[46M] With sharp back pain, fever, and bloody stools

Patient Description

A 46-year-old male presents with sharp, steady pain in the back and lower left under the ribs, worsening with movement, particularly bending down. Lying on the back is the least painful position. The pain began yesterday morning and has increased in severity. Accompanying symptoms include fever for a few hours over the past two nights, frequent clamminess over the last two days, and dark, warmer urine with decreased frequency. The patient reports bright red blood in the stool with every bowel movement for a few weeks, persistent tiredness, nausea yesterday, and weight loss due to reduced appetite despite feeling hungry. There is swelling around the lower left ribs and feet. Medical history includes aortic coarctation repair at age 9, high blood pressure for 10-15 years, and bacterial meningitis as a child. No recent infections or doctor visits due to lack of insurance. Medications taken include ibuprofen (400mg yesterday) and Pepto-Bismol (one dose yesterday evening). No known allergies or regular medications.

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Arora's Assessment

What might be happening

Your symptoms could be related to several potential issues:

  1. Kidney or Urinary Tract Issues: The pain under your ribs, changes in urine color, and fever might suggest a kidney infection or stones. These conditions can cause sharp pain and fever.

  2. Gastrointestinal Bleeding: The presence of bright red blood in your stool could indicate bleeding in the lower gastrointestinal tract, possibly from hemorrhoids or another source. This needs evaluation, especially with ongoing symptoms.

  3. Heart-Related Concerns: Given your history of heart problems and high blood pressure, the fatigue, shortness of breath, and swelling could be related to heart function. It's important to rule out any cardiac issues.

  4. Infection or Inflammation: The fever and clamminess might indicate an infection or inflammatory process in your body.

Typical treatments or tests might include blood tests, urine analysis, imaging like an ultrasound or CT scan, and possibly a colonoscopy to investigate the source of bleeding.

What you can do

Pain and Fever:

  • Consider seeking medical attention promptly, especially if the pain worsens or fever persists.
  • Stay hydrated and rest as much as possible.

Blood in Stool:

  • It's important to have this evaluated by a healthcare provider. They may recommend a stool test or further investigation.

Fatigue and Shortness of Breath:

  • Monitor your symptoms closely. If they worsen, especially with chest pain, seek emergency care.

General Tips:

  • Keep a journal of your symptoms using MDandMe to track any changes and share with your provider.
  • Avoid heavy lifting or activities that worsen your pain.

What you should look out for

Seek immediate medical care if you experience:

  • Severe or worsening pain
  • High fever or chills
  • Increased shortness of breath or chest pain
  • Significant changes in urine output or color

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask

What could cause sharp pain under the ribs and changes in urine color?

Sharp pain under the ribs and changes in urine color could be indicative of kidney issues, such as a kidney infection or kidney stones. These conditions can cause sharp pain, fever, and changes in urine appearance.

What are the possible reasons for bright red blood in the stool?

Bright red blood in the stool often suggests bleeding in the lower gastrointestinal tract, which could be due to hemorrhoids, anal fissures, or other conditions. It is important to have this evaluated by a healthcare provider.

How can high blood pressure and a history of heart problems affect current symptoms?

High blood pressure and a history of heart problems can contribute to symptoms like fatigue, shortness of breath, and swelling. These could be signs of heart-related issues, and it is important to monitor these symptoms closely and seek medical evaluation.

What should be done if experiencing fever and clamminess along with other symptoms?

If experiencing fever and clamminess along with other symptoms, it may indicate an infection or inflammatory process. It is important to seek medical attention, especially if the fever persists or other symptoms worsen.

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