[53F] With throat pain and watery stools, history of lupus and fibromyalgia

Patient Description

A 53-year-old female with a history of lupus, fibromyalgia, arthritis, and bone spurs in the spine presents with new onset throat pain and watery stools over the past few days. The patient reports that the throat pain began suddenly and has not been relieved by any measures. She denies fever, chills, cough, runny nose, nausea, vomiting, abdominal pain, or cramping. The patient has not traveled recently, consumed any unusual foods, or been exposed to anyone who is sick. She has been under significant stress recently and reports a recent flare-up of lupus symptoms, including fatigue, generalized pain, and a desire to sleep. The patient has no history of thyroid conditions and has not experienced any changes in her voice, difficulty swallowing, weight, or appetite. She has been through menopause and has not started any new medications or supplements recently. No known drug allergies. The patient is unable to recall the specific medications she is currently taking but has been on the same medications for years.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Swollen Thyroid and Sore Throat

  • Thyroiditis: Inflammation of the thyroid gland can cause swelling and pain in the throat. This could be related to an autoimmune condition, especially given your history of lupus.
  • Infection: A viral or bacterial infection could cause throat pain and swelling. This is less likely given the absence of fever or other typical infection symptoms, but it is still a possibility.

Watery Farts

  • Gastrointestinal Disturbance: Stress and autoimmune conditions like lupus can sometimes cause gastrointestinal symptoms, including watery stools or gas.
  • Dietary Factors: Although you haven't identified any new foods, sometimes even familiar foods can cause issues if your digestive system is sensitive.

Unifying Diagnosis

  • Autoimmune Flare-Up: Given your history of lupus and fibromyalgia, it's possible that your symptoms are part of a broader autoimmune flare-up. Stress can exacerbate these conditions, leading to a variety of symptoms, including gastrointestinal issues and throat pain.

What you can do

For Swollen Thyroid and Sore Throat

  • See a Doctor: It's important to consult with a healthcare provider to rule out thyroiditis or other serious conditions. They may recommend blood tests or imaging studies.
  • Stay Hydrated: Drink plenty of fluids to keep your throat moist and reduce discomfort.
  • Over-the-Counter Pain Relief: You can use over-the-counter pain relievers like acetaminophen or ibuprofen to help manage the pain.

For Watery Farts

  • Monitor Your Diet: Keep a food diary to track what you eat and any symptoms that follow. This can help identify any potential triggers.
  • Stay Hydrated: Drink plenty of water to stay hydrated, especially if you are experiencing watery stools.
  • Probiotics: Consider taking a probiotic supplement to help balance your gut flora.

General Advice

  • Manage Stress: Stress can exacerbate autoimmune conditions. Techniques like deep breathing, meditation, and gentle exercise can help manage stress levels.
  • Track Symptoms: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider. This can be very helpful for your healthcare provider to understand your condition better.

What you should look out for

Given the complexity of your symptoms and your history of autoimmune conditions, it's important to seek medical care if you experience any of the following:

  • Difficulty Breathing or Swallowing: This could indicate a more serious issue with your throat or thyroid.
  • Severe Abdominal Pain: This could be a sign of a more serious gastrointestinal issue.
  • High Fever or Chills: These could indicate an infection that needs prompt medical attention.
  • Sudden Weight Loss or Gain: This could be a sign of a thyroid issue or other underlying condition.

Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan.

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6 mo ago

Top picked over-the-counter products for Sore Throat: At-Home Management

People Also Ask


Can stress cause throat pain and gastrointestinal issues in patients with autoimmune conditions?

Yes, stress can exacerbate autoimmune conditions like lupus and fibromyalgia, potentially leading to symptoms such as throat pain and gastrointestinal disturbances, including watery stools.


What are the common symptoms of a lupus flare-up?

Common symptoms of a lupus flare-up include increased fatigue, joint pain, skin rashes, fever, and sometimes gastrointestinal issues. Stress and other factors can trigger these flare-ups.


How can thyroiditis be distinguished from other causes of throat pain?

Thyroiditis often presents with throat pain, swelling, and sometimes changes in voice or difficulty swallowing. Blood tests and imaging studies can help distinguish it from other causes of throat pain, such as infections.


What dietary changes can help manage watery stools in patients with autoimmune conditions?

Keeping a food diary to identify potential triggers, avoiding known irritants, and incorporating probiotics to balance gut flora can help manage watery stools. It's also important to stay hydrated and consult with a healthcare provider for personalized advice.


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