[43F] With persistent abdominal and back pain

What might be happening

Based on the symptoms you've described, several potential conditions could be causing your pain:

1. Kidney Infection (Pyelonephritis):

   • Rationale: Lower back pain, especially if it's tender and swollen, along with cloudy urine, can suggest a kidney infection. Nausea and vomiting are also common symptoms.
   • Typical Testing: Urinalysis, urine culture, and possibly imaging studies like an ultrasound or CT scan.
   • Treatment: Antibiotics are typically prescribed to treat the infection. Pain management and hydration are also important.

2. Gallbladder Issues (Cholecystitis or Gallstones):

   • Rationale: Pain under the rib cage on the left side, especially if it worsens with pressure, could be related to gallbladder issues. Nausea and vomiting bile are also common symptoms.
   • Typical Testing: Ultrasound of the abdomen, liver function tests, and possibly a HIDA scan.
   • Treatment: Treatment may include dietary changes, medications to dissolve gallstones, or surgery to remove the gallbladder.

3. Gastrointestinal Issues (Gastritis or Peptic Ulcer Disease):

   • Rationale: Persistent pressure pain under the rib cage, especially if it worsens with pressure, could be related to inflammation of the stomach lining or an ulcer.
   • Typical Testing: Endoscopy, blood tests for H. pylori, and possibly imaging studies.
   • Treatment: Medications to reduce stomach acid, antibiotics if H. pylori is present, and dietary changes.

4. Musculoskeletal Issues:

   • Rationale: Pain that worsens with movement like walking or bending could be related to muscle strain or other musculoskeletal issues.
   • Typical Testing: Physical examination and possibly imaging studies like X-rays or MRI.
   • Treatment: Rest, physical therapy, pain relievers, and anti-inflammatory medications.

What you can do

While waiting to see a healthcare professional, you can try the following to help manage your symptoms:

1. Stay Hydrated: Drink plenty of water to help flush out any potential infection and stay hydrated.
2. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain. However, avoid taking them on an empty stomach if you suspect a gastrointestinal issue.
3. Dietary Changes: Avoid fatty, spicy, or acidic foods that could exacerbate gallbladder or gastrointestinal issues.
4. Rest: Try to rest and avoid activities that worsen your pain, such as heavy lifting or strenuous exercise.

What you should look out for

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

• Fever or Chills: These could indicate an infection that requires immediate treatment.
• Severe Abdominal Pain: If the pain becomes unbearable or significantly worsens.
• Blood in Urine or Stool: This could indicate a more serious underlying condition.
• Inability to Keep Fluids Down: Persistent vomiting can lead to dehydration and requires medical attention.
• Yellowing of the Skin or Eyes (Jaundice): This could indicate a liver or gallbladder issue.

Important Note

Please remember that this information is not a substitute for professional medical advice. It's important to consult a healthcare provider for a formal diagnosis and appropriate treatment. If your symptoms worsen or you have any concerns, seek medical attention immediately.