OpenHealth Q&A

Seeking Advice on Prolonged Stomach Discomfort and Recent Episodes

I appreciate your time and expertise as I lay out my situation, and I'm hopeful any medical professionals could provide their insights. Thank you! **Background and Medications:** I'm a 21-year-old female, weighing 115 pounds and standing 5 feet 7 inches tall. My current medications include 20mg of doxycycline daily (prescribed for a condition that occasionally causes redness and irritation in my eyes), 30mg of Prozac (for OCD), and low-dose birth control to help manage my menstrual cycle. My doxycycline and birth control use began approximately three years ago, while I started Prozac this year. All medications were prescribed following the onset of my chronic abdominal pain, which I've discussed with various doctors. I have experimented with prescription antispasmodics and over-the-counter medications for acute flare-ups, but these have not provided relief. My history of OCD and anxiety leaves me uncertain if these might be contributing factors or if they create a feedback loop regarding my physical symptoms. **Previous Diagnoses and Tests:** A few years back, I underwent a gastric emptying test, which indicated my stomach emptying was just "borderline delayed," though it didn’t raise concerns among my doctors. An upper endoscopy with a biopsy for H. pylori returned a negative result. Blood tests conducted for common food intolerances also yielded negative outcomes. After a bout of appendicitis two years ago, I had both an ultrasound and a CT scan that showed no digestive issues, and my appendectomy went smoothly. The prevailing opinion among my healthcare providers leans toward IBS, albeit with some uncertainty. **Symptoms:** For over five years now, I have been experiencing ongoing abdominal cramps that affect the lower and middle areas of my stomach. The sensations can be reminiscent of the discomfort felt just before vomiting or experiencing diarrhea following a meal gone wrong. At times, I liken the feeling to “my intestines being twisted” or “a bruised sensation internally.” While the pain isn’t debilitating, it occupies my thoughts and has persisted to a concerning degree. I also frequently feel nauseous, fearing an impending need to vomit. Approximately once a month, I face a significant flare-up characterized by severe cramps that come in waves, typically waking me up at odd hours. These episodes last for about 5 to 10 minutes and usually end with diarrhea (occasionally a yellowish hue), sweating, and nausea, after which I generally feel better. Luckily, I haven’t encountered such a flare-up in recent months. Additionally, I've struggled with constipation for about one to two years, which has only recently improved—possibly due to an increase in food intake, as my anxiety about eating has affected my appetite. During particularly bad stretches, I went up to a week without a bowel movement, followed by bouts of diarrhea. There were a few instances of bright red blood on toilet paper during this time, but that hasn’t occurred in the past few months. Currently, my bowel movements are regular but tend to produce very dark stools—not black but definitely dark. I also experience a significant amount of gas. As for dietary triggers, I have not pinpointed any specific foods that consistently provoke these symptoms. Reactions do not strictly follow the consumption of gluten, dairy, or high-fiber items. Occasionally, greasy fried foods may trigger discomfort, but I've also felt pain after eating plain grilled chicken and rice, or sometimes even after not eating at all. I am reaching out now as I have been experiencing persistent and notable cramping in the middle and lower stomach for four consecutive days. This pain is unyielding, resembling the discomfort before diarrhea or vomiting, yet no relief comes afterward. It tends to intensify before bowel movements but doesn’t dissipate afterwards. Maintaining my weight is proving challenging with these symptoms, and I worry that I may be overlooking something serious. Any guidance would be immensely appreciated!

Answers (1)

6/28/2025, 2:30:52 AM

OpenHealth AI

Thank you for sharing your detailed situation. It's clear you're experiencing significant discomfort over a prolonged period, and I commend you for reaching out for advice. Here’s a summary of your current concerns and some actionable steps to consider.

Key Points:

• You have a history of abdominal pain and gastrointestinal symptoms consistent with a possible diagnosis of Irritable Bowel Syndrome (IBS).
• You are currently on medications that may interact and potentially affect your gastrointestinal health.
• Recent episodes of persistent cramping and changes in bowel movements are a cause for concern.

Explanation:

Your symptoms are complex and multifaceted, linking both physical and psychological aspects. Conditions like IBS can often be exacerbated by stress and anxiety, potentially leading to a recursive cycle of symptoms. The episodes of severe cramping, nausea, and bowel irregularities you describe indicate that your gastrointestinal system is sensitive. Regardless of the underlying cause, it's crucial to find relief and manage these symptoms effectively.

Actionable Next Steps:

1. Symptom Diary: Start keeping a detailed diary of your symptoms, dietary intake, bowel movements, and any potential triggers. This might help identify patterns or specific foods that worsen your symptoms, even if they seem random now.

2. Stress Management: Since anxiety can worsen gastrointestinal symptoms, consider implementing stress-reducing practices like mindfulness, yoga, or gentle exercise, which can help in managing both mental and physical symptoms.

3. Dietary Focus: Aim for a balanced diet rich in fiber to promote regular bowel movements. Some find relief with a low-FODMAP diet, which reduces certain carbohydrates that can cause digestive distress. Discuss this with a dietitian if possible.

4. Hydration and Rest: Ensure adequate hydration and maintain a regular sleep schedule, as both can significantly impact digestive health.

5. Medication Review: Since you are on multiple medications, a review with a healthcare provider may help determine if any are contributing to gastrointestinal symptoms. It might be beneficial to speak to a gastroenterologist if the discomfort persists.

6. Monitor Your Symptoms: If your cramping and discomfort do not improve within a few days, or if you notice any new symptoms such as fever, persistent vomiting, or more frequent episodes of blood in your stool, it will be essential to seek medical attention more urgently.

Conclusion:

Your health and well-being are paramount, and while IBS can be challenging to manage, many effective coping strategies exist. Keep an open dialogue with your healthcare providers about your ongoing symptoms and experiment gradually with your diet and stress management techniques. You're not alone in this, and with perseverance, you can find methods to alleviate your discomfort. If you need more tailored advice as you proceed, feel free to reach out again.