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Suggest Treatment For Recurrent Abdominal Pain And Kidney Stones
Question: I just had a CT Scan with dx of "puncate 2mm nonobstructing left renal stone" No hydronephorsis or uretal stones. Yet I had about 2 weeks of moderate pain from the stone in December, 3 weeks in January without pain and now 2 weeks with moderate pain that is controlled with Percocet 5-325. If the stone is still in the kidney, I thought that a small stone would not cause discomfort if still up high. My follow up with the urologist is not for another 2 weeks. Do you have any recommendations please?
Brief Answer:
Further tests
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
This is very true that a 2 mm stone in the kidney can not cause pain on its own.
There is a report of non-obstructing left renal stone of a 2 mm stone, no hydronephrosis or ureteral stone.
But still you had pain for 2 weeks in Dec and now 2 weeks of moderate pain - controlled with Percocet.
Yes, a small stone of the size of 2 mm would not cause discomfort still now.
My recommendations would be as follows:
Blood tests : Routine and urea and creatinine.
Urine: Routine, microscopy, culture and sensitivity.
A course of an antibiotic.
Plenty of oral fluids.
Intravenous Pyelography if required.
It is possible that you have recurrent Urinary tract infection.
I Hope that this answer helps you to get correct diagnosis and treatment.
Please feel free to ask further relevant questions, I would be happy to get your feedback and some clarifications:
Since when have you got the pain / discomfort ?
What are the exact symptoms ?
Have you any symptoms related to urination like burning, frequency or symptoms related to the bowel like nausea, vomiting, distension, loose stools or constipation ?
Location of the pain ?
Character : like throbbing / burning / severe / twisting ?
Please feel free to give feedback, ask for relevant questions or if you feel that there is a "gap-of- communication .
Further tests
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
This is very true that a 2 mm stone in the kidney can not cause pain on its own.
There is a report of non-obstructing left renal stone of a 2 mm stone, no hydronephrosis or ureteral stone.
But still you had pain for 2 weeks in Dec and now 2 weeks of moderate pain - controlled with Percocet.
Yes, a small stone of the size of 2 mm would not cause discomfort still now.
My recommendations would be as follows:
Blood tests : Routine and urea and creatinine.
Urine: Routine, microscopy, culture and sensitivity.
A course of an antibiotic.
Plenty of oral fluids.
Intravenous Pyelography if required.
It is possible that you have recurrent Urinary tract infection.
I Hope that this answer helps you to get correct diagnosis and treatment.
Please feel free to ask further relevant questions, I would be happy to get your feedback and some clarifications:
Since when have you got the pain / discomfort ?
What are the exact symptoms ?
Have you any symptoms related to urination like burning, frequency or symptoms related to the bowel like nausea, vomiting, distension, loose stools or constipation ?
Location of the pain ?
Character : like throbbing / burning / severe / twisting ?
Please feel free to give feedback, ask for relevant questions or if you feel that there is a "gap-of- communication .
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Each time I have seen the urologist (3x) I provide a urine sample. Each time there has been a trace of blood in the urine. I have not been advised of any bacterial infection.
The pain that I have almost always starts late in the afternoon or early evening, although today I have had pain since 1 PM. I do not have pain on arising in the morning. The pain is a dull ache that is constant. I can feel when it is starting as it progresses. I have not had any nausea. My last stone was 5 years ago and was 7 mm which I was able to pass. I have had prior history as well and know the difference between a severe attack accompanied by nausea. I would say this pain is like a bad stomach ache that does not get better without the Percocet and overnight rest, however it has been daily for about two weeks now.
I do not have any burning on urination or greater frequency of urination.
The pain that I have almost always starts late in the afternoon or early evening, although today I have had pain since 1 PM. I do not have pain on arising in the morning. The pain is a dull ache that is constant. I can feel when it is starting as it progresses. I have not had any nausea. My last stone was 5 years ago and was 7 mm which I was able to pass. I have had prior history as well and know the difference between a severe attack accompanied by nausea. I would say this pain is like a bad stomach ache that does not get better without the Percocet and overnight rest, however it has been daily for about two weeks now.
I do not have any burning on urination or greater frequency of urination.
Brief Answer:
Second opinion to find other causes of pain.
Detailed Answer:
Thanks for your feedback.
The pain starts in the afternoon or early evening evening- dull constant ache - like a bad stomach ache that goes on till you take Percocet - 2 weeks - no urinary symptoms...
All this suggests me to think in the different direction. This may be most probably due to myalgia of the muscles in the said area or colitis.
What is the report of the CT scan ?
I think you need to be seen by another Surgeon like a General Surgeon or an Orthopedic Surgeon to see for another causes of pain you can have.
You should take a precaution not to take Percocet so often as there is a chance of getting addicted to it and get entangled into the vicious cycle of pain > Percocet > pain ... I mean this is avoidable.
I hope this helps you.
Second opinion to find other causes of pain.
Detailed Answer:
Thanks for your feedback.
The pain starts in the afternoon or early evening evening- dull constant ache - like a bad stomach ache that goes on till you take Percocet - 2 weeks - no urinary symptoms...
All this suggests me to think in the different direction. This may be most probably due to myalgia of the muscles in the said area or colitis.
What is the report of the CT scan ?
I think you need to be seen by another Surgeon like a General Surgeon or an Orthopedic Surgeon to see for another causes of pain you can have.
You should take a precaution not to take Percocet so often as there is a chance of getting addicted to it and get entangled into the vicious cycle of pain > Percocet > pain ... I mean this is avoidable.
I hope this helps you.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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