[35F] With blood in urine, nausea, and abdominal discomfort

Patient Description

A 35-year-old female presents with blood in urine noticed approximately 10 hours ago, accompanied by nausea for the past 5 hours and sharp, crampy abdominal discomfort located below the belly button, just above the bikini line, which started suddenly 2 hours ago. The patient also reports experiencing heartburn since last night, with a burning sensation in the throat rated as 8 out of 10 at its worst, despite taking 6 chewable Tums. No specific foods have been identified as triggers for the heartburn. The patient denies any fever, chills, vomiting, increased frequency or urgency of urination, recent changes in diet, recent travel, new medications or supplements, or changes in the menstrual cycle. Past medical history includes high blood pressure diagnosed 13 years ago, hypothyroidism, and vitamin D deficiency diagnosed 4 years ago. The patient has a history of kidney stones and urinary tract infections but has not experienced any back pain or pain radiating to the sides or groin. Current medications include Vitamin D3, Vitamin C, Iron, Women's One A Day Vitamin, Hydrochlorothiazide, Xanax, Lamictal, Buspirone HCL, Pristiq, Levothyroxine sodium, Amlodipine besylate, Adderall, Melatonin, Doxepin, Topamax, Zyrtec, Singulair, and Acyclovir. No known drug allergies.

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Arora's Assessment

What might be happening

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

Blood in Urine, Nausea, and Abdominal Pain

  1. Kidney Stones: Given your history of kidney stones, the presence of blood in your urine, nausea, and abdominal pain could indicate a recurrence. Kidney stones can cause sharp, crampy pain and may lead to blood in the urine.
  2. Urinary Tract Infection (UTI): UTIs can also cause blood in the urine, abdominal pain, and nausea. Although you haven't experienced increased frequency or urgency of urination, UTIs can present in various ways.

Heartburn

  1. Gastroesophageal Reflux Disease (GERD): Your heartburn and burning sensation in your throat could be due to GERD, a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Unifying Diagnosis

  1. Kidney Stones with Secondary GERD: It's possible that the stress and discomfort from kidney stones could be exacerbating or triggering GERD symptoms, leading to heartburn.

What you can do

Blood in Urine, Nausea, and Abdominal Pain

  • Seek Medical Attention: Given the presence of blood in your urine and your history of kidney stones, it's important to see a healthcare provider as soon as possible. They may perform imaging tests like an ultrasound or CT scan to check for kidney stones and a urinalysis to look for signs of infection.
  • Stay Hydrated: Drink plenty of water to help flush out your urinary system. This can help with both kidney stones and UTIs.
  • Pain Management: Over-the-counter pain relievers like ibuprofen can help manage pain, but consult your doctor before taking any medication, especially given your existing conditions and medications.

Heartburn

  • Dietary Changes: Avoid foods and drinks that can trigger heartburn, such as spicy foods, caffeine, alcohol, and fatty foods.
  • Elevate Your Head: When sleeping, elevate the head of your bed to prevent acid from flowing back into your esophagus.
  • Over-the-Counter Antacids: Continue using antacids like Tums, but be cautious not to exceed the recommended dosage. If symptoms persist, consult your healthcare provider for stronger medications.

General Advice

  • Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and get insights. This can be helpful for your healthcare provider to understand your condition better.
  • Consult Your Doctor: Given the complexity of your symptoms and your medical history, it's crucial to consult a healthcare provider for a formal diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe or worsening abdominal pain
  • High fever or chills
  • Vomiting that doesn't stop
  • Difficulty urinating or severe pain during urination
  • Fainting or severe dizziness

Remember, while I can provide information and suggestions, I am not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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4 mo ago


People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe, sharp pain in the back or side, blood in the urine, nausea, vomiting, and sometimes fever and chills if an infection is present.


How can I differentiate between a urinary tract infection and kidney stones?

While both conditions can cause abdominal pain and blood in the urine, kidney stones often cause severe, sharp pain that may radiate to the groin, whereas UTIs typically cause a burning sensation during urination and increased frequency or urgency to urinate.


What lifestyle changes can help manage or prevent heartburn?

To manage or prevent heartburn, avoid trigger foods such as spicy or fatty foods, caffeine, and alcohol. Eating smaller meals, not lying down immediately after eating, and elevating the head of your bed can also help. Maintaining a healthy weight and avoiding smoking are beneficial as well.


When should I seek medical attention for blood in my urine?

You should seek medical attention for blood in your urine if it is accompanied by severe pain, fever, chills, or if it persists. Immediate attention is necessary if you experience difficulty urinating or severe pain during urination.


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