[50F] Experiencing abdominal discomfort and changes in bowel habits

Patient Description

A 50-year-old female presents with a 2-day history of dull abdominal pain described as a 'nervous feeling' with no relief from changes in position or activity. The patient reports observing solid white dots in her stool approximately five times, alongside constipation. The patient has experienced a decrease in appetite and a 6-pound weight loss over the past 1.5 weeks, as well as increased nocturnal urination likely related to increased water intake. The patient's medical history includes high blood pressure diagnosed 15 years ago, anxiety diagnosed 20 years ago, high cholesterol now managed, tachycardia diagnosed 1.5 years ago, and recent diagnosis of pre-diabetes 3 weeks ago. The patient has a known medication allergy to Metformin. Current medications include Atenolol (10 mg once daily), Metoprolol (50 mg once daily), Lisinopril (29-12-.5 mg twice daily), Atorvastatin (40 mg every other day), and Klor-Con M20 (potassium supplement) taken twice daily. There is a family history of colon cancer and diabetes.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

    • Treatment of IBS typically involves long-term strategies to manage symptoms, including changes in diet, medication, and stress management.
  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a virus, bacteria, or parasites. Symptoms can include abdominal pain, diarrhea, and vomiting.

    • Treatment usually involves rest, hydration, and over-the-counter remedies. It's important to replace fluids lost through diarrhea or vomiting.
  • Gallstones: These are hard deposits in the gallbladder that can cause abdominal pain. If a gallstone blocks your bile ducts, pressure increases in the gallbladder, causing a gallbladder attack.

    • Treatment may involve medication to dissolve the gallstones or surgery to remove the gallbladder.
  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system — your kidneys, bladder, ureters, and urethra. Most UTIs are caused by bacteria, but some are caused by viruses and fungi. UTIs are among the most common infections in humans.

    • Treatment usually involves antibiotics to kill the bacteria causing the infection.
  • Anxiety Disorder: Given your history of anxiety and the description of your abdominal pain as a "nervous feeling", it's possible that your symptoms are related to anxiety. Anxiety can cause a wide range of physical symptoms, including stomach discomfort, palpitations, and changes in appetite.

    • Treatment for anxiety disorders can include therapy, medication, or a combination of both.

Please note that this is not an exhaustive list of all possible conditions, these are just the most common ones.

What you can do

  1. Keep a symptom diary: Note down when your symptoms occur, what you're doing at the time, and what food and drink you've consumed.
  2. Stay hydrated: Especially if you're experiencing diarrhea, make sure you're drinking enough fluids to replace what you've lost.
  3. Try to eat small, light meals: If you're finding it hard to eat, try having small, light meals throughout the day rather than three large meals.
  4. Rest: Make sure you're getting enough rest. Your body needs energy to fight off infections and to recover from bouts of diarrhea.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Blood in your stool
  • High fever (temperature over 100.4°F)
  • Persistent vomiting
  • Signs of dehydration, such as dry mouth, extreme thirst, little to no urination, and severe weakness

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

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. It is a chronic condition that requires long-term management.


How can anxiety affect physical health, particularly the digestive system?

Anxiety can manifest physically in various ways, including stomach discomfort, changes in appetite, palpitations, and increased urination. Stress and anxiety can exacerbate digestive issues, leading to symptoms like abdominal pain and changes in bowel habits.


What are the potential causes of solid white dots in stool?

Solid white dots in stool can be caused by undigested food, medications, or supplements. In some cases, they may indicate the presence of parasites or other digestive issues. It's important to consult a healthcare provider for an accurate diagnosis.


What lifestyle changes can help manage pre-diabetes?

Managing pre-diabetes involves lifestyle changes such as maintaining a healthy diet, engaging in regular physical activity, losing excess weight, and monitoring blood sugar levels. These changes can help prevent the progression to type 2 diabetes.


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