[29F] With severe lower abdominal cramping, blood in urine, and nausea

Patient Description

A 29-year-old female has been experiencing severe lower abdominal cramping for the past two days, which she rates as a 7 out of 10 in severity. She has not found any relief for the cramping. Additionally, she noticed a large amount of blood in her urine starting just now. She also reports nausea but denies fever or back pain. There is no painful urination, but she has observed unusual vaginal discharge that is dark brown or bloody. She also experiences pelvic pain. The patient has a history of urinary tract infections (UTIs) and was recently treated with antibiotics for a UTI about a month ago. She has completed the full course of antibiotics. There is no recent travel history, and she does not have any pre-existing conditions or chronic illnesses. She is not currently taking any over-the-counter medications, supplements, or topical medications.

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Arora's Assessment

What might be happening

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

  1. Urinary Tract Infection (UTI): Given your history of UTIs and the presence of blood in your urine, it's possible that you have another UTI. UTIs can cause lower abdominal cramping, blood in the urine, and changes in urination frequency or urgency. Nausea can also be a symptom.

  2. Kidney Stones: These can cause severe lower abdominal or pelvic pain, blood in the urine, and nausea. The pain is often described as sharp and may come in waves.

  3. Gynecological Issues: Conditions such as endometriosis, ovarian cysts, or pelvic inflammatory disease (PID) can cause lower abdominal cramping, unusual vaginal discharge, and pelvic pain. Blood in the urine is less common but can occur if there is significant inflammation or infection.

  4. Gastrointestinal Issues: While less likely given your symptoms, gastrointestinal issues such as severe constipation or irritable bowel syndrome (IBS) can cause lower abdominal cramping and nausea.

What you can do

For Lower Abdominal Cramping and Blood in Urine:

  • Seek Medical Attention: Given the severity of your symptoms and the presence of blood in your urine, it's important to see a healthcare provider as soon as possible. They may perform a urinalysis, blood tests, or imaging studies to determine the cause.
  • 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.
  • Pain Relief: Over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol) can help manage pain, but consult your doctor before taking any medication.

For Nausea:

  • Eat Small, Frequent Meals: Eating smaller, more frequent meals can help manage nausea.
  • Ginger: Ginger tea or ginger supplements can help alleviate nausea.
  • Stay Hydrated: Sip on clear fluids like water, broth, or herbal tea.

For Unusual Vaginal Discharge:

  • Consult Your Doctor: Unusual vaginal discharge, especially if it's dark brown or bloody, should be evaluated by a healthcare provider to rule out infections or other gynecological issues.

General Tips:

  • Track Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.
  • Rest: Ensure you get plenty of rest to help your body recover.

What you should look out for

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

  • Severe Pain: If your pain becomes unbearable or is accompanied by fever, chills, or vomiting.
  • Increased Blood in Urine: If you notice an increase in the amount of blood in your urine.
  • Difficulty Urinating: If you experience difficulty urinating or a complete inability to urinate.
  • Fainting or Dizziness: If you feel faint or dizzy, especially if it is severe or persistent.

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to ask.

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4 mo ago


People Also Ask


What could cause blood in urine and severe lower abdominal cramping?

Blood in urine and severe lower abdominal cramping can be caused by conditions such as urinary tract infections, kidney stones, or gynecological issues like endometriosis or pelvic inflammatory disease. It's important to seek medical attention to determine the exact cause.


Can a urinary tract infection cause nausea and pelvic pain?

Yes, a urinary tract infection can cause nausea and pelvic pain. These symptoms occur due to the body's response to the infection and inflammation in the urinary tract.


What are the possible reasons for unusual vaginal discharge?

Unusual vaginal discharge can be due to infections, hormonal changes, or gynecological conditions such as pelvic inflammatory disease or endometriosis. It's important to consult a healthcare provider for an accurate diagnosis.


How can I manage nausea and abdominal pain at home?

To manage nausea and abdominal pain at home, you can try eating small, frequent meals, drinking ginger tea, staying hydrated, and using over-the-counter pain relievers like ibuprofen or acetaminophen, but consult your doctor before taking any medication.

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