[44M] With dull back pain, bloody stool, and chills

Patient Description

A 44-year-old male presents with dull pain in the left middle side near the back, which started suddenly last Tuesday and has gradually worsened. The pain is exacerbated by standing up and alleviated by laying down. The patient also reports experiencing chills and feeling feverish today, though he works in the heat. Additionally, he noticed blood in his stool once but has not experienced any changes in urination, bowel habits, or blood in his urine. The pain radiates to the groin area. There is no history of recent injuries, heavy lifting, fever, significant weight loss, swelling, or tenderness in the area of pain. The patient denies nausea, vomiting, recent urinary tract infections, or kidney issues. He consumes alcohol occasionally, uses CBD, and is a current tobacco smoker. He has not traveled recently and has no family history of kidney disease or related issues. His diet does not include a lot of high-oxalate foods, and he has no pre-existing medical conditions. He occasionally takes ibuprofen for headaches and has no known medication allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Kidney Stones: Kidney stones can cause severe pain in the back and side, often radiating to the groin. The pain can be dull and worsen with movement. Blood in the stool is not typical, but blood in the urine can occur. Chills and fever can indicate an infection.

    • Treatment: Treatment may include pain relief, increased fluid intake, and in some cases, medical procedures to remove or break up the stones.
  • Kidney Infection (Pyelonephritis): This is a type of urinary tract infection that can cause back pain, fever, chills, and sometimes blood in the urine. It can be serious and requires prompt medical attention.

    • Treatment: Antibiotics are typically required to treat the infection. Pain relief and increased fluid intake are also important.
  • Muscle Strain or Injury: Although you mentioned no recent injuries, muscle strain can sometimes occur without a clear cause. This can lead to dull pain that worsens with movement.

    • Treatment: Rest, over-the-counter pain relievers like ibuprofen, and applying heat or ice to the affected area can help.
  • Diverticulitis: This condition involves inflammation or infection of small pouches in the digestive tract and can cause abdominal pain, fever, and blood in the stool.

    • Treatment: Treatment may include antibiotics, a liquid diet, and in some cases, surgery.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Stay Hydrated: Drink plenty of water to help flush out your kidneys and prevent dehydration.
  2. Rest: Try to rest as much as possible and avoid activities that worsen your pain.
  3. Pain Relief: Over-the-counter pain relievers like ibuprofen can help manage your pain. Be sure to follow the recommended dosage.
  4. Monitor Symptoms: Keep track of your symptoms, including any changes in pain, fever, or the appearance of blood in your stool or urine. Use the MDandMe journal to record your symptoms and track your progress.
  5. Seek Medical Attention: Given the presence of blood in your stool and your other symptoms, it's important to see a healthcare provider as soon as possible for a thorough evaluation.

What you should look out for

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

  • Severe Pain: If your pain becomes unbearable or significantly worsens.
  • High Fever: A fever over 100.4°F that does not improve with over-the-counter medications.
  • Persistent Blood in Stool or Urine: If you continue to notice blood in your stool or urine.
  • Difficulty Urinating: If you have trouble urinating or notice a significant change in your urine output.
  • Severe Abdominal Pain: If you develop severe abdominal pain that does not improve with rest or pain relievers.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment. If you have any further questions or need additional support, feel free to continue the conversation.

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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 pain in the back and side, pain that radiates to the groin, blood in the urine, nausea, vomiting, and sometimes fever and chills.


How can I differentiate between a kidney infection and a muscle strain?

A kidney infection often presents with symptoms like fever, chills, back pain, and sometimes blood in the urine, whereas a muscle strain typically causes localized pain that worsens with movement and does not usually involve fever or chills.


What should I do if I notice blood in my stool?

If you notice blood in your stool, it's important to seek medical attention to determine the cause. It could be due to conditions like diverticulitis or hemorrhoids, but a healthcare provider can provide a proper diagnosis.


Can lifestyle factors like smoking and alcohol consumption affect kidney health?

Yes, smoking and excessive alcohol consumption can negatively impact kidney health. Smoking can reduce blood flow to the kidneys, while excessive alcohol can lead to dehydration and increase the risk of kidney stones.


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