[38F] Experiencing flank pain, indigestion, and recent irregular menstrual cycle

Patient Description

A 38-year-old female presents with a history of intermittent sharp flank pain on the left side under the rib cage, exacerbated by touch and lying on the affected side, with a pain severity of 4/10. The pain has been present for about a year and is relieved by heat application. She also reports chronic indigestion for approximately 4 years, with a severity of 5/10, triggered by certain foods such as eggs, dairy, and peanut butter, and persisting throughout the day. Recently, she experienced an irregular menstrual cycle that was 14 days late and heavier than usual, followed by 4 days of spotting, which was more than just a few drops at times. This was the first occurrence of irregular menstruation and spotting. Additionally, she has been experiencing vaginal dryness with some discharge for the past two days, which she describes as slightly uncomfortable and a new symptom for her. Her medical history includes anxiety and depression diagnosed 15 years ago, indigestion diagnosed 10 years ago, and being overweight since January 2015. She is not currently on any medications and has no known allergies. There is no history of recent injuries, fever, chills, nausea, vomiting, changes in urine color, or significant weight changes. She denies the use of tobacco, recreational drugs, and alcohol consumption.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Kidney Stones: Your left-sided flank pain could be due to a kidney stone. These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain when they move through the urinary tract.

    • Treatment typically involves pain relievers and drinking lots of water to help pass the stone. In some cases, a procedure may be needed to remove or break up larger stones.

  • Gastroesophageal Reflux Disease (GERD): This is a chronic 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 and cause indigestion.

    • Treatment usually involves lifestyle changes and over-the-counter medications. If these don't help, your doctor may recommend prescription medications or surgery.

  • Premenstrual Syndrome (PMS) or Hormonal Imbalance: Your irregular periods, spotting, and vaginal dryness could be due to hormonal changes in your body. These can occur naturally as you age or due to conditions like polycystic ovary syndrome (PCOS).

    • Treatment often involves hormonal medications like birth control pills to regulate your menstrual cycle.

What you can do

While you should definitely see a healthcare provider for a formal diagnosis and treatment, here are some things you can do in the meantime:

  1. Drink plenty of water to help pass a potential kidney stone and ease your indigestion.
  2. Avoid foods that trigger your indigestion.
  3. Apply a warm compress to your flank to help manage the pain.
  4. Keep a menstrual diary to track any changes in your cycle, which can help your doctor diagnose potential hormonal issues.

What you should look out for

You should seek immediate medical attention if you experience:

  • Severe pain in your back or side that won't go away
  • Blood in your urine
  • Fever and chills
  • Vomiting
  • White, pink, or brown urine
  • Frequent urination
  • Painful urination

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago

People Also Ask

What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the back or side, pain that radiates to the lower abdomen and groin, pain that comes in waves and fluctuates in intensity, painful urination, pink, red, or brown urine, nausea and vomiting, and frequent urination.

How can I manage chronic indigestion or GERD at home?

To manage chronic indigestion or GERD at home, you can try eating smaller meals, avoiding trigger foods (such as spicy or fatty foods), not lying down immediately after eating, elevating the head of your bed, and using over-the-counter antacids or medications. It's also helpful to maintain a healthy weight and avoid smoking.

What could cause irregular menstrual cycles and spotting?

Irregular menstrual cycles and spotting can be caused by hormonal imbalances, stress, significant weight changes, polycystic ovary syndrome (PCOS), thyroid issues, or perimenopause. It's important to consult a healthcare provider for a proper diagnosis.

What are some potential causes of vaginal dryness?

Vaginal dryness can be caused by hormonal changes, particularly a decrease in estrogen levels, which can occur during menopause, breastfeeding, or as a side effect of certain medications. Other causes include stress, lack of arousal during intercourse, and certain medical conditions. It's advisable to discuss symptoms with a healthcare provider for appropriate management.

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