[59F] Experiencing waves of abdominal pain radiating to arms and legs

Patient Description

A 59-year-old female reports experiencing intermittent cramping in the mid-abdominal area, which radiates to her arms and legs. These episodes occur approximately 8 times a day and last for about 15 minutes each. The pain is often triggered by anxiety, excitement, food, or drink. The patient also experiences nausea, constipation, bloating, and has noticed blood in her stool. She has had a fever and chills. Her medical history includes a gastric bypass surgery in 1997 and a recent colonoscopy and endoscopy, during which biopsies were taken. The results of these biopsies are not yet available. The patient is currently taking medications but did not specify which ones. There is a family history of gastrointestinal diseases, heart disease, stroke, autoimmune diseases, diabetes, cancer, or psychiatric illnesses, though specific details were not provided.

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Arora's Assessment

What might be happening

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

  1. Gastrointestinal Issues:

    • Irritable Bowel Syndrome (IBS): IBS can cause cramping, abdominal pain, bloating, and changes in bowel habits. Stress and certain foods can trigger symptoms.
    • Gastric Bypass Complications: Given your history of gastric bypass surgery, complications such as adhesions, internal hernias, or nutritional deficiencies could be contributing to your symptoms.
  2. Musculoskeletal Pain:

    • Fibromyalgia: This condition can cause widespread musculoskeletal pain, including in the arms and legs, along with fatigue and other symptoms.
    • Peripheral Neuropathy: This condition can cause pain, tingling, and muscle cramps in the extremities and may be related to nutritional deficiencies or other underlying conditions.
  3. Systemic Conditions:

    • Congestive Heart Failure (CHF): Given your family history, it's important to consider CHF, which can cause symptoms like bloating, pain, and fatigue.
    • CNS Lymphoma: While less common, your family history of CNS lymphoma warrants consideration, especially if you have systemic symptoms like fever and chills.

What you can do

Abdominal Pain and Cramping:

  • Dietary Adjustments: Avoid foods and drinks that trigger your symptoms. Consider a low-FODMAP diet, which can help manage IBS symptoms.
  • Hydration: Drink plenty of water to help with constipation and overall digestive health.
  • Stress Management: Practice relaxation techniques such as deep breathing, meditation, or yoga to help manage anxiety and stress, which can exacerbate symptoms.

Musculoskeletal Pain:

  • Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. Be sure to follow the recommended dosage.
  • Physical Activity: Gentle exercises, such as stretching and low-impact activities like walking or swimming, can help alleviate pain and improve overall well-being.
  • Heat and Cold Therapy: Applying heat or cold packs to painful areas can provide relief.

General Health:

  • Follow-Up with Your Doctor: Given the severity and duration of your symptoms, it's important to follow up with your healthcare provider for further evaluation and to discuss the results of your recent biopsies.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share longitudinal medical notes with your provider. This can help in identifying patterns and triggers.

What you should look out for

Given the complexity and severity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care more urgently include:

  • Severe or worsening pain: If your pain becomes unbearable or significantly worsens.
  • Signs of infection: Fever, chills, or any signs of infection should be addressed promptly.
  • Changes in bowel habits: Persistent constipation, diarrhea, or blood in your stool should be evaluated by a healthcare provider.
  • Unexplained weight loss: If you experience significant weight loss without trying.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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5 mo ago


People Also Ask


What could be causing the blood in my stool?

Blood in the stool can be caused by various conditions, including hemorrhoids, diverticulosis, inflammatory bowel disease, or more serious conditions like colorectal cancer. It's important to have this symptom evaluated by a healthcare provider to determine the underlying cause.


How can anxiety and stress trigger abdominal pain?

Anxiety and stress can affect the digestive system by altering gut motility and increasing the perception of pain. This can lead to symptoms like cramping, bloating, and changes in bowel habits, often seen in conditions like Irritable Bowel Syndrome (IBS).


What are the potential complications of gastric bypass surgery that could relate to my symptoms?

Complications from gastric bypass surgery can include nutritional deficiencies, internal hernias, and adhesions, which can cause symptoms like abdominal pain, cramping, and changes in bowel habits. It's important to monitor these symptoms and discuss them with your healthcare provider.


How can I manage nausea and constipation effectively?

To manage nausea and constipation, consider dietary changes such as increasing fiber intake, staying hydrated, and avoiding foods that trigger symptoms. Over-the-counter medications like anti-nausea drugs and laxatives may also help, but it's best to consult with a healthcare provider for personalized advice.


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