrhea or constipation.


What are the potential side effects of Ocrevus infusions?

Potential side effects of Ocrevus infusions include infusion reactions, infections, and less commonly, symptoms like fever, diarrhea, and abdominal pain. It's important to discuss any side effects with your healthcare provider.


When should someone with diarrhea seek immediate medical attention?

Immediate medical attention should be sought if someone with diarrhea experiences severe abdominal or rectal pain, blood in the stool, persistent vomiting, signs of dehydration, or a fever over 102°F.


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