[20F] With urinary discomfort and left lung pain

Patient Description

A 20-year-old female presents with discomfort while urinating and constant pain under the left lung, described as a burning sensation. The urinary discomfort has been ongoing for about three weeks, rated as a 4 out of 10 in severity, and came on gradually. The patient reports an unusual odor in the urine but denies increased frequency, urgency, blood in the urine, or fever. The patient also experiences sharp pains in the uterus, pelvic pain, and lower back pain. Symptoms worsen after consuming caffeinated beverages, which the patient has tried reducing without significant improvement. The patient has an IUD and has not had a period in a couple of months. She was diagnosed with polycystic ovarian syndrome (PCOS) in May 2023. Current medications include a daily allergy medicine and probiotics, and a muscle relaxer and prenatal vitamin taken every other day. The allergy medicine is for allergies to cats and dogs. No known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations:

Discomfort While Urinating and Cloudy Urine

  • Urinary Tract Infection (UTI): Even though your doctor tested for a UTI and the results were negative, it's still possible to have a low-grade infection or another type of urinary issue. UTIs can cause discomfort while urinating, cloudy urine, and an unusual odor.
  • Interstitial Cystitis: This is a chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. It can mimic UTI symptoms but doesn't show up on standard tests.
  • Dehydration: Drinking only 2-3 bottles of water a day might not be enough, especially if you're consuming caffeinated beverages, which can be dehydrating.

Pain Under the Left Lung

  • Gastroesophageal Reflux Disease (GERD): The burning sensation under your left lung could be due to acid reflux, where stomach acid irritates the lining of your esophagus.
  • Costochondritis: This is inflammation of the cartilage that connects a rib to the breastbone, causing sharp pain in the chest that can be mistaken for lung pain.
  • Musculoskeletal Pain: Given your history of muscle tension and the use of muscle relaxers, this pain could be related to muscle strain or tension.

Sharp Pains in the Uterus

  • Polycystic Ovarian Syndrome (PCOS): Sharp pains in the uterus could be related to ovarian cysts, which are common in PCOS.
  • Endometriosis: This condition involves tissue similar to the lining inside the uterus growing outside it, causing pain.

What you can do

Discomfort While Urinating and Cloudy Urine

  • Hydrate: Increase your water intake to help flush out your urinary system.
  • Avoid Irritants: Reduce or eliminate caffeine and acidic foods, which can irritate the bladder.
  • Consult Your Doctor: Since your symptoms persist, consider asking for further tests, such as a urine culture or a referral to a urologist.

Pain Under the Left Lung

  • Monitor Your Diet: Avoid foods that trigger acid reflux, such as spicy or fatty foods.
  • Over-the-Counter Medications: Antacids or acid reducers can help if GERD is suspected.
  • Consult Your Doctor: If the pain persists, seek medical advice to rule out other conditions.

Sharp Pains in the Uterus

  • Pain Management: Over-the-counter pain relievers like ibuprofen can help manage pain.
  • Consult Your Gynecologist: Given your history of PCOS, it's important to discuss these symptoms with your gynecologist for further evaluation and management.

What you should look out for

Given the complexity of your symptoms, it's important to seek medical care if you experience any of the following:

  • Severe Pain: If any of your pains become severe or debilitating.
  • Fever: A fever could indicate an infection that needs immediate attention.
  • Blood in Urine: This could be a sign of a more serious urinary issue.
  • Shortness of Breath: Especially if the pain under your left lung worsens.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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3 mo ago


People Also Ask


What could cause discomfort while urinating if a UTI test is negative?

Discomfort while urinating with a negative UTI test could be due to interstitial cystitis, dehydration, or other urinary issues. It's important to consult a healthcare provider for further evaluation.


How can I manage pain under the left lung that feels like a burning sensation?

Pain under the left lung that feels like a burning sensation could be due to gastroesophageal reflux disease (GERD), costochondritis, or musculoskeletal pain. Managing diet, using over-the-counter medications, and consulting a doctor can help address these symptoms.


What are the possible causes of sharp pains in the uterus for someone with PCOS?

Sharp pains in the uterus for someone with PCOS could be related to ovarian cysts or conditions like endometriosis. It's important to discuss these symptoms with a gynecologist for proper evaluation and management.


How does caffeine affect urinary and pelvic symptoms?

Caffeine can irritate the bladder and exacerbate urinary and pelvic symptoms. Reducing or eliminating caffeine intake may help alleviate these symptoms, but if they persist, further medical evaluation is recommended.


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