[43F] Experiencing abdominal pain, bloating, and bowel irregularities

Patient Description

A 43-year-old female presents with a 7-month history of intermittent severe left-sided lower abdominal pain that sometimes alleviates with bowel movements or passing gas. The pain is sharp and localized, with associated lower back pain. She experiences significant bloating and a feeling of fullness, which affects her bladder and is exacerbated by certain foods. Her bowel habits fluctuate between constipation and diarrhea, with the latter being foamy and containing undigested food. Accompanying symptoms include extreme fatigue, a feeling of unwellness, occasional nausea, lightheadedness with a spinning sensation, and cognitive difficulties such as brain fog. She also reports straining to urinate. There is no history of recent travel, allergies, or medication use. She has experienced weight loss, tiredness, pale skin, and shortness of breath but no changes in menstrual cycle or vaginal discharge. No pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

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

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. Your description of alternating diarrhea and constipation, along with abdominal pain and bloating, aligns with this condition.

    • Treatment typically involves long-term management of diet, lifestyle and stress. Medications and counseling may also be part of the treatment plan.
  • Diverticulitis: This condition occurs when small, bulging pouches (diverticula) that can form in your digestive system become inflamed or infected. This can cause severe abdominal pain, fever, nausea, and a marked change in your bowel habits.

    • Mild diverticulitis can be treated with rest, changes in your diet and antibiotics. Severe or recurring diverticulitis may require more invasive treatments.
  • Ovarian Cysts: These are fluid-filled sacs or pockets in an ovary or on its surface. Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months. However, ovarian cysts — especially those that have ruptured — can cause serious symptoms.

    • Treatment can range from monitoring to surgery, depending on the type of cyst and its symptoms.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. Your extreme fatigue and cognitive difficulties (brain fog) could be indicative of this condition.

    • Treatment focuses on symptom relief.

Please note that these are potential explanations for your symptoms, but there could be other reasons for your symptoms.

What you can do

  1. Keep a symptom diary: Note down when your symptoms occur and what you're doing when they happen to help identify potential triggers.
  2. Try dietary changes: Some people find that certain foods exacerbate their symptoms. Common culprits include dairy products, gluten, and certain types of carbohydrates known as FODMAPs.
  3. Stay hydrated: This is especially important if you're experiencing diarrhea, as you can lose a lot of water and electrolytes.
  4. Rest and take care of yourself: Make sure you're getting enough sleep and managing stress as best you can.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You have persistent vomiting or diarrhea
  • You notice blood in your stool
  • You have a high fever (over 100.4°F or 38°C)
  • You experience sudden, sharp abdominal pain

Please remember that while I strive to provide accurate and helpful health information, this advice is not a substitute for professional medical advice. Always seek the advice of a qualified healthcare provider with any questions you may have regarding your medical condition.

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11 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, and changes in bowel habits such as diarrhea or constipation. Symptoms can vary in intensity and may be triggered by certain foods or stress.


How can dietary changes help manage symptoms of diverticulitis?

Dietary changes for managing diverticulitis often include a high-fiber diet to prevent future flare-ups, avoiding seeds and nuts that might irritate the digestive tract, and staying hydrated. During an acute attack, a low-fiber or liquid diet may be recommended.


What are the potential complications of untreated ovarian cysts?

Untreated ovarian cysts can lead to complications such as rupture, which can cause severe pain and internal bleeding, or ovarian torsion, where the ovary twists and cuts off its blood supply, potentially leading to tissue death.


What lifestyle changes can help manage Chronic Fatigue Syndrome (CFS)?

Lifestyle changes for managing CFS include establishing a regular sleep routine, pacing activities to avoid overexertion, managing stress through techniques like meditation or yoga, and maintaining a balanced diet to support overall health.


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