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Suggest Treatment For Severe Abdominal Pain Caused By Kidney Stone
Question: 38 year old female, non smoker
Developed severe pain to her right side on Christmas Day. Went to the ER. Ultrasound came back clear. Was told it was a UTI. Put on antibiotics for 7 days. Pain did not decrease... moved to her back.
Went back to ER, ultrasound, Ua and CT with XXXXXXX All clear. White blood cell counts are in range.
Developed severe pain to her right side on Christmas Day. Went to the ER. Ultrasound came back clear. Was told it was a UTI. Put on antibiotics for 7 days. Pain did not decrease... moved to her back.
Went back to ER, ultrasound, Ua and CT with XXXXXXX All clear. White blood cell counts are in range.
Brief Answer:
Explained
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your description, a Urinary tract infection and stone have been ruled out. If the pain is in the right iliac fossa then acute appendicitis would not have resolved easily plus with the normal white count, its also unlikely. Clinical examination of the right iliac fossa and periumbilical region would have shown signs of peritonitis including guarding, rigidity and tenderness. If the pain is in the right upper quadrant then an EKG should be done to look for a cardiac cause, no matter how unlikely. Its a vital organ and a cardiac abnormality should be ruled out. An ETT / stress test may be also be advised, additionally. Gall stones leading cholelithiasis is another possibility but that would have been detected on ultrasound. Musculoskeletal pain / costochondritis can be the cause and should be treated with NSAIDs. They should be avoided if there is a history of GERD/ Gastritis. PPI cover can be given along with NSAIDs in that case. GERD itself can also cause abdominal pain and can be addressed empirically in this way if no cause is isolated.
Wishing you best of health
Thanks
Let me know if you have any query
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
Explained
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your description, a Urinary tract infection and stone have been ruled out. If the pain is in the right iliac fossa then acute appendicitis would not have resolved easily plus with the normal white count, its also unlikely. Clinical examination of the right iliac fossa and periumbilical region would have shown signs of peritonitis including guarding, rigidity and tenderness. If the pain is in the right upper quadrant then an EKG should be done to look for a cardiac cause, no matter how unlikely. Its a vital organ and a cardiac abnormality should be ruled out. An ETT / stress test may be also be advised, additionally. Gall stones leading cholelithiasis is another possibility but that would have been detected on ultrasound. Musculoskeletal pain / costochondritis can be the cause and should be treated with NSAIDs. They should be avoided if there is a history of GERD/ Gastritis. PPI cover can be given along with NSAIDs in that case. GERD itself can also cause abdominal pain and can be addressed empirically in this way if no cause is isolated.
Wishing you best of health
Thanks
Let me know if you have any query
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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