[52M] Experiencing severe abdominal bloating and lethargy

Patient Description

A 52-year-old male reports severe, painful bloating that has been persistent for a couple of days and has become acutely severe in the last few hours. The patient describes the bloating as all-encompassing with a distended and hard stomach, accompanied by painful cramps, gas, and chills. The bloating is constant and does not improve with bowel movements or passing gas. The patient also experiences lethargy, described as moderately severe, which has been impacting daily activities for a couple of days. There is no relief from the bloating regardless of food intake, and the patient reports vomiting and an inability to pass gas. The patient has a history of high blood pressure diagnosed 4-5 years ago but is not currently on any medication. There is no known family history of gastrointestinal diseases, no recent injuries, and no substance use. The patient does not have any allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible diagnoses include:

  • Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can cause symptoms such as bloating, vomiting, and abdominal pain.

    • Treatment usually involves rest, hydration, and over-the-counter remedies to manage symptoms. Antibiotics may be prescribed if a bacterial infection is suspected.
  • Gastric Outlet Obstruction: This is a blockage that prevents stomach contents from entering the small intestine. This can be caused by various conditions such as peptic ulcers, stomach cancer, or certain types of surgery.

    • Treatment typically involves addressing the underlying cause of the obstruction. This may involve medication, endoscopic therapy, or surgery.
  • Gallstones: These are hard deposits in the gallbladder that can cause severe abdominal pain, particularly after meals.

    • Treatment may involve medication to dissolve the gallstones, or surgery to remove the gallbladder.
  • Pancreatitis: This is inflammation of the pancreas, which can cause severe abdominal pain, vomiting, and lethargy.

    • Treatment usually involves hospitalization for pain management and hydration. In some cases, surgery may be needed.

Please note that these are possible diagnoses and you should seek immediate medical attention for a formal diagnosis and treatment.

What you can do

  1. Seek immediate medical attention: Given the severity of your symptoms, it's important to get evaluated by a healthcare professional as soon as possible. They can provide a formal diagnosis and appropriate treatment.

  2. Stay hydrated: Drink plenty of fluids to prevent dehydration, especially if you're vomiting.

  3. Rest: Try to get as much rest as possible to help your body recover.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, seek immediate medical attention.
  • If you notice blood in your vomit or stool, seek immediate medical attention.
  • If you experience severe abdominal pain that does not improve, seek immediate medical attention.

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9 mo ago


People Also Ask


What are the common causes of severe bloating and abdominal pain?

Common causes of severe bloating and abdominal pain include gastroenteritis, gastric outlet obstruction, gallstones, and pancreatitis. Each condition has specific symptoms and requires different treatments, so it's important to consult a healthcare professional for an accurate diagnosis.


How can I differentiate between gastroenteritis and more serious conditions like gastric outlet obstruction?

Gastroenteritis often presents with symptoms like diarrhea, vomiting, and abdominal cramps, and is usually self-limiting. In contrast, gastric outlet obstruction may cause persistent vomiting, inability to pass gas, and severe bloating. If symptoms are severe or persistent, medical evaluation is necessary to rule out serious conditions.


What are the potential complications of untreated gallstones?

Untreated gallstones can lead to complications such as cholecystitis (inflammation of the gallbladder), pancreatitis, or bile duct obstruction. These conditions can cause severe pain and may require surgical intervention.


When should I seek immediate medical attention for abdominal symptoms?

You should seek immediate medical attention if you experience severe abdominal pain that does not improve, vomiting blood, blood in your stool, or if your symptoms worsen or new symptoms develop. These could be signs of a serious condition that requires prompt treatment.

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