A Surprising Cause of Abdominal Pain and Other GI Symptoms

This transcript has been edited for clarity.

Hello. I'm Paul Auwaerter with Medscape Infectious Diseases and the Johns Hopkins University School of Medicine in the Division of ID.

I thought I would discuss two patients who had a surprising explanation for gastrointestinal symptoms. As an ID consultant, we often are asked to see patients who have difficult or hard-to-understand problems, and certainly we see our share of people who might have persistent symptoms after traveler's diarrhea, things that might resemble irritable bowel syndrome, and so on.

There are two patients that we came to what would be a clinical diagnosis, but one that seemed very apt and not one that I initially considered at all. I thought it would be worth sharing with you in case you might see similar patients. These are two quick cases I'll mention. Both were women.

The first was a woman in her early sixties who I had seen in the past for fever of unknown origin, which was due to recurrent aspiration and polypharmacy. She was otherwise well from that standpoint, and because of the pandemic, I hadn't seen her in a while, but she came in with complaints of really unrelenting nausea, vomiting, abdominal pain, and four to five loose stools a day.