[53F] Experiencing severe abdominal pain post-hysterectomy

Patient Description

A 53-year-old female is reporting severe, constant, throbbing abdominal pain localized to the left side, extending to the ribs. The pain is exacerbated by straining activities such as sweeping, talking loudly, bending over, or using the bathroom. The patient has a history of a recent hysterectomy due to fast-growing precancerous conditions, and also has a diagnosed hiatal hernia. The pain is described as so severe that it causes screaming, sweating, and difficulty breathing. It tends to subside somewhat after 10-20 minutes of resting. The patient also reports the presence of blood on the tissue after bowel movements, but with normal stools. There is no history of similar pain prior to the last three months, and the pain has been worsening. No fever or chills are reported, but episodes of sweating occur a few times a day, particularly during intense pain. The patient also experiences dizziness and rates the associated shortness of breath as 10/10 in severity, which is a new symptom for her.

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Arora's Assessment

What might be happening

Based on the information provided, you might be experiencing:

  • Gastroenteritis: This is an inflammation of the lining of the intestines caused by a virus, bacteria or parasites. Symptoms include severe abdominal pain, diarrhea, and sometimes blood in the stool.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be necessary if the cause is bacterial.
  • Diverticulitis: This is a condition where small, bulging pouches (diverticula) in the digestive tract become inflamed or infected. Symptoms include severe pain in the lower left side of the abdomen, fever, and changes in bowel movements.

    • Treatment typically involves antibiotics, pain relievers, and a liquid diet until your bowel heals. Surgery may be necessary in severe cases.
  • Gastric ulcers: These are sores that develop on the lining of the stomach, upper small intestine or esophagus. Symptoms include a burning stomach pain, feeling of fullness, bloating, fatty food intolerance, heartburn, and nausea.

    • Treatment typically involves proton pump inhibitors (PPIs), H2 blockers, and antacids. In some cases, antibiotics may be needed.

Please note that these are possible conditions and not a definitive diagnosis. You should consult with a healthcare professional for an accurate diagnosis.

What you can do

Given the severity of your symptoms, it's important to seek immediate medical attention. Here are some steps you can take:

  1. Go to the nearest emergency department or urgent care center. If you're unable to transport yourself, call an ambulance.
  2. Avoid eating or drinking anything until you've been evaluated by a healthcare professional.
  3. Try to stay calm and take slow, deep breaths to help manage your pain and breathing.

What you should look out for

You should seek immediate medical attention if you experience:

  • Increased severity or frequency of pain
  • Vomiting blood or having blood in your stool
  • High fever (temperature over 100.4°F)
  • Inability to pass gas or have a bowel movement
  • Sudden dizziness or fainting

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare professional for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of diverticulitis?

Common symptoms of diverticulitis include severe pain in the lower left side of the abdomen, fever, nausea, vomiting, and changes in bowel habits such as constipation or diarrhea.


How can a hiatal hernia contribute to abdominal pain?

A hiatal hernia can cause abdominal pain by allowing stomach acid to move back into the esophagus, leading to heartburn and discomfort. It can also cause pressure and pain in the chest and abdomen, especially when bending over or lying down.


What should I do if I notice blood in my stool?

If you notice blood in your stool, it's important to consult a healthcare professional. While it can be caused by minor issues like hemorrhoids, it can also indicate more serious conditions such as diverticulitis or gastrointestinal bleeding.


How can I differentiate between gastric ulcers and other abdominal conditions?

Gastric ulcers typically cause a burning pain in the stomach, which may be relieved by eating or taking antacids. Other conditions like diverticulitis or gastroenteritis may present with more localized pain, fever, or changes in bowel habits. A healthcare professional can perform tests to accurately diagnose the condition.


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