[22F] Experiencing lower abdominal pain, bloating, and frequent urination

Patient Description

A 22-year-old female presents with lower abdominal pain described as pressure with intermittent sharp pains, bloating, and frequent urination for approximately three weeks. The abdominal pain is rated 7/10 in severity and is sometimes relieved by pain medication. The patient has been prescribed Nitrofurantoin mono 100 mg twice daily starting Wednesday, following a week-long course of Ciprofloxacin 500 mg twice daily. Despite antibiotics, symptoms have persisted, including pain during and after intercourse. The patient has a history of UTI and microscopic hematuria but no STDs, abnormal discharge, or visible blood in urine. No significant past medical history, known drug allergies, or use of recreational drugs, alcohol, or tobacco. No other medications reported except for occasional pain relief for headaches.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possible conditions that could be causing your discomfort:

  • Urinary Tract Infection (UTI): You've mentioned that you were diagnosed with a UTI and had blood in your urine. UTIs can cause lower abdominal pain, frequent urination, and discomfort. However, you've been on antibiotics, and these symptoms should have improved if a UTI was the only issue.

    • Treatment for UTIs typically involves antibiotics, which you've been taking. It's important to complete the full course of antibiotics even if symptoms improve to ensure the infection is fully cleared.
  • Interstitial Cystitis: This is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain. The condition is a part of a spectrum of diseases known as painful bladder syndrome.

    • Treatment for interstitial cystitis can involve medications, physical therapy, and sometimes surgery.
  • Endometriosis: This is a condition where tissue similar to the lining inside the uterus (called the endometrium), is found outside the uterus, where it induces a chronic inflammatory reaction that may result in scar tissue. It can cause symptoms like pelvic pain, painful periods, and pain during or after sex.

    • Treatment for endometriosis can involve pain relievers, hormone therapy, and sometimes surgery.
  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs. It can cause lower abdominal pain, pain during intercourse, and frequent urination.

    • Treatment for PID typically involves antibiotics.
  • Ovarian Cysts: These are fluid-filled sacs or pockets in an ovary or on its surface. Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless.

    • Treatment for ovarian cysts can involve monitoring, birth control pills, or surgery.

Please note that these are possibilities based on the symptoms you've described, and it's important to see a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed antibiotics as directed by your healthcare provider.
  2. Over-the-counter pain relievers can help with the discomfort. Always follow the package instructions.
  3. A heating pad or hot water bottle applied to your lower abdomen may also help with the pain.
  4. Stay hydrated and avoid caffeine, alcohol, and spicy foods, which can irritate your bladder.
  5. Keep track of your symptoms and any triggers, which can be helpful information for your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • Fever or chills
  • Nausea or vomiting
  • Difficulty urinating or extremely frequent urination
  • Abnormal vaginal discharge or bleeding

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


What could be causing persistent lower abdominal pain despite antibiotic treatment for a UTI?

Persistent lower abdominal pain despite antibiotic treatment for a UTI could be due to other conditions such as interstitial cystitis, endometriosis, or pelvic inflammatory disease. It's important to consult with a healthcare provider for further evaluation and diagnosis.


What are the symptoms and treatment options for interstitial cystitis?

Interstitial cystitis is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. Treatment options include medications, physical therapy, dietary changes, and in some cases, surgery. It's important to work with a healthcare provider to determine the best treatment plan.


How can endometriosis affect abdominal pain and what are the treatment options?

Endometriosis can cause symptoms like pelvic pain, painful periods, and pain during or after sex. Treatment options include pain relievers, hormone therapy, and sometimes surgery. Consulting with a healthcare provider can help determine the most appropriate treatment based on individual symptoms and needs.


What should I do if I suspect I have an ovarian cyst?

If you suspect you have an ovarian cyst, it's important to consult with a healthcare provider. They may recommend monitoring the cyst, using birth control pills to prevent new cysts, or surgery if the cyst is large or causing significant symptoms. Regular follow-up is important to manage the condition effectively.


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2 Comments


Leo#3962

9 mo ago

Sounds consistent with a UTI. But if you've finished this course of antibiotics and symptoms are still occurring, your doctor should consider culturing any bacteria that may be present in your urine and analyzing the antibiotic resistance profile

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Tate McEwan#4033

9 mo ago

Be cautious if your doctor prescribes additional antibiotics without running any tests, as you don't want to end up with a antibiotic-resistant bug. Consider seeing a different primary care doc or OB-GYN as this might not be a UTI at all

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