[18F] Experiencing severe urinary and abdominal pain with systemic symptoms

Patient Description

An 18-year-old female presents with a 2-year history of extreme pain during urination, calcified kidneys, kidney stones, blood in urine, and foul-smelling urine described as popcorn-like, which has been persistent for a year. The pain is sharp, electric, and contraction-like, radiating from the back to the hips and causing bone pain rather than muscle pain. The patient also reports frequent UTIs, lethargy, tiredness, fainting, and seizures associated with pain episodes for the past 6 months. The urine is consistently cloudy, and the patient experiences nausea and vomiting. The patient's medical history includes a concussion and spinal injury from 2 years ago. The patient denies any fever or chills and has not found anything that reduces the urine odor. The tiredness is severe and constant when in pain, and the patient rates the severity of fainting episodes as 7 out of 10, which are triggered by pain. The lethargy has been present for 6 months and makes it difficult for the patient to get up and walk. Seizures occur due to panic related to the pain.

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Arora's Assessment

What might be happening

Based on your symptoms, possible diagnoses include:

  • Urinary Tract Infection (UTI): UTIs can cause pain during urination, cloudy and strong-smelling urine, and frequent urination. They can also cause fatigue and lethargy.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Kidney Stones: These can cause severe pain in the abdomen and back, blood in the urine, and frequent urination. They can also cause nausea and vomiting.

    • Treatment can range from pain management and drinking lots of fluids to help pass the stone, to medical procedures to remove or break up larger stones.
  • Interstitial Cystitis (IC): This is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain.

    • Treatment typically involves medications to help relax the bladder and physical therapy.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition.

    • Treatment typically involves a combination of lifestyle changes, dietary restrictions, and medication to manage symptoms.

Please remember that these are potential diagnoses based on the symptoms you've described. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Drink plenty of water: This can help flush bacteria out of your urinary system, which may reduce symptoms if you have a UTI.
  2. Avoid caffeine, alcohol, and spicy foods: These can irritate your bladder and potentially worsen your symptoms.
  3. Over-the-counter pain relievers: These may help manage your pain in the short term, but they are not a long-term solution.
  4. Rest: If you're feeling fatigued, make sure to get plenty of sleep and try to reduce stress as much as possible.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You have a high fever (over 100.4°F)
  • You experience sudden, severe abdominal pain
  • You start vomiting and can't keep down fluids
  • Your symptoms worsen or don't improve within a few days

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of kidney stones and how are they treated?

Common symptoms of kidney stones include severe pain in the back or side, blood in the urine, frequent urination, nausea, and vomiting. Treatment can involve pain management, increased fluid intake to help pass the stone, and medical procedures to remove or break up larger stones.


How can urinary tract infections (UTIs) affect overall health and what are the treatment options?

UTIs can cause pain during urination, cloudy and strong-smelling urine, frequent urination, fatigue, and lethargy. Treatment typically involves antibiotics prescribed by a doctor, along with increased fluid intake to help flush out the bacteria.


What is interstitial cystitis and how is it managed?

Interstitial cystitis is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. Management typically involves medications to relax the bladder, physical therapy, and lifestyle changes to avoid bladder irritants.


What lifestyle changes can help manage chronic fatigue syndrome?

Managing chronic fatigue syndrome often involves lifestyle changes such as maintaining a balanced diet, regular gentle exercise, stress reduction techniques, and ensuring adequate sleep. Medications may also be used to manage specific symptoms.


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