Unexplained Abdominal Pain and Diarrhea in Seniors

Q: Unexplained Abdominal Pain and Diarrhea in Seniors

Hello： It may be necessary to know the interval between the two occurrences, the characteristics of the diarrhea, whether there is a fever, and any other chronic conditions in order to make a further assessment. <br>Generally, if abdominal pain is accompanied by significant diarr

Abdominal pain and diarrhea of unknown origin?

Hello Doctor: My mother is 72 years old and recently experienced two episodes of severe abdominal pain of unknown origin, accompanied by "profuse" diarrhea.
We were not present at the time, but according to her description, she was unable to contact an ambulance for help due to the severity of her diarrhea.
After inquiring, she mentioned that it was not caused by food poisoning, and these episodes occurred only those two times without any recurrence.
Subsequently, she has been returning to the hospital for regular check-ups and asked her family medicine physician about it.
However, it seems that due to her unclear description, no special examinations were conducted.
I still feel concerned that such intense pain could indicate an underlying issue, especially since it only happened during those two episodes.
My father passed away from stomach cancer, and after learning about his diagnosis, we realized that some of his previous symptoms were indicative of stomach cancer.
Therefore, I would like to ask the doctor if my mother's abdominal pain and "profuse" diarrhea could be symptoms of any underlying disease.
Should she undergo any specific examinations?

Miss Hsieh, 40~49 year old female. Ask Date: 2021/01/28

Dr. Lin Wufu reply Internal Medicine

Hello: It may be necessary to know the interval between the two occurrences, the characteristics of the diarrhea, whether there is a fever, and any other chronic conditions in order to make a further assessment.
Generally, if abdominal pain is accompanied by significant diarrhea, it is usually related to inflammatory diseases, while cancer itself rarely presents as diarrhea.
Additionally, some elderly individuals may have long-term constipation issues, which can lead to a buildup of stool in the abdomen, resulting in a significant bowel movement one day, potentially causing abdominal pain along with the large volume of stool.
Typically, the pain will alleviate after the bowel movement.
It is recommended that if these symptoms persist, you should consult a gastroenterologist or a family medicine physician for evaluation to determine if further examinations are necessary.

Reply Date: 2021/01/28

More Info

Understanding unexplained abdominal pain and diarrhea in seniors is crucial, especially considering the potential underlying health issues that can arise with age. Your concern for your mother, given her recent episodes of severe abdominal pain and diarrhea, is entirely valid.
Abdominal pain and diarrhea can stem from a variety of causes, particularly in older adults. Some common reasons include gastrointestinal infections, inflammatory bowel disease (IBD), diverticulitis, and even more serious conditions such as bowel obstructions or malignancies. Given your mother's age and the history of your father's gastric cancer, it is prudent to approach this situation with caution.

1. Gastrointestinal Infections: These can be viral, bacterial, or parasitic. Symptoms often include abdominal pain, diarrhea, and sometimes fever. If your mother had a recent infection, it could explain the acute nature of her symptoms. However, since she mentioned that it wasn't food-related, this may be less likely.

2. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with abdominal pain and diarrhea. These diseases often have periods of exacerbation and remission, which could explain the episodic nature of her symptoms.

3. Diverticulitis: This condition occurs when diverticula (small pouches that can form in the walls of the colon) become inflamed or infected. It can cause significant abdominal pain, often in the lower left quadrant, and changes in bowel habits, including diarrhea.

4. Bowel Obstruction: In older adults, bowel obstructions can occur due to various reasons, including adhesions from previous surgeries, hernias, or tumors. Symptoms typically include severe abdominal pain, vomiting, and constipation or diarrhea.

5. Malignancies: Given your father's history of gastric cancer, it is understandable to be concerned about the possibility of cancer in your mother. Symptoms such as unexplained weight loss, persistent abdominal pain, changes in bowel habits, or blood in the stool should be taken seriously.

Given these possibilities, it is essential to ensure that your mother receives a thorough evaluation. Here are some steps you might consider:
- Consult a Gastroenterologist: A specialist can provide a more in-depth evaluation of her symptoms. They may recommend tests such as blood work, stool tests, imaging studies (like an abdominal ultrasound or CT scan), or even a colonoscopy to visualize the colon and rule out any serious conditions.

- Keep a Symptom Diary: Documenting when the pain occurs, its intensity, associated symptoms (like fever or changes in appetite), and any dietary changes can help the physician make a more accurate diagnosis.

- Discuss Family History: Make sure to inform her healthcare provider about your father's history of cancer, as this can influence the diagnostic approach.

- Regular Follow-ups: Since your mother has regular check-ups, ensure that her healthcare providers are aware of these episodes. If her symptoms recur or worsen, it may warrant more immediate attention.

In conclusion, while the episodes of abdominal pain and diarrhea may have been isolated incidents, they should not be overlooked, especially in the context of her age and family history. A proactive approach involving consultation with a specialist and thorough diagnostic testing is advisable to rule out any serious underlying conditions. Your vigilance in seeking further evaluation for your mother is commendable and could potentially lead to early detection and treatment of any significant health issues.

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