[61F] With chronic abdominal distention, heartburn, and urinary frequency

Patient Description

A 61-year-old female presents with a 7-month history of persistent abdominal distention described as a heavy, tight feeling, similar to being 6 months pregnant, accompanied by aching pain. The distention is constant and does not improve with time of day or after eating. The patient also reports daily heartburn, which has progressively worsened over the same period, causing significant chest burning and pain. Despite using heartburn medication, she prefers not to take it continuously. The patient experiences frequent urination, including waking up 2-3 times at night, although urine tests have returned clear. Additionally, she reports sharp, shooting pain on the left side that sometimes radiates down her leg and back pain under her ribs. There have been no changes in bowel habits, and bowel movements are reported as normal.

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Arora's Assessment

What might be happening

Based on the information you provided, several possible conditions could explain your symptoms:

  • Gastroesophageal Reflux Disease (GERD): Chronic heartburn is a common symptom of GERD. It can cause a burning sensation in the chest and may worsen after eating or lying down.

    • Treatment often includes lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down immediately after eating. Medications like antacids, H2 blockers, or proton pump inhibitors (PPIs) can also help.
  • Irritable Bowel Syndrome (IBS): This condition can cause chronic abdominal pain, bloating, and changes in bowel habits. It can also lead to urinary frequency due to the close proximity of the bowel and bladder.

    • Treatment typically involves dietary changes, stress management, and sometimes medications to manage symptoms.
  • Urinary Tract Infection (UTI): Frequent urination can be a symptom of a UTI, although you mentioned your urine test was clear. Sometimes, symptoms can persist even after an infection has cleared.

    • Treatment usually involves antibiotics if an infection is present. Drinking plenty of water can help flush out the urinary tract.
  • Pelvic Organ Prolapse: This occurs when the muscles and tissues supporting the pelvic organs weaken, causing them to drop lower in the pelvis. This can lead to urinary frequency, abdominal discomfort, and back pain.

    • Treatment can include pelvic floor exercises, lifestyle changes, or in some cases, surgery.
  • Ovarian Cysts or Other Gynecological Issues: Conditions like ovarian cysts can cause abdominal distention, pain, and urinary frequency.

    • Treatment depends on the specific condition but may include medications or surgical intervention.

What you can do

  1. Consult a Doctor: Given the duration and severity of your symptoms, it's crucial to consult a healthcare provider for a thorough evaluation. They may recommend tests such as blood work, imaging studies, or endoscopy to determine the cause.
  2. Dietary Changes: Avoid foods and beverages that trigger heartburn, such as spicy foods, caffeine, and alcohol. Eating smaller, more frequent meals may also help.
  3. Hydration: Drink plenty of water to help with urinary frequency and overall digestive health.
  4. Over-the-Counter Medications: You can continue using over-the-counter medications for heartburn as needed, but it's essential to discuss long-term use with your doctor.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain or swelling
  • Blood in your stool or urine
  • Unexplained weight loss
  • Fever or chills
  • Difficulty breathing or swallowing

Remember, while this information can be helpful, it's not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include chronic heartburn, a burning sensation in the chest, regurgitation of food or sour liquid, difficulty swallowing, and chest pain, especially after eating or lying down.


How can Irritable Bowel Syndrome (IBS) affect urinary frequency?

IBS can affect urinary frequency due to the close proximity of the bowel and bladder. The bowel's irritation or distention can exert pressure on the bladder, leading to increased urgency and frequency of urination.


What are the potential causes of persistent abdominal distention in women?

Persistent abdominal distention in women can be caused by conditions such as ovarian cysts, fibroids, ascites, gastrointestinal issues like IBS, or gynecological conditions like pelvic organ prolapse.


What lifestyle changes can help manage heartburn symptoms?

Lifestyle changes to manage heartburn include avoiding trigger foods (such as spicy foods, caffeine, and alcohol), eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed during sleep.

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