Managing Gastrointestinal Distress: Is Urgent Care the Right Choice?
I’m a 35-year-old female taking 300 mg of lamotrigine, 40 mg of omeprazole, and 20 mg of propranolol twice daily. I recently reduced my dose of sertraline. I have a history of GERD and constipation-predominant IBS since I was a child, and occasionally, I notice blood in my stools during flare-ups, occasionally with pus. A sitzmark study indicated that I have a slow colonic transit, with three-quarters of the markers still present in my descending colon and upper sigmoid colon after five days. Additionally, last year, a benign polyp was removed during a colonoscopy. In the past three days, I’ve experienced intermittent intense abdominal discomfort, alongside constipation and vomiting. During attempts to have a bowel movement, I’ve experienced symptoms akin to vasovagal syncope, although I haven’t fainted since I tense my legs. I’ve only managed to pass a few tiny, hard stools; most of what’s been evacuated has been mucus, and notably, I observed blood since last night. While these symptoms aren’t new to me, a typical flare usually resolves within a day, transitioning to diarrhea before I feel relief. What’s different this time is the heightened intensity of my pain, the prolonged duration of this flare (I’ve missed three days of work), and frequent vomiting at least two to three times a day due to the pain. Around 12:30 PM today, after vomiting, I realized that the Tums I took last night hadn’t been digested, which feels concerning. My husband is quite worried that my digestion may have significantly slowed or even halted, and he suggests that I should consider seeking urgent care. Recently, I attempted some remedies, including gas relief medication (Gas-X), which I took twice yesterday and once today, and I consumed two teaspoons of Epsom salt yesterday and three teaspoons about an hour and a half ago. I’m also trying to maintain my hydration, but unfortunately, a lot of the fluids I take in come back up when I vomit. Would visiting urgent care provide any assistance for my pain? While the frequency of needing to use the bathroom and the occasional vomiting might not bother me as much, the severe discomfort is quite unbearable. Thank you for your insights!
Answers (1)
7/24/2025, 9:31:00 PM
OpenHealth AI
It sounds like you are experiencing significant gastrointestinal distress with prolonged symptoms, including abdominal pain, constipation, vomiting, and the alarming presence of blood and mucus. Given the severity and duration of your symptoms, as well as your history of gastrointestinal issues, it’s important to address this situation urgently.
Main Points:
- The intensity and persistency of your symptoms indicate a need for immediate attention.
- The presence of blood in stools and severe abdominal pain warrants a medical evaluation to rule out any serious conditions.
Explanation:
Given your background of GERD, IBS, and the findings from your sitzmark study, it's understandable that flare-ups can be challenging. However, the length of your current flare (three days), the increased intensity of pain, and the vomiting suggest that something more may be going on. The fact that your medication (like Tums) has not been well-digested raises concerns about possible gastrointestinal blockage or severe constipation, especially considering your slow transit time.
Next Steps:
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Seek Urgent Care: It is advisable to visit urgent care or an emergency room, especially since you’re experiencing severe pain, vomiting, and blood in your stools. This will allow healthcare providers to assess your condition more thoroughly, potentially perform imaging studies, and provide relief measures such as IV fluids if necessary.
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Monitor Symptoms: While you are preparing to seek medical attention, keep a detailed record of your symptoms—note the frequency of vomiting, times when pain worsens, and any changes in stool color and consistency. This information can be helpful for healthcare providers.
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Hydration: Continue attempting to stay hydrated, but if vomiting persists and you can’t keep fluids down, it's crucial to seek immediate care, as you could be at risk of dehydration.
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Avoid Further Remedies: Stop taking over-the-counter remedies like Epsom salt and Gas-X until you've been evaluated, as these could either worsen your symptoms or complicate the picture.
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Comfort Measures: While you await treatment, consider gentle positions that may relieve some abdominal discomfort, such as lying on your side or using a heating pad on a low setting over your abdomen.
Your discomfort and the symptoms you're experiencing deserve prompt attention. Prioritize getting the care you need, and take your husband’s concerns seriously, as urgent evaluation can provide you relief and clarity. Thank you for sharing your situation, and take care in seeking the help you need.
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