[50F] With abdominal pain, night sweats, and fatigue

Patient Description

A 50-year-old female presents with a long-standing history of sharp abdominal pain rated 8/10, primarily during defecation, and located in the middle of the abdomen. The patient has also been experiencing night sweats approximately 1-2 times per week, severe enough to soak through pajamas. Additionally, the patient reports fatigue and intermittent fever or chills. The patient has experienced weight loss. Past medical history includes irritable bowel syndrome diagnosed at age 23, depression at age 14, anxiety at age 35, chronic pancreatitis at age 48, and arthritis. The patient is currently on Zoloft for depression and reports no other medications.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, here are some possible conditions:

  • Irritable Bowel Syndrome (IBS): Your history of IBS could explain your abdominal pain, especially since you mentioned that the pain is relieved after bowel movements. IBS is a chronic condition that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, diarrhea or constipation.

    • Treatment for IBS often includes dietary adjustments, lifestyle changes, and managing stress.
  • Chronic Pancreatitis: This is a condition where the pancreas becomes inflamed over a long period of time, leading to permanent damage. It can cause abdominal pain, weight loss, and fatigue.

    • Treatment usually involves pain management, dietary changes, and sometimes surgery.
  • Menopause: Given your age and symptoms of night sweats, it's possible that you could be entering menopause. This is a natural biological process that marks the end of menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period.

    • Treatment often involves hormone therapy, medications to prevent or treat osteoporosis, and lifestyle changes to manage symptoms.
  • Depression and Anxiety: Both these conditions can cause physical symptoms such as fatigue, weight loss, and even abdominal pain. It's important to manage these conditions with the help of a healthcare professional.

    • Treatment usually involves a combination of medication, psychotherapy, and lifestyle changes.

What you can do

  1. Continue taking your prescribed medication. Zoloft is used to treat depression and anxiety, which could be contributing to your symptoms.
  2. Try to maintain a balanced diet and regular exercise routine. This can help manage symptoms of IBS, pancreatitis, and menopause, as well as improve your overall health.
  3. Keep a symptom diary. This can help you and your healthcare provider identify patterns and triggers for your symptoms.
  4. Practice stress management techniques. This can help manage symptoms of IBS, depression, and anxiety.

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
  • Unexplained weight loss
  • Severe or worsening fatigue

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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11 mo ago

People Also Ask


What are the common symptoms of chronic pancreatitis?

Common symptoms of chronic pancreatitis include persistent abdominal pain, weight loss, fatigue, and digestive issues such as diarrhea or oily stools. It occurs due to long-term inflammation of the pancreas, leading to permanent damage.


How can menopause cause night sweats and what are some ways to manage them?

Menopause can cause night sweats due to hormonal changes, particularly the decrease in estrogen levels. To manage night sweats, consider wearing lightweight clothing, keeping the bedroom cool, using fans, and avoiding triggers like spicy foods and caffeine.


Can depression and anxiety cause physical symptoms like abdominal pain and fatigue?

Yes, depression and anxiety can manifest as physical symptoms, including abdominal pain, fatigue, and weight changes. These conditions can affect the body's stress response, leading to various physical symptoms.


What lifestyle changes can help manage irritable bowel syndrome (IBS)?

Lifestyle changes that can help manage IBS include following a balanced diet, avoiding trigger foods, eating smaller meals, staying hydrated, exercising regularly, and practicing stress management techniques such as yoga or meditation.


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