[43F] Experiencing abdominal pain, blurred vision, night sweats, and swollen lymph nodes
Patient Description
A 43-year-old female presents with a four-month history of dull, constant, and intense right lower quadrant pain that increases with movement but is tolerable when lying still. The patient has a history of constipation, exacerbated since a hemorrhoidectomy in 2020, with bowel movements every 4-6 days or requiring an enema. Recently, the patient has experienced blurred vision, particularly when reading or seeing up close, and night sweats despite a cool sleeping environment. Swollen lymph nodes were noted two weeks ago in the groin, underarms, and neck, with underarm nodes also being painful. The patient has a medical history of hereditary angioedema diagnosed in 2012 and psoriasis diagnosed in 2010. Current medications include Topiramate, citalopram, Berinert C1 inhibitor, and Skyrizi. No allergies to medications have been reported. No recent weight changes, menstrual cycle irregularities, unusual vaginal discharge, or signs of infection around the swollen lymph nodes have been observed. The patient also reports fatigue. A CT scan was performed with normal results, and no fever or chills have been present.
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Arora's Assessment
What might be happening
Based on the information you've provided, there are several possibilities that could be causing your symptoms:
- Appendicitis: This condition is characterized by inflammation of the appendix, which is located in the right lower quadrant of your abdomen. The pain associated with appendicitis is typically dull, constant, and can become more intense with movement. However, appendicitis usually presents acutely and your symptoms have been ongoing for several months. Also, your CT scan was normal which makes this less likely.
- Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause abdominal pain, bloating, gas, and constipation or diarrhea. Your symptoms of right lower quadrant pain and constipation could be related to IBS. However, IBS doesn't typically cause night sweats or swollen lymph nodes.
- Lymphoma: This is a type of cancer that begins in the lymphatic system. The lymphatic system is part of the body's immune system and helps fight infections and diseases. Symptoms can include swollen lymph nodes, fatigue, night sweats, and unexplained weight loss. However, it's important to note that there are many other, less serious conditions that can also cause these symptoms.
What you can do
Given the range of your symptoms and their persistence, it's important to seek medical attention. Here are some steps you can take:
- Schedule an appointment with your primary care provider as soon as possible. They can perform a physical examination and order additional tests if necessary.
- 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.
- Stay hydrated and maintain a balanced diet. This can help manage your constipation and overall health.
What you should look out for
If you experience any of the following symptoms, seek immediate medical attention:
- Severe abdominal pain
- High fever (temperature over 100.4°F)
- Bloody or black stools
- Sudden worsening of your symptoms
Please remember that while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.
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11 mo ago