[19F] Experiencing sharp pain during urination and severe lower right back pain

Patient Description

A 19-year-old female has been experiencing sharp pain towards the end of urination and increased frequency of urination for about a month. She has also noticed a change in the smell and color of her urine. Additionally, she reports severe sharp pain in the lower right side of her back, which is exacerbated at night and with breathing, to the point of waking her from sleep. She experiences chills and nausea but has no known family history of kidney stones, no pre-existing conditions, allergies, or adverse reactions to medications, and is not on any medications. She has been in a monogamous relationship for the past two years.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the most likely diagnoses include:

  • Urinary Tract Infection (UTI): A UTI is an infection in any part of your urinary system — your kidneys, ureters, bladder, and urethra. Most UTIs are caused by bacteria, but some are caused by viruses and fungi. UTIs are more common in women than men. They can occur anywhere along your urinary tract, which includes your kidneys, bladder, and urethra. The symptoms you've described, such as pain during urination, frequent urination, and changes in the color and smell of your urine, are common symptoms of a UTI.

    • Treatment for UTIs typically involves antibiotics to kill the bacteria causing the infection. Drinking plenty of water can also help dilute your urine and ensure that you'll urinate more frequently, allowing bacteria to be flushed from your urinary tract before an infection can begin.
  • Kidney Stones: Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain when they move through the urinary tract. The pain you've described in your lower back and during urination, as well as the changes in your urine, could be symptoms of kidney stones.

    • Treatment for kidney stones varies depending on the size and type of the stone and whether it is causing symptoms or blocking your urinary tract. Small stones with minimal symptoms can often be managed with pain relief medication and drinking plenty of water to help pass the stone. Larger stones may require more extensive treatment.
  • Pyelonephritis: This is a type of urinary tract infection where one or both kidneys become infected. They can be infected by bacteria or a virus. It can cause back pain and fever.

    • Treatment typically involves antibiotics. In severe cases, hospitalization may be required.

What you can do

While waiting for your appointment with a healthcare professional, here are some things you can do to alleviate your symptoms:

  1. Drink plenty of water: This can help dilute your urine and ensure that you'll urinate more frequently, allowing bacteria to be flushed from your urinary tract before an infection can begin.
  2. Avoid drinks that may irritate your bladder: Avoid coffee, alcohol, and soft drinks containing citrus juices and caffeine until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate.
  3. Use a heating pad: Apply a heating pad to your abdomen, back, or side to help manage any pain you may be experiencing.

What you should look out for

You should seek immediate medical attention if:

  • Your symptoms worsen or do not improve within a few days
  • You develop a high fever
  • You start vomiting or cannot keep down fluids
  • You have severe pain in your back or side that won't go away

Remember, I'm an AI and this advice is based on the symptoms you've told me. It's really important to consult with a healthcare professional who can evaluate your health and provide appropriate treatment.

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8 mo ago


People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain in women.


How can kidney stones be treated and managed?

Treatment for kidney stones depends on the size and type of the stone. Small stones may pass on their own with pain relief and increased water intake. Larger stones might require medical procedures or surgery to remove or break them up.


What is pyelonephritis and how is it different from a regular UTI?

Pyelonephritis is a type of UTI that affects one or both kidneys. It is more severe than a regular UTI and can cause symptoms like back pain, fever, chills, and nausea. It often requires antibiotics and sometimes hospitalization.


When should I seek immediate medical attention for urinary symptoms?

You should seek immediate medical attention if your symptoms worsen, you develop a high fever, start vomiting, cannot keep down fluids, or experience severe, persistent pain in your back or side.

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