[49F] With severe abdominal pain and distension

Patient Description

A 49-year-old female presents with severe abdominal pain and distension for the past two days. The pain began suddenly with sharp pain at the top of the stomach, followed by severe cramping. The abdomen is hard and distended, causing discomfort while walking. Bowel movements are normal with intermittent diarrhea, but no changes in stool color or consistency. There is no nausea, fever, vomiting, or blood in the stool. The patient reports reduced appetite but continues to eat. There is no unintentional weight loss or changes in urination, though it hurts when trying to push out urine. The patient has not had any abdominal surgeries and is currently traveling, with symptoms starting upon boarding a plane. No unusual foods have been consumed recently. Menstrual history is normal. The patient has a history of IBS, diagnosed approximately seven years ago, and is allergic to garlic, though no exposure is suspected. Current medication includes levothyroxine. Recently started supplements include Berberine, pro-resolving mediators, Alpha Lipoic Acid, and Quercetin.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Irritable Bowel Syndrome (IBS) Flare-Up: Given your history of IBS, it's possible that your symptoms are related to a flare-up. IBS can cause abdominal pain, cramping, and changes in bowel habits, including diarrhea. Stress, dietary changes, or new supplements could potentially trigger a flare-up.

    • Treatment typically involves dietary modifications, stress management, and sometimes medications to manage symptoms.
  • Gastrointestinal Distress from Supplements: The new supplements you started taking could be contributing to your symptoms. Some supplements can cause gastrointestinal side effects, including abdominal pain and cramping.

    • Consider stopping the supplements temporarily to see if your symptoms improve, but consult with a healthcare provider before making any changes.
  • Gastroenteritis or Foodborne Illness: Although you haven't reported nausea or vomiting, a mild form of gastroenteritis or a foodborne illness could cause abdominal pain and diarrhea.

    • These conditions often resolve on their own, but staying hydrated and resting is important.

What you can do

  1. Consult a Healthcare Provider: It's important to discuss your symptoms with a healthcare provider to get a formal diagnosis and appropriate treatment.
  2. Monitor Your Symptoms: Keep track of your symptoms, including any changes in pain, bowel movements, or new symptoms. You can use MDandMe to journal your symptoms, track progress, and share insights with your provider.
  3. Dietary Adjustments: Consider following a low-FODMAP diet, which is often recommended for managing IBS symptoms. Avoid foods that you know trigger your symptoms.
  4. Stay Hydrated: Ensure you are drinking plenty of fluids, especially if you are experiencing diarrhea.
  5. Rest and Relaxation: Stress can exacerbate IBS symptoms, so try to find ways to relax and manage stress.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Blood in your stool or black, tarry stools
  • Persistent vomiting or inability to keep fluids down
  • High fever or chills
  • Signs of dehydration, such as dizziness, dry mouth, or decreased urination

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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28 d ago

People Also Ask


Can IBS cause severe abdominal pain and distension?

Yes, IBS can cause severe abdominal pain and distension, especially during a flare-up. Symptoms can include cramping, changes in bowel habits, and discomfort.


Could new supplements be causing my gastrointestinal symptoms?

Yes, new supplements can cause gastrointestinal symptoms such as abdominal pain and cramping. It's advisable to consult with a healthcare provider before stopping any supplements.


What are the signs that I should seek immediate medical attention for abdominal pain?

You should seek immediate medical attention if you experience severe or worsening abdominal pain, blood in your stool, persistent vomiting, high fever, or signs of dehydration.


How can I manage an IBS flare-up while traveling?

To manage an IBS flare-up while traveling, consider following a low-FODMAP diet, stay hydrated, manage stress, and avoid known dietary triggers. It's also helpful to keep a symptom journal to track any changes.


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