[41F] Experiencing persistent bloating, excessive gas, and liver lesions

Patient Description

A 41-year-old female presents with persistent upper abdominal bloating, feeling full of air, and constant excessive gas, passing approximately once every 3-5 minutes. These symptoms have been present for 6-7 months and have significantly worsened in recent weeks. The patient has also been informed of numerous large liver lesions and an enlarged liver, discovered last week through imaging studies. Additionally, the patient reports a low-grade fever persisting for months, periodic sharp aching joint pain rated 5-7 out of 10, and severe body itching without rash lasting days to weeks. The patient has a history of conflicting diagnoses regarding Systemic Lupus Erythematosus (SLE) approximately 10 years ago. Current medications include 300mg Bupropion and 10mg Lexapro for depression and anxiety, with no known drug allergies except for Penicillin. No recent changes in bowel habits or stool color were reported, and there is no indication of jaundice. The patient denies any significant weight loss, abdominal injuries, or procedures.

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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:

  • Liver disease: Your symptoms of liver lesions, an enlarged liver, and yellow stools could be indicative of liver disease. Liver disease can cause a variety of symptoms, including bloating, gas, and changes in stool color. The itching you're experiencing could also be related, as liver disease can cause bile to build up in the skin, leading to itching.

    • Treatment for liver disease depends on the underlying cause and may include lifestyle changes, medication, or in severe cases, a liver transplant.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause symptoms such as bloating, gas, and abdominal pain. However, IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.

    • Treatment of IBS typically involves long-term management of diet, lifestyle and stress. Medications and counseling could also be beneficial.
  • Depression and Anxiety: These conditions can cause a variety of physical symptoms, including digestive problems like bloating and gas. The exhaustion and difficulty staying awake you're experiencing could also be related to these conditions.

    • Treatment typically involves a combination of medication and psychotherapy.
  • Systemic Lupus Erythematosus (SLE): This is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue. It can cause a wide range of symptoms, including joint pain, fatigue, and skin rashes. The confusion and difficulty staying awake you're experiencing could be related to lupus, as it can affect the nervous system.

    • Treatment typically involves medication to suppress the immune system and manage symptoms.

What you can do

  1. Consult your doctor: Given the complexity and severity of your symptoms, it's important to seek medical attention as soon as possible. Your doctor can order further tests to confirm a diagnosis and start you on appropriate treatment.

  2. Monitor your symptoms: Keep track of your symptoms and note any changes or patterns. This information can be helpful for your doctor in diagnosing and treating your condition.

  3. Maintain a healthy lifestyle: Eating a balanced diet, getting regular exercise, and getting plenty of sleep can help manage your symptoms and improve your overall health.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool
  • Jaundice (yellowing of the skin or eyes)
  • Sudden weight loss
  • Severe itching

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

People Also Ask


What could be causing persistent upper abdominal bloating and excessive gas?

Persistent upper abdominal bloating and excessive gas can be caused by several conditions, including liver disease, irritable bowel syndrome (IBS), and even stress or anxiety. It's important to consult a healthcare provider for a proper diagnosis.


How are liver lesions and an enlarged liver related to my symptoms?

Liver lesions and an enlarged liver can be indicative of liver disease, which can cause symptoms like bloating, gas, and itching. The liver's inability to process bile properly can lead to these symptoms.


Can Systemic Lupus Erythematosus (SLE) cause joint pain and itching without a rash?

Yes, Systemic Lupus Erythematosus (SLE) can cause joint pain and itching without a rash. SLE is an autoimmune disease that can affect various parts of the body, including the skin and joints, leading to these symptoms.


What are the potential treatments for liver disease?

Treatment for liver disease depends on the underlying cause. It may include lifestyle changes, medications to manage symptoms or slow disease progression, and in severe cases, a liver transplant. It's crucial to work with a healthcare provider to determine the best treatment plan.


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