[25M] With dull cramping kidney pain and proteinuria

Patient Description

A 25-year-old male presents with dull cramping pain in the left rib cage and back area, persisting for five days, predominantly occurring at night when lying down. The patient reports persistent fatigue and increased urinary frequency at night, with urinalysis indicating proteinuria for approximately one year. Occasional leg or foot swelling, moderate nausea, slight loss of appetite, and abdominal bloating with rib area pain are noted. The patient has a history of rectal prolapse, treated with three surgeries, including two robotic rectopexies and one open rectopexy with resection, first diagnosed in 2020. Current medications include Adderall XR 40mg daily and Buprenorphine 1mg daily, along with vitamins. The patient has an allergy to IV contrast, no known family history of kidney disease, and no recent travel or recreational drug use.

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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 for what you might be experiencing:

  1. Kidney Issues: The dull cramping pain in your left rib cage and back area, along with protein in your urine, could suggest a kidney-related issue. Conditions such as kidney stones, infections, or other kidney diseases might cause these symptoms. Protein in the urine, known as proteinuria, can be a sign of kidney damage or disease.

  2. Musculoskeletal Pain: The pain in your rib cage and back could also be related to musculoskeletal issues, especially if it's aggravated by certain positions, like lying down. This could be due to muscle strain or other structural issues in the back or rib area.

  3. Post-Surgical Changes: Given your history of abdominal surgeries, it's possible that some of your symptoms, like abdominal bloating and pain, could be related to post-surgical changes or adhesions.

  4. Chronic Fatigue: Your fatigue could be related to several factors, including your current medications, underlying medical conditions, or even stress and lifestyle factors.

What you can do

  1. Consult a Healthcare Provider: It's important to discuss these symptoms with a healthcare provider who can perform a thorough evaluation, including physical examination and possibly imaging or lab tests, to determine the cause of your symptoms.

  2. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share your medical notes with your healthcare provider. This can help in identifying patterns or triggers for your symptoms.

  3. Stay Hydrated: Ensure you're drinking enough water throughout the day, as staying hydrated is important for kidney health.

  4. Monitor Your Symptoms: Keep an eye on any changes in your symptoms, such as increased pain, changes in urine output, or new symptoms.

What you should look out for

  • Seek Immediate Medical Attention: If you experience severe pain, blood in your urine, fever, or any other concerning symptoms, seek medical attention promptly.

  • Monitor for Swelling: If you notice persistent or worsening swelling in your legs or feet, it's important to inform your healthcare provider.

  • Changes in Urination: Any significant changes in your urinary habits, such as decreased urine output or dark-colored urine, should be reported to your healthcare provider.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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1 mo ago


People Also Ask


What could be causing the dull cramping pain in the left rib cage and back area?

The dull cramping pain in the left rib cage and back area could be due to kidney-related issues such as kidney stones or infections, musculoskeletal problems like muscle strain, or post-surgical changes from previous abdominal surgeries.


What does proteinuria indicate and why is it important?

Proteinuria, or protein in the urine, can indicate kidney damage or disease. It is important because it may suggest underlying kidney issues that need to be addressed to prevent further damage.


How can past surgeries affect current abdominal symptoms?

Past surgeries, especially abdominal ones, can lead to post-surgical changes such as adhesions or scar tissue, which might cause symptoms like abdominal bloating and pain.


What are some potential causes of persistent fatigue?

Persistent fatigue can be caused by various factors including medication side effects, underlying medical conditions, stress, lifestyle factors, or a combination of these.


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