[46M] With flank pain and urinary changes

Patient Description

A 46-year-old male presents with sudden onset of lower flank pain and stiffness in the back near the kidneys, persisting for three days. The pain worsens with standing or walking. The patient reports changes in urination, including increased frequency, a stronger smell, and the presence of blood. Accompanying symptoms include chills, nausea, and vomiting. The patient has a history of kidney stones and pancreatitis, diagnosed 15 years ago. No current medications are reported, and the patient has allergies to eggs. There has been no recent travel or significant changes in fluid intake.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Kidney Stones: Given your history and symptoms like severe flank pain, blood in urine, and nausea, kidney stones are a likely cause. They can cause intense pain and urinary changes as they move through the urinary tract.

    • Treatment: Often involves pain management, increased fluid intake, and sometimes medical procedures to remove or break down the stones.
  • Urinary Tract Infection (UTI): The frequent urination, chills, and changes in urine smell could indicate a UTI, which can sometimes accompany kidney stones.

    • Treatment: Typically involves antibiotics, so it's important to see a healthcare provider for a proper diagnosis and prescription.
  • Pyelonephritis: This is a kidney infection that can cause similar symptoms, including back pain, chills, and nausea.

    • Treatment: Requires prompt medical attention and antibiotics.

What you can do

  • Stay Hydrated: Drink plenty of water to help flush out your urinary system.
  • Pain Relief: Over-the-counter pain relievers like acetaminophen may help, but consult a healthcare provider first.
  • Seek Medical Attention: It's important to see a doctor for a proper diagnosis and treatment plan, especially given your symptoms and medical history.
  • Use MDandMe: Track your symptoms, any changes, and your fluid intake. This information can be helpful for your healthcare provider.

What you should look out for

  • Seek Immediate Care: If you experience severe pain, high fever, or vomiting that doesn't stop, seek medical attention promptly.
  • Monitor Symptoms: Keep an eye on any worsening symptoms or new developments, such as increased pain or fever.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment.

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3 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, blood in the urine, frequent urination, nausea, vomiting, and sometimes fever or chills.


How can a urinary tract infection be distinguished from other kidney-related issues?

A urinary tract infection often presents with symptoms like frequent urination, a burning sensation during urination, cloudy or strong-smelling urine, and sometimes fever. It can be distinguished from other kidney issues by a urinalysis and urine culture, which can detect bacteria and white blood cells.


What are the potential complications of untreated pyelonephritis?

Untreated pyelonephritis can lead to serious complications such as chronic kidney disease, kidney abscesses, sepsis, and in severe cases, kidney failure. Prompt treatment with antibiotics is crucial.


What lifestyle changes can help prevent kidney stones?

To help prevent kidney stones, it is recommended to stay well-hydrated, reduce salt and protein intake, maintain a healthy weight, and avoid foods high in oxalates if you are prone to certain types of stones. Regular check-ups with a healthcare provider can also help manage risk factors.


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