Hi,

From your description, I believe you are having two related problems but one likely leading to the occurrence of the other (most probably your genital problem leading to a subsequent digestive problem).

The problems could also be very unrelated but occurred coincidentally.

On the one side, you are having affection of the left testis and/or spermatic cord most likely due to infection (Epididymitis) but could also be due to testicular torsion, orchitis, testicular tumor etc.

The other hand you are having a digestive problem, which could be due to irritable bowel syndrome, constipation (with other possible infectious and non-infectious causes) and to a further extend colorectal tumor or fecaloma (smoking history).

Let us discuss your issue separately.

Your genital problem, since an attempted treatment was already started, I will suggest that some few tests be done before engaging in further treatment.

First, tests for STIs have to be done: Chlamydia serology, syphilis serology, gonorrhea, urethral swap, and urine analysis + midstream urine culture and if possible a Doppler ultrasound.

It is possible that you are having a sexually transmitted infection and had to be treated with appropriate antibiotics. Doing a Doppler ultrasound will help rule out other causes like torsion (very unlikely given your age), testicular tumor (given your smoking history, but unlikely given the spongy nature of the palpable mass).

Nonetheless, a good physical exam by a doctor could reveal a lot of signs. Presently you will need anti-inflammatory medication like ibuprofen to kill the pain and alleviate the inflammation (your situation should be treated urgently before an irreversible damage is done) before you can see a doctor.

Depending on the extend and severity of this genital affection, you could develop constipation as a consequence. Use of laxatives/stool softeners, eating XXXXXXX fibers meals and fruits such as pawpaw, drinking much water ( if possible warm) and avoiding milky meals and hard food for now till your stool gets softer will be a good way to start handling your hard dry stool issue before a gastroenterologist intervenes.

Rectal exams would be well indicated here to rule out possible fecaloma (if that is the case, then rectal revision will be done).
PS: Your history of hernia is not related to your present situation.

Hope this helps and if further questions, I am right here.

Thank you
Dr Nsah

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Hi XXXXXXX
Your situation right requires emergency intervention before any irreversible damage occurs to your reproductive organ as you are presenting with a sexually transmitted infection. Specific test as mentioned earlier will be needed in order to determine the exact type of STI involved. A course of antibiotics such as penicillin shots or oral azithromycin + doxycycline regimen and any other antibiotics prescribed by your doctor would be indicated.
You will need to take appropriate antibiotics right away.
Note that we are not allowed to prescribe drugs to you because of medico-legal issues. You will have to see a physician right away even without insurance.
This is transmitted through sexual means and can be prevented in most cases by using a condom during sexual encounters.
Hope this helps and wish you the best
Dr Nsah

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Hi,

Yes you can have urinary tract infection which can manifest the same symptoms. Usually the STD causing germs are N. gonorrhea, Treponema pallidium (syphilis), Chlamydia, T. vaginalis and other viral/fungal germs. For urinary tract infection/orchiepididymitis we can have other germs like E. coli, amoeba, etc What ever the case, analysis to determine which particular germ has to be done and specific treatment given.

Hope this helps
Dr Nsah

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