[52M] Experiencing sharp lower abdominal pain with nausea and fatigue

Patient Description

A 52-year-old male reports a sharp pain in the lower abdomen that has been present for 2 days. The pain, rated 7/10 in severity, lessens when sitting but worsens when standing or lying down. Accompanying symptoms include nausea that sets in some time after eating, fatigue, cramping post-meals, and loud stomach growling noises. The patient's last bowel movement was described as tan and solid. There is no fever, chills, blood in the stool, inability to pass gas, vomiting, diarrhea, or sudden weight loss. The patient has a medical history of ischemic colitis (diagnosed in 2018), Ehlers-Danlos syndrome (2021), asthma (2005), nerve damage, rheumatoid arthritis, and high cholesterol. Current medications include Belbucca, hydrocortisone, hydrocodone, ipratropium bromide and albuterol sulfate, Advair, rosuvastatin, gabapentin, lidocaine, and hydroxychloroquine. No new medications have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Viral gastroenteritis is particularly common and is often referred to as a stomach or intestinal flu. Symptoms can include abdominal pain, nausea, and fatigue. However, gastroenteritis usually also includes diarrhea or vomiting, which you did not report.
- Treatment usually involves rest, hydration, and over-the-counter remedies. Antibiotics may be necessary if the cause is bacterial.
Gastritis: This is an inflammation of the stomach lining. Symptoms can include abdominal pain, nausea, and fatigue. Gastritis can be caused by many things including certain medications, excessive alcohol consumption, and infections.
- Treatment usually involves addressing the underlying cause and may include over-the-counter or prescription medications.
Gallstones: These are hard deposits in the gallbladder that can cause abdominal pain. The pain is usually worse after eating.
- Treatment may involve dietary changes, medications, or in some cases, surgery.
Ischemic Colitis: Given your history of ischemic colitis, this could be a flare-up. Ischemic colitis occurs when blood flow to part of the large intestine (colon) is reduced, usually due to narrowed or blocked blood vessels (arteries). The condition can cause pain and may damage your colon.
- Treatment typically involves treating the cause of the reduced blood flow, such as heart disease or atherosclerosis.

What you can do

While waiting for your appointment with your doctor, you can:

Rest and stay hydrated. Drink plenty of fluids to avoid dehydration, especially if you're feeling fatigued.
Try to eat small, light meals and avoid foods that are high in fat and sugar.
Over-the-counter antacids or pain relievers may help, but you should check with a healthcare provider before starting any new medication given your current prescriptions.

What you should look out for

Please seek immediate medical attention if you:

Notice blood in your stool or vomit
Experience severe or worsening pain
Develop a fever
Become unable to keep down fluids or food

Please remember that while I strive to provide accurate information, I'm an AI and not a doctor. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

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