[28F] With frequent urination, lower left side pain, and lightheadedness

Patient Description

A 28-year-old female presents with a frequent urge to urinate, pain on the lower left side, lightheadedness, and slight nausea for the past few days. The frequent urination occurs every few minutes, with minimal output, and started gradually. The patient is currently on her period, making it difficult to observe changes in urine color or smell. She reports no changes in fluid intake or new medications. The pain on the lower left side is described as sharp and achy. She has experienced chills and possible nighttime fever, along with potential diarrhea. The patient recently traveled to Jamaica and may have consumed local water or food. Her medical history includes polycystic ovary syndrome (PCOS), diagnosed two years ago. She is currently taking Spironolactone, half a tablet every night, and has no known drug allergies. Recently, she has taken Advil (big liquid gel capsule) about four times in the past 24 hours and tried Midol twice, with unknown dosages.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Urinary Tract Infection (UTI)

  • Rationale: Frequent urge to urinate with little output, lower abdominal pain, chills, and possible fever are classic signs of a UTI.
  • Typical Treatments: UTIs are usually treated with antibiotics. A urine test can confirm the diagnosis.

Kidney Infection (Pyelonephritis)

  • Rationale: If the infection has spread to your kidneys, it can cause more severe symptoms like sharp pain in the lower back or side, chills, fever, nausea, and vomiting.
  • Typical Treatments: This condition also requires antibiotics, but more severe cases might need hospitalization for intravenous antibiotics.

Gastrointestinal Infection

  • Rationale: Given your recent travel to Jamaica and the possibility of consuming different food or water, a gastrointestinal infection could explain your nausea, diarrhea, and lightheadedness.
  • Typical Treatments: Treatment often involves staying hydrated, rest, and sometimes antibiotics if a bacterial infection is confirmed.

Polycystic Ovary Syndrome (PCOS) Complications

  • Rationale: While PCOS itself might not directly cause these symptoms, it can complicate your overall health and make you more susceptible to other conditions.
  • Typical Treatments: Managing PCOS often involves hormonal treatments and lifestyle changes, but specific symptoms like those you're experiencing would need targeted treatment.

What you can do

Urinary Symptoms and Pain

  • See a doctor as soon as possible: Given the possibility of a UTI or kidney infection, it's important to get a urine test and possibly a blood test to confirm the diagnosis and start appropriate treatment.
  • Stay hydrated: Drink plenty of water to help flush out your urinary system.
  • Avoid irritants: Avoid caffeine, alcohol, and spicy foods, which can irritate your bladder.

Nausea and Diarrhea

  • Stay hydrated: Drink clear fluids like water, broth, or an oral rehydration solution.
  • Eat bland foods: Stick to the BRAT diet (bananas, rice, applesauce, toast) until your stomach settles.
  • Monitor your symptoms: If your diarrhea persists for more than a couple of days or you become severely dehydrated, seek medical attention.

Lightheadedness

  • Rest: Make sure to rest and avoid sudden movements that could make you feel more lightheaded.
  • Monitor your blood pressure: If you have a home blood pressure monitor, check your readings and report any significant changes to your doctor.

General Advice

  • Use MDandMe: Journal your symptoms, track your progress, and share your notes with your healthcare provider for a more comprehensive evaluation.

What you should look out for

Given the severity of some of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • High fever or persistent chills
  • Severe abdominal or back pain
  • Persistent vomiting or inability to keep fluids down
  • Signs of severe dehydration (e.g., very dark urine, dizziness, dry mouth)
  • Blood in your urine or stool

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

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5 mo ago


People Also Ask


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

Common symptoms of a UTI include a frequent urge to urinate, pain or burning sensation during urination, cloudy or strong-smelling urine, and lower abdominal pain. Fever and chills may also occur if the infection spreads to the kidneys.


How can recent travel affect gastrointestinal health?

Recent travel can expose individuals to different bacteria and viruses, especially if consuming local food or water, leading to gastrointestinal infections. Symptoms may include nausea, diarrhea, vomiting, and abdominal pain.


What are the potential side effects of taking Spironolactone?

Spironolactone can cause side effects such as dizziness, headache, stomach upset, and increased urination. It may also affect electrolyte balance, leading to high potassium levels, which can be serious.


How can PCOS affect overall health and susceptibility to other conditions?

PCOS can lead to hormonal imbalances, which may increase the risk of developing other health issues such as insulin resistance, type 2 diabetes, and cardiovascular problems. It can also affect menstrual cycles and fertility.


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