Experiencing Stomach Discomfort?
A 38-year-old Caucasian woman residing in Australia, standing at 165 cm and weighing 108 kg, does not consume alcohol or smoke. **Medical Background:** She underwent laparoscopic cholecystectomy in 2015. Recently diagnosed with fatty liver, she has been following a strict 1200-calorie diet and has successfully lost 10 kg since January. Additionally, she has histories of diverticulosis, gastro-oesophageal reflux disease (GORD), low iron levels, and anxiety issues. **Current Medications:** Her daily regimen includes Pantoprazole at 40 mg, two iron tablets, fluoxetine at 20 mg, and one vitamin D tablet. **Recent Investigations:** An MRI of her abdomen conducted recently indicated the presence of only fatty liver. She had a colonoscopy and gastroscopy in 2021, which confirmed conditions of GORD and diverticulosis. Blood tests from March, taken during a flare, indicated a CRP level of 25, GGT level of 85, and ALT level of 35, with a full blood count showing no abnormalities detected. **Bowel Health:** After her gallbladder surgery, she noticed a significant change; it became challenging for her to eat without needing to use the bathroom during meals. While this symptom eventually subsided, she now alternates between episodes of constipation and more frequent loose stools. **Current Symptoms:** Lately, she sometimes experiences severe stomach pain and a sensation of fullness that prevents her from eating or drinking without discomfort. This is often accompanied by sulfur burping followed by vomiting of undigested food, which can occur up to 22 hours after eating. Additionally, she deals with episodes of diarrhea lasting a couple of days, but then she returns to normal as if nothing had transpired. The patient endures flare-ups approximately once a month or every couple of months and remains uncertain of the underlying cause. Initially, she considered gastroenteritis but questions whether it is possible to experience it this frequently. What potential factors could be contributing to her ongoing symptoms?
Answers (1)
4/23/2025, 12:10:44 PM
OpenHealth AI
Your symptoms, including severe stomach pain, sensation of fullness, sulfur burping, vomiting undigested food, and alternating between diarrhea and constipation, can be distressing. These signs suggest several potential underlying issues that warrant careful consideration.
Main Points:
You could be experiencing symptoms related to your previous gallbladder surgery, dietary changes, or conditions like diverticulosis or GORD. It's important to manage your diet, monitor symptoms, and explore triggers for the flare-ups.
Explanation:
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Post-Cholecystectomy Symptoms: After gallbladder removal, some individuals may experience changes in digestion, such as difficulty in digesting fats, which could lead to discomfort, diarrhea, and sometimes nausea or vomiting.
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GORD and Dietary Factors: Your gastro-oesophageal reflux disease (GORD) might be contributing to symptoms like sulfur burping and vomiting. High-fat meals or certain foods can exacerbate reflux symptoms, leading to further discomfort.
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Diverticulosis Impact: This can also play a role in bowel irregularities and abdominal pain. Episodes of constipation and diarrhea could be linked to diverticular inflammation.
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Dietary Load: The strict 1200-calorie diet may lack essential nutrients or fiber, leading to digestive issues. Sudden dietary changes can also stress your gastrointestinal system.
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Flare-Up Frequency: While gastroenteritis typically presents with more acute symptoms, flare-ups of gut-related issues can occur frequently, especially if triggered by dietary indiscretions or irritation.
Next Steps:
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Food Journal: Keep a detailed journal of what you eat and when symptoms occur. This can help identify specific triggers linked to your flare-ups.
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Diet Evaluation: Gradually increase your fiber intake (if tolerated) and consider small, frequent meals that are low in fat and avoid known irritants (spicy foods, caffeine, fatty foods).
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Hydration: Ensure you're staying well-hydrated, especially during episodes of diarrhea, to prevent dehydration.
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Stress Management: Given your anxiety history, consider incorporating stress-reduction techniques like mindfulness, yoga, or meditation, as stress can exacerbate gastrointestinal symptoms.
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Symptom Monitoring: Track the frequency and severity of your symptoms over the next month. Note any changes or patterns that can inform further management.
If these strategies do not alleviate your symptoms or if they worsen, re-evaluating your medications and possible imaging or testing might be needed. It's crucial to stay in tune with your body and adapt your approach as necessary.
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