[58M] Experiencing abdominal pain, blurred vision, and neurological symptoms

Patient Description

A 58-year-old male presents with a constellation of symptoms including cramping and sharp abdominal pain on the right side, which is exacerbated a few hours after eating and alleviated by switching to a liquid diet. The patient has also experienced a significant change in bowel habits over the past four weeks, alternating between constipation and watery, loose diarrhea approximately every seven days. Accompanying these gastrointestinal symptoms, the patient reports a loss of taste and a new onset of blurred vision in the left eye, described as out of focus, persisting for the same four-week duration. Neurologically, the patient experiences occasional lightheadedness, akin to standing up too quickly, occurring once or twice weekly for a month. The patient has been diagnosed with inflammation of the distal ileum, which is associated with the reported gastrointestinal symptoms. The patient's weight has decreased by 30 pounds over the past three months. Currently, the patient is on blood pressure medication and prednisone, with no known drug allergies or adverse reactions to medications. No recent travel or new foods were reported that could explain the symptoms.

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Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

  • Inflammatory Bowel Disease (IBD): This is a term that includes conditions such as Crohn's disease and ulcerative colitis. These conditions are characterized by chronic inflammation of the gastrointestinal (GI) tract, which can cause symptoms like abdominal pain, diarrhea, and weight loss. The inflammation in your distal ileum that was found during your colonoscopy could be a sign of IBD.

    • Treatment for IBD often involves medications to reduce inflammation and manage symptoms. In severe cases, surgery may be required.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. Unlike IBD, IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.

    • The treatment for IBS is focused on relieving symptoms. Lifestyle changes, including diet and managing stress, can help.
  • 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 highly infectious. Symptoms can include diarrhea, abdominal pain, vomiting, headache, fever and chills.

    • Most cases of gastroenteritis resolve within a few days without specific treatment. Rest and rehydration are usually sufficient.
  • Side effects of medication: Prednisone, a steroid medication, can cause a variety of side effects including abdominal pain, changes in vision, and weight loss.

What you can do

  1. Follow your doctor's advice: If you have been diagnosed with inflammation of the distal ileum, it's important to follow the treatment plan prescribed by your doctor. This may include taking certain medications, making dietary changes, or undergoing further testing or procedures.

  2. Monitor your symptoms: Keep track of your symptoms and let your doctor know if they get worse or if you develop new symptoms. This can help your doctor determine if your treatment plan needs to be adjusted.

  3. Stay hydrated and eat a balanced diet: If you're experiencing diarrhea, it's important to drink plenty of fluids to prevent dehydration. Eating a balanced diet can also help ensure you're getting the nutrients you need.

  4. Consider lifestyle changes: Regular exercise, adequate sleep, and stress management can all play a role in managing symptoms of IBD and IBS.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, such as severe abdominal pain, blood in your stool, unexplained weight loss, or persistent vomiting, seek medical attention immediately.
  • If you notice any changes in your vision, seek medical attention immediately. This could be a sign of a serious side effect of prednisone.

Please remember that 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 accurate information.

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1 yr ago

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People Also Ask


What are the common symptoms of Inflammatory Bowel Disease (IBD)?

Common symptoms of Inflammatory Bowel Disease (IBD) include abdominal pain, diarrhea, weight loss, fatigue, and sometimes blood in the stool. The symptoms can vary depending on the severity and location of the inflammation in the gastrointestinal tract.


Can prednisone cause changes in vision?

Yes, prednisone can cause changes in vision as a side effect. It is important to report any new or worsening vision problems to your healthcare provider, as this could indicate a serious side effect.


How can I manage alternating constipation and diarrhea?

Managing alternating constipation and diarrhea can involve dietary changes such as increasing fiber intake, staying hydrated, and avoiding trigger foods. It's also important to manage stress and follow any specific treatment plans provided by your healthcare provider.


What lifestyle changes can help manage symptoms of IBD or IBS?

Lifestyle changes that can help manage symptoms of IBD or IBS include regular exercise, maintaining a balanced diet, ensuring adequate sleep, and practicing stress management techniques such as meditation or yoga. These changes can help improve overall well-being and reduce symptom severity.


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