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Suggest Treatment For Chronic UTI
Question: I have been having several symptoms lately which I feel may be related to endometriosis, ovarian issues or perhaps gut/bowel issues and would like further insight into what you think this may be and what sort of specialist treatment/tests I should seek out?
I have always experienced painful period pain on the first 2 days of my period but now have symptoms which have started to appear regularly throughout the month even when I'm not ovulating and not on my period. This includes a dull aching pain through my pelvis, a slight pain or throbbing around my right ovary which comes and goes, a feeling of heaviness/slight pain around my bowel area/lower back, very very slight spots of blood in my stool occasionally. When I have my period for the first couple of days I do also feel a particular heaviness/pain in my bowel area just before needing to go to the bathroom or when passing wind.
I also have random occasional IBS type symptoms where for no particular reason after a meal I'll suddenly get cramps in my stomach followed by a short bout of diarrhoea where I'm running to the bathroom for a couple of hours before returning to feeling fine again. This happens even when I don't have my period although happens very very occasionally (perhaps once a month)
I have always experienced painful period pain on the first 2 days of my period but now have symptoms which have started to appear regularly throughout the month even when I'm not ovulating and not on my period. This includes a dull aching pain through my pelvis, a slight pain or throbbing around my right ovary which comes and goes, a feeling of heaviness/slight pain around my bowel area/lower back, very very slight spots of blood in my stool occasionally. When I have my period for the first couple of days I do also feel a particular heaviness/pain in my bowel area just before needing to go to the bathroom or when passing wind.
I also have random occasional IBS type symptoms where for no particular reason after a meal I'll suddenly get cramps in my stomach followed by a short bout of diarrhoea where I'm running to the bathroom for a couple of hours before returning to feeling fine again. This happens even when I don't have my period although happens very very occasionally (perhaps once a month)
Brief Answer:
PID/IBS/CHRONIC UTI
Detailed Answer:
Hello,
Thanks for the query to HCM for an opinion,
I understand that pain during the initial 2 days of your menstruation which you have always had is infact common for most of the women and it usually subsides on the 3rd day onwards when the flow and uterine contractions decrease. On the other hand the concern can be because of a dull aching pain in the right iliac fossa region and throughout the pelvis across the month indicates a possibility of a pelvic inflammatory disease or a CHRONIC UTI.
You should ideally get a urine culture and pelvic ultrasound done with a per vaginal exam by your gynecologist who would be able to clearly differentiate between PID or any organic cause like an ovarian or an endometriotic cyst.
Endometriosis can be possibility in form of adenomyosis of uterus and hence an ultrasound pelvis would be able to detect that.
The blood in stools and diarrhoea after meals do indicate an IBS and one needs to get a colonoscopy done for it if the bleeding is heavy. It can be the other possible cause of mild discomfort through out the month in the lower abdomen.
So please get a gynecologist and gastroenterologist appointment done, you may get back to me with the investigations.
Regards
PID/IBS/CHRONIC UTI
Detailed Answer:
Hello,
Thanks for the query to HCM for an opinion,
I understand that pain during the initial 2 days of your menstruation which you have always had is infact common for most of the women and it usually subsides on the 3rd day onwards when the flow and uterine contractions decrease. On the other hand the concern can be because of a dull aching pain in the right iliac fossa region and throughout the pelvis across the month indicates a possibility of a pelvic inflammatory disease or a CHRONIC UTI.
You should ideally get a urine culture and pelvic ultrasound done with a per vaginal exam by your gynecologist who would be able to clearly differentiate between PID or any organic cause like an ovarian or an endometriotic cyst.
Endometriosis can be possibility in form of adenomyosis of uterus and hence an ultrasound pelvis would be able to detect that.
The blood in stools and diarrhoea after meals do indicate an IBS and one needs to get a colonoscopy done for it if the bleeding is heavy. It can be the other possible cause of mild discomfort through out the month in the lower abdomen.
So please get a gynecologist and gastroenterologist appointment done, you may get back to me with the investigations.
Regards
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hi Dr XXXXXXX
Now that you mention chronic UTI. I failed to mention that I do also have a mild case of Interstitial Cystitis (non-bacterial inflammation of the bladder) which I have had for the past 2 years now. Is it possible that this is causing some of the symptoms?
I'm concerned that symptoms could possibly be ovarian cancer or bowel cancer. Do you feel this is something I should get tested for?
