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Stomach bloating, pain, anemia, panic disorder, rectal bleeding. Treatment ?

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General & Family Physician
Practicing since : 2003
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in the last few days my lower stomach has become very bloated looking (my pants are barely fitting me now) and i have bouts of pain in that area throughout the day. I feel like the pain is a little worse on the right side. It's mostly a XXXXXXX achy pain & I feel lots of pressure if I press down on it. The pain gets alot worse if i pull my knees up to my chest. my face looks extremely puffy especially around my chin spreading all the way to both of my ears (it pretty much looks like i grew a double chin overnight) & I have had a few episodes of vomiting/diarrhea - I have not seen any blood or anything in either... my energy has stayed decent & i have been drinking lots of fluids to replace what i lost. what could this be from? I'm 22 yrs old 5'5 117 lbs. unemployed, no children & i've never been pregnant. one of my medical conditions is eczema, the other is a.d.d. and i have been on and off of adderall to treat it, the other is pernicious anemia which i take supplements for & the last one is panic disorder..i see a therapist once a week to help me manage it. i also watch what I eat and work out on a daily basis. a few months ago i had my cbc, thyroid & food allergies checked... all came back normal. 2 years ago i went to a gastroenterologist because i had rectal bleeding, but the endoscopy & other procedure came back normal. As for medications i take birth control (seasonique) on a regular basis. No problems with menstruation, i just had my last cycle about 2 weeks ago & i have not noticed any side effects from the birth control.
Posted Fri, 20 Apr 2012 in Abdominal Pain
Answered by Dr. Deepak Anvekar 35 minutes later

Thanks for the query and the detailed history.

The symptoms of right lower sided pain, Nausea, persistent vomiting along with abdominal distention could be due to one of the following conditions:-

1. Acute appendicitis

2. Ovarian cyst with or without rupture or torsion: this is a condition that can release excess of estrogen hormones in the blood resulting in fluid retention and hence facial and abdominal distention.

3. Any pelvic infection related to the intestines or colon (Enteritis Or Colitis).

You might benefit by visiting the Emergency Room so that you can be evaluated with a panel of blood tests and a ultrasound of the abdomen and pelvis OR a CT scan to diagnose the underlying condition and initiate necessary interventions for proper treatment.

I hope this helps.

Please feel free to consult me again if you have additional queries.


Dr Anvekar.
Above answer was peer-reviewed by
Follow-up: Stomach bloating, pain, anemia, panic disorder, rectal bleeding. Treatment ? 26 minutes later
thank you. Is it okay to wait a few days before going to the emergency room? I don't know much about these conditions or how serious they are.
Answered by Dr. Deepak Anvekar 20 minutes later

Thanks for writing back.

The conditions that I suspect, that you might be having, need to be ruled out as soon as possible. Waiting a few days would not be advisable as they can get into severe complications if not treated at the earliest.

Complications in cases of appendicitis - include perforation of the bowel, formation of intraabdominal abscesses, formation of gangrene, which can prolong the suffering if treatment is delayed.

If ovarian cyst rupture or torsion is not treated earlier, it might result in requirement for removal of a ovary which can cause infertility at a later date.

Hence I would suggest you not to take your symptoms lightly and seek medical help at the earliest.

I hope this clears your doubts.


Dr. Deepak Anvekar.
Above answer was peer-reviewed by
Follow-up: Stomach bloating, pain, anemia, panic disorder, rectal bleeding. Treatment ? 11 hours later
Thanks so much for all of your help. I'm so sorry to bug you again, but something really random happened this morning. I got my period two weeks early. It's light-normal flow. Does that rule out any of the conditions?... like should I still go to ER or would a normal doctor visit in the next week or two be okay? (I don't have medical insurance so that is why I'm a little hesitant to go to the hospital.) I still have all of my symptoms though the pain and nausea got a little worse (still no fever)... I just don't know if this has anything to do with it?

I really appreciate your responses. Thanks again.
Answered by Dr. Deepak Anvekar 6 hours later

You are most welcome.

I do understand your situation. Being young and having financial difficulties can cause issues having very expensive medical insurance.

Presence of vaginal bleeding, now, could possibly rule out appendicitis.

In case all your symptoms have now subsided or have become very tolerable, then you might have had a premenstrual syndrome which was followed by breakthrough bleeding (spotting) which can sometimes occur at the time of ovulation. This occurs due to surge in hormone levels at the time of ovulation causing the uterine lining to shed and appear as vaginal bleeding (similar to your periods). In such a case taking a NSAID like Naprosyn might help to relieve all your symptoms. You can consult your doctor at your convenience in this situation.

In case the earlier symptoms - of abdominal pain, bloating, nausea and vomiting - are persisting and worsened - Then the bleeding you had, could be a sign that you may be having a ruptured ovarian cyst. This condition needs to be evaluated and treated on a urgent basis.

If no medical attention is given and in case you probably have smaller cysts the symptoms which are tolerable might subside within a few hours or days. In such cases seeing your regular doctor in a few days might also be acceptable.

But in case the symptoms have worsened than before and you cannot tolerate them, then you might consider to seek medical help at the nearest Emergency room.

I hope the information above helps you to decide on your health care needs.

Please feel free to consult me again if you have any other medical issues.

Take care and wish you a speedy recovery.

Dr. Anvekar.
Above answer was peer-reviewed by
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