[67F] Experiencing abdominal pain, loss of appetite, and fatigue

Patient Description

A 67-year-old female presents with a 6-week history of sudden, severe, spasm-like abdominal pain located to the left of the navel and below the ribcage. The pain occurs every few days and lasts less than a minute. The patient has been experiencing a loss of appetite for several months, forcing herself to eat, with no significant weight change. Additionally, she reports a year-long history of fatigue and a loss of interest in previously enjoyed activities such as socializing and photography, feeling that something is wrong. The patient also describes having loose bowel movements on average 4-5 times daily, particularly in the morning and after meals, with a light brown/yellowish stool consistency similar to oatmeal. There is a feeling of abdominal heaviness before getting out of bed, which resolves within 30-60 minutes. The patient has been generally healthy, with no known drug allergies and no regular medications except for occasional migraine medication. A recent colonoscopy in November revealed no need for biopsies.

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Arora's Assessment

What might be happening

Based on the information you've provided, some possible diagnoses include:

  • Gastroenteritis: This is inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing diarrhea and vomiting. However, this is less likely given the duration of your symptoms.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. Antibiotics may be necessary if a bacterial infection is identified.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, diarrhea or constipation, or both. Your symptoms of abdominal pain and diarrhea could be indicative of this condition.

    • Treatment often involves long-term management of diet, lifestyle changes, and stress. In some cases, medication or counseling might be recommended.
  • Depression: Your loss of interest in activities you used to enjoy, feelings of fatigue, and changes in appetite could be signs of depression. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.

    • Treatment typically involves a combination of medication, psychotherapy, and lifestyle changes.
  • Gastritis: This is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic). Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs.

    • Treatment typically involves antacids and other drugs to reduce stomach acid, avoiding hot and spicy foods, and stress management.

Please note that these are potential explanations for your symptoms, but further testing and consultation with a healthcare professional is necessary to confirm a diagnosis.

What you can do

  1. Consult a healthcare professional: Given the duration and severity of your symptoms, it is important to seek medical advice. They may recommend further testing such as blood tests, stool tests, or imaging studies to help identify the cause of your symptoms.

  2. Monitor your symptoms: Keep track of your symptoms, including when they occur, their severity, and any potential triggers. This information can be helpful for your healthcare provider in determining a diagnosis.

  3. Stay Hydrated: Diarrhea can lead to dehydration, so it's important to drink plenty of fluids. Water is the best choice, but broths or soups can also be beneficial.

  4. Eat a BRAT diet: If your stomach is upset, eating a BRAT diet (Bananas, Rice, Applesauce, Toast) can help. These foods are easy on the stomach and can help bulk up your stool.

  5. Mental Health Support: If you're feeling depressed, it's important to talk to someone about it. This could be a trusted friend or family member, or a mental health professional. There are also many hotlines available if you need to talk.

What you should look out for

  • If your abdominal pain becomes severe or constant
  • If you notice blood in your stool or if your diarrhea worsens
  • If you develop a fever (temperature over 100.4°F) or chills
  • If your feelings of depression worsen or if you start having thoughts of harming yourself

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of Irritable Bowel Syndrome (IBS)?

Common symptoms of IBS include cramping, abdominal pain, bloating, gas, diarrhea, and constipation. Symptoms can vary in intensity and may be triggered by certain foods, stress, or hormonal changes.


How can depression affect physical health?

Depression can lead to physical symptoms such as fatigue, changes in appetite, sleep disturbances, and a general feeling of malaise. It can also exacerbate chronic conditions and affect the immune system.


What dietary changes can help manage symptoms of gastritis?

To manage gastritis, it is recommended to avoid spicy, acidic, or fried foods. Eating smaller, more frequent meals and avoiding alcohol and caffeine can also help. Incorporating foods like bananas, rice, applesauce, and toast (BRAT diet) can be soothing for the stomach.


When should I seek medical attention for abdominal pain?

You should seek medical attention for abdominal pain if it becomes severe or constant, if you notice blood in your stool, if diarrhea worsens, if you develop a fever or chills, or if you experience significant weight loss or dehydration.


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