[44F] Experiencing diarrhea, rashes, and back pain

Patient Description

A 44-year-old female presents with a three-day history of diarrhea, which has become watery today, and a year-long history of rashes across her cheeks, nose, neck, chest, and arms. The rashes are characterized by intermittent redness and itching, with raised bumps on the chest and arms but not on the face. She also reports a two-week history of back pain under the ribs, which is dull and persistent, worsening to sharp bursts upon movement, particularly at night. Additionally, she has been diagnosed with Metatarsalgia, tendinitis, and plantar fasciitis, causing sharp pain in the metatarsals for the past six months. She experiences numbness in her forearms and hands during sleep, a condition that has persisted for several years. The patient has a medical history of hypothyroidism, rosacea, and Raynaud's diagnosed in 2018. She is currently taking Lexapro (10mg for 2 years), Synthroid (88mcg daily on an empty stomach), and Dupixent (300mg/2mL every two weeks), along with supplements including vegan calcium, fish oil, and vitamin E. She has no known drug allergies and does not use recreational drugs, alcohol, or tobacco products.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible unifying 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. The cause of IBS isn't well understood, but it often occurs in people who have increased sensitivity of gut nerves to normal sensations.

    • Treatment of IBS typically involves symptom management only, such as dietary changes, stress management, and sometimes medications.
  • Rosacea: This is a common skin condition that causes redness and visible blood vessels in your face. It may also produce small, red, pus-filled bumps. The signs and symptoms may flare up for weeks to months and then go away for a while.

    • Treatment for rosacea focuses on controlling signs and symptoms. Most often this requires a combination of good skin care and prescription drugs.
  • Raynaud's disease: This is a condition that causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. The smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas.

    • Treatment of Raynaud's depends on its severity and whether you have other health conditions. For most people, Raynaud's disease is more a nuisance than a disability.
  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Hypothyroidism may not cause noticeable symptoms in the early stages, but over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.

    • Treatment of hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine.
  • Metatarsalgia: This is a condition in which the ball of your foot becomes painful and inflamed. It often occurs in the metatarsal heads, or the area just before the toes. It is often due to overuse injuries or high-impact activities.

    • Treatment of metatarsalgia often involves rest, ice, and over-the-counter pain relievers.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to narrow relieve your symptoms or figure out what's going on:

  1. Keep a symptom diary: This can help you and your doctor identify patterns that might indicate what's causing your symptoms.
  2. Stay hydrated: Drink plenty of fluids to help prevent dehydration, which can worsen your symptoms.
  3. Eat a balanced diet: This can help ensure you're getting the nutrients you need, which can help your body function at its best.
  4. Get plenty of rest: This can help your body recover and can also reduce stress, which can exacerbate many of the conditions you're experiencing.
  5. Try gentle exercise: This can help improve circulation, reduce stress, and improve your overall health. However, be sure to listen to your body and avoid any activities that cause or worsen pain.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or you develop new symptoms
  • If you notice blood in your stool or vomit
  • If you develop a fever (temperature over >100.4°F) or chills
  • If you experience severe pain, especially in your chest or abdomen
  • If you have difficulty breathing or swallowing

Please note that while I strive to provide accurate and helpful health information, I am an AI and not a doctor. It's important to consult with a healthcare professional who can provide advice tailored to your individual circumstances.

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1 yr ago

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

People Also Ask


What are the common symptoms and triggers of rosacea?

Common symptoms of rosacea include facial redness, visible blood vessels, and sometimes small, red, pus-filled bumps. Triggers can include hot drinks, spicy foods, alcohol, temperature extremes, sunlight, stress, and certain cosmetics.


How can I manage the symptoms of irritable bowel syndrome (IBS) at home?

To manage IBS symptoms at home, consider dietary changes such as increasing fiber intake, avoiding trigger foods, and eating smaller, more frequent meals. Stress management techniques like yoga or meditation can also help, as well as staying hydrated and getting regular exercise.


What lifestyle changes can help alleviate symptoms of Raynaud's disease?

To alleviate symptoms of Raynaud's disease, keep your body warm, especially your hands and feet. Avoid smoking and manage stress levels. Regular exercise can improve circulation, and avoiding caffeine can help reduce symptoms.


What are some effective treatments for metatarsalgia?

Effective treatments for metatarsalgia include resting the affected foot, applying ice to reduce swelling, using over-the-counter pain relievers, and wearing supportive footwear with proper cushioning. Custom orthotics may also be recommended by a healthcare provider.


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