[65M] Experiencing nocturnal left flank pain

Patient Description

A 65-year-old male reports dull pain located on the left side of the torso, approximately one-third of the way up the flank, that develops at night. The pain has been present for three days and is rated 7 out of 10 in severity. The patient has a history of prostate cancer (treated 13 years ago with no recurrence), shingles, and diverticulitis. Recent health issues include the flu and an upper lung infection treated with two courses of antibiotics, with symptoms clearing about a week and a half ago. The patient is currently experiencing mild constipation, which is atypical for him, despite regular fiber supplementation and recent use of Metamucil. He takes atorvastatin 10mg daily and has consumed two beers over the last week. No recent changes in urinary habits, nausea, vomiting, weight loss, or loss of appetite have been noted. There is no family history of kidney disease or kidney stones, and the patient has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in your side or back, below the ribs. The pain can come in waves and fluctuate in intensity.

    • Treatment: Drinking water can help a stone pass naturally. If the stone is too large, medical procedures or surgery may be needed.
  • Musculoskeletal Pain: This is pain that affects the muscles, ligaments and tendons, along with the bones. The pain can be localized in one area, or widespread. It can be acute or chronic, and can be a result of overuse or injury.

    • Treatment: Rest, physical therapy, pain relievers, and sometimes surgery are treatments.
  • Diverticulitis: This is an inflammation or infection in one or more small pouches in the digestive tract. Your past medical history includes diverticulitis, and it can recur.

    • Treatment: Antibiotics, pain relievers, and a liquid diet can help your colon rest. In severe cases, surgery may be needed.

What you can do

  1. Drink plenty of water: This can help a kidney stone pass and can also help with constipation.
  2. Over-the-counter pain relievers: These can help with pain. However, they should be used sparingly and not for long periods of time.
  3. Rest: If the pain is due to a musculoskeletal issue, rest can help.

What you should look out for

You should seek immediate medical attention if you experience:

  • Severe pain that does not improve with rest or over-the-counter pain relievers
  • Blood in your urine
  • Fever or chills
  • Nausea or vomiting
  • Difficulty passing urine

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. You should consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the side and back, below the ribs, 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 musculoskeletal pain be distinguished from other types of pain?

Musculoskeletal pain is often localized to a specific area and can be associated with movement or physical activity. It may feel like a deep ache or sharp pain and can be accompanied by stiffness or tenderness in the affected area. Unlike visceral pain, it is usually not associated with internal organ issues.


What are the signs that diverticulitis might be recurring?

Signs that diverticulitis might be recurring include abdominal pain, particularly on the lower left side, fever, nausea, a noticeable change in bowel habits such as constipation or diarrhea, and bloating. If these symptoms occur, it is important to consult a healthcare provider.


How can constipation be managed effectively in older adults?

Constipation in older adults can be managed by increasing dietary fiber intake, staying hydrated by drinking plenty of water, engaging in regular physical activity, and using over-the-counter laxatives or stool softeners as recommended by a healthcare provider. It's also important to address any underlying medical conditions that may contribute to constipation.


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