OpenHealth Q&A

Chronic Abdominal Discomfort and Constipation in a 22-Year-Old Female

I am a 22-year-old female, standing 5 feet tall and weighing 95 pounds, seeking insight into my ongoing health concerns. My medical background includes a variety of issues: - Frequent bouts of bacterial vaginosis and yeast infections over the past two years. - An appendectomy performed in August 2024, during which a 1cm perforation was discovered. - Development of ovarian cysts. - A C. difficile infection treated effectively with Vancomycin in September 2024. - Onset of heart palpitations starting in September 2024. - Experiencing fainting spells and symptoms aligned with Postural Orthostatic Tachycardia Syndrome (POTS) that persisted until May 2025. As a child, I struggled with being underweight and restrictive eating behaviors, however, I have since managed to improve my condition. Notably, I gained 10 pounds during a trip to Japan from January to May 2025. Additional concerns include mild scoliosis, hypotension, and severe headaches localized to the left temple that have been persistent since March 2025. During a visit to the emergency department in October 2025 due to heart palpitations and dizziness, tests returned mostly normal, although a high D-Dimer level was noted. A cardiologist suggested the possibility of supraventricular tachycardia (SVT). Familial health history is significant, particularly with my mother suffering from severe rheumatoid arthritis and Sjogren’s syndrome, as well as a family history of stomach ulcers. My maternal grandfather had a stroke and diabetes. I began experiencing troubling symptoms in September 2025, manifesting 5-6 days per week as a persistent, dull ache located on the left side of my abdomen, particularly around the belly button. This discomfort escalates to severe pain at least once a month, after which I often experience nausea followed by vomiting that temporarily alleviates the pain. For the last two months, I have been dealing with pain localized in the left side of my back and abdomen, spreading occasionally to the right side during urination, and this sensation intensifies during my menstrual period. Since September 2025, I have noted continuous, involuntary pressure and extension of my rectum, which remains tense and unyielding, an issue that began after I suffered a tear in the anal sphincter/perineal area in April 2025. Additional symptoms include: - A gurgling noise from my stomach after eating. - Cramping similar to menstrual discomfort. - Frequent urges to urinate. - Discomfort during sexual activity. - A peculiar twitching sensation in my left leg while seated, akin to a blood vessel trying to function. - Occasional sharp chest pains potentially related to my posture. My bowel habits appear to be regular, with daily movements occurring one to two times. I have undergone several medical evaluations: - Thyroid function is normal. - Celiac disease screening returned negative. - Blood tests revealed normal glucose levels and a general metabolic panel, though potassium levels were low. - A tilt table test indicated no evidence of POTS. - A bladder assessment confirmed complete emptying. - Various urine tests were all negative for infection. Recent CT scans revealed a backup extending throughout the transverse colon since my surgery, with a follow-up scan showing no improvement. During my hospital stay for C. difficile, I was placed on medications including Colace and Miralax to assist in clearing the colon obstruction. Recommended management strategies from my healthcare providers include: - Staying well-hydrated and maintaining a nutritious diet, both of which I have been adhering to. - Engaging in physical activity, specifically yoga; however, I often feel too unwell to do much beyond attending college classes. I make an effort to walk regularly. - Preparing for a colonoscopy, though I have concerns about the long-term efficacy of this approach, especially since similar preparations did not yield lasting results in the past. - I have a pelvic floor therapy appointment scheduled for January to address some of these issues further.

Answers (1)

12/13/2025, 4:11:04 PM

OpenHealth AI

It sounds like you're experiencing a complex set of chronic abdominal discomfort, constipation, and several other related symptoms. This can be understandably distressing, and it's important to approach your situation step by step by addressing the most pressing concerns and managing your symptoms.

Summary of Key Points:

1. You have persistent abdominal pain with episodes of severe discomfort and symptoms suggestive of colon obstruction and pelvic floor issues.
2. You are actively managing your health through hydration, diet, and future medical appointments, including pelvic floor therapy and a colonoscopy.

Explanation:

The symptoms you've described—including persistent left-sided abdominal pain, discomfort during urination, and involuntary rectal pressure—may suggest issues with intestinal motility or pelvic floor dysfunction. Given your history of gastrointestinal problems, such as the C. difficile infection and the recent CT findings of a colon backup, addressing these issues is crucial.

The signs of nausea and vomiting after severe pain could indicate that your bowel is struggling to function properly. Given the complexity of your symptoms and variables like previous surgeries and pelvic floor issues, it’s important to take a multifaceted approach.

Actionable Next Steps:

1. Focus on Your Diet:

   • Continue to prioritize a balanced diet rich in fiber, as this could help improve bowel function. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.
   • Avoid foods that can exacerbate bloating or discomfort, such as those high in fats, dairy (if you're sensitive), or excessive sugars.

2. Hydration:

   • Maintain good hydration, but pay attention to electrolyte balance. Ensure you're consuming adequate amounts of water and consider foods or drinks that include electrolytes, particularly potassium, since your levels were noted to be low.

3. Physical Activity:

   • If fatigue limits your activity level, try gentle exercises that won't exhaust you. Short walks, stretching, or specific yoga poses can be beneficial for easing tension in the abdominal/pelvic region while also improving gut motility.

4. Pelvic Floor Therapy:

   • Attend your scheduled pelvic floor therapy appointment. This can be vital for addressing muscular issues that may be contributing to your symptoms, especially with the history of anal sphincter tears.

5. Symptom Tracking:

   • Keep a detailed symptom diary, noting the timing, severity, and nature of your symptoms, including what you eat and your hydration status. This information will be valuable for your healthcare provider to tailor your management plan better.

6. Communication with Healthcare Providers:

   • Before your colonoscopy, discuss your concerns regarding previous prep results with your healthcare team. Given your complicated history, they may explore different preparations or use imaging techniques to ensure optimal management.

7. Monitoring Symptoms:

   • If you notice an increase in symptoms, such as significantly worsening pain, fever, or changes in bowel habits, reach out to your healthcare provider promptly.

Reassurance:

It's important to approach this situation with patience and persistence. Chronic symptoms can take time to resolve, and you're taking the right steps by seeking help and being proactive in your management. You're not alone in this, and there are strategies and therapies that can provide relief and improvement over time. Please don’t hesitate to ask if you have further questions or need more information.