Now that you mention chronic UTI. I failed to mention that I do also have a mild case of Interstitial Cystitis (non-bacterial inflammation of the bladder) which I have had for the past 2 years now. Is it possible that this is causing some of the symptoms?
I'm concerned that symptoms could possibly be ovarian cancer or bowel cancer. Do you feel this is something I should get tested for?
Brief Answer:
chronic uti is a possibility + IBS
Detailed Answer:
Hello,
YES , there is a possibility that all these symptoms except the blood in stools in likely to be due to chronic UTI itself but a cancer be it ovarian or bowel seems unlikely to not have progressed to a higher stage in last 2 years and without any weight loss per se. However it is imperative that you should get a urine culture and a pelvic ultrasound done ( which shall rule out any adenomyosis, endometriosis , or any adnexal masses per se).
A colonoscopy may be ordered after discussion with a gastroenterologist for a possible likelihood of IBS accompanied as a secondary cause.
Regards
chronic uti is a possibility + IBS
Detailed Answer:
Hello,
YES , there is a possibility that all these symptoms except the blood in stools in likely to be due to chronic UTI itself but a cancer be it ovarian or bowel seems unlikely to not have progressed to a higher stage in last 2 years and without any weight loss per se. However it is imperative that you should get a urine culture and a pelvic ultrasound done ( which shall rule out any adenomyosis, endometriosis , or any adnexal masses per se).
A colonoscopy may be ordered after discussion with a gastroenterologist for a possible likelihood of IBS accompanied as a secondary cause.
Regards
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hi Dr XXXXXXX
I went to a GP who did an internal pelvic examination. She seemed to think everything looked and felt fine. She also took some swabs to check for infection and they have come back normal.
She has suggested that it is possible that the abdominal pain is actually being caused by a problem with my lower back/pelvic frame being out of alignment and that the lower back pain is actually causing the abdominal pain and not vice versa. She has suggested I visit a chiropractor.
Just wondering if you have a second opinion on whether this sounds plausible or whether you feel I should investigate further with a pelvic ultra-sound?
I went to a GP who did an internal pelvic examination. She seemed to think everything looked and felt fine. She also took some swabs to check for infection and they have come back normal.
She has suggested that it is possible that the abdominal pain is actually being caused by a problem with my lower back/pelvic frame being out of alignment and that the lower back pain is actually causing the abdominal pain and not vice versa. She has suggested I visit a chiropractor.
Just wondering if you have a second opinion on whether this sounds plausible or whether you feel I should investigate further with a pelvic ultra-sound?
Brief Answer:
further USG and gastroenterologist opinion required.
Detailed Answer:
Hello,
Its good that the swab cultures have turned out to be negative and that rules out any vaginal infection or any cervicitis which could have been the cause. however a urine culture would anyhow be mandatory in your case to rule out cystitis.
Secondly a pelvic and abdominal ultrasound would be helpful in dilineating any adenomyotic or endometriotic lesion in the pelvis which is not evident by physical exam and secondly a gastroenterologist opinion is again must for IBS( Irritable bowel syndrome), which can explain blood in stools, bloating and the diarrhoea episodes which can very well be the cause of abdominal pain.
Now if you had a map-alignment of spine, that would yes indeed give you discomfort but the abdominal symptoms wouldn't be caused due to it. So no harm getting an opinion about your back but a gastroenterologist visit and ultrasound exam should be your next steps.
Regards
further USG and gastroenterologist opinion required.
Detailed Answer:
Hello,
Its good that the swab cultures have turned out to be negative and that rules out any vaginal infection or any cervicitis which could have been the cause. however a urine culture would anyhow be mandatory in your case to rule out cystitis.
Secondly a pelvic and abdominal ultrasound would be helpful in dilineating any adenomyotic or endometriotic lesion in the pelvis which is not evident by physical exam and secondly a gastroenterologist opinion is again must for IBS( Irritable bowel syndrome), which can explain blood in stools, bloating and the diarrhoea episodes which can very well be the cause of abdominal pain.
Now if you had a map-alignment of spine, that would yes indeed give you discomfort but the abdominal symptoms wouldn't be caused due to it. So no harm getting an opinion about your back but a gastroenterologist visit and ultrasound exam should be your next steps.
Regards
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Above answer was peer-reviewed by :
Dr. Deepak
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