Pain-below belly button, upper/lower back pain and upper abdominal pain

[aurora1010]

Since March, I’ve been getting pain that just starts out of nowhere. It’s either below my belly button (sometimes radiating to my left or ride side) and seems to spread downward into my private area (lower back pain usually comes when this happens). When this pain happens, the area below my belly button hurts when I touch it. It feels like a stabbing/pulling pain. It can get so bad at times that I can’t walk or stand up straight—nothing seems to make it go away even when I take medicine like Tylenol. I feel pressure, and sometimes pain when I have to urinate but, never a burning feeling. The other type of pain I’ve been getting is upper abdominal pain, like where the gallbladder is (when this happens, I also get pain on either my upper right or upper left part of my back). I also get waves of nausea and have moderate anemia (around 10). In addition, doctors have found microscopic hematuria for almost a year now, but in the past 3 months, I’ve been able to see blood clots in my urine. I already had a bunch of ultrasounds, which did reveal a large cyst on my right side which I’m currently taking birth control pills for in attempts to shrink it, and I already had two cat scans (one without contrast, one with contrast through iv).  However, the cat scans didn’t find anything. Now, my urologist has scheduled a cystoscopy for the 29th, of this month. I’m worried that nothing has been found yet. Any ideas that I can look into or ask my doctors? Also, I’m 19 years old and I’m a virgin, so my gynecologist and urologist aren’t able to examine my private area because I’m not sexually active. Do you think it might be time to let them? I will be thankful for any advice!

[aurora1010]

Thank you for all your help! I will!

[Dr. Kokil Mathur]

Hi
There is no harm in consulting a nephrologist. You should press for atypical cultures of urine to know if there is tuberculosis or mycoplasma or any other atypical bacteria.
Also it would be good to consult the gynecologist once again.
Hope this helps. It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!

[aurora1010]

I had my cystoscopy today, and my urologist said my bladder is clear. He said he saw nothing wrong. Also, no infections are present, which means no bladder infections or UTIs. Now he wants me to go see a nephorologist. Do you think this is the right way to go with this, or should I be going back to my gynecologist because he has not examined me yet (only talked, and reviewed the results from the ultrasounds) ?
Thank you for all your time and all your help!

[Dr. Kokil Mathur]

Hi
Thanks for keeping me posted!
Yes, sludge is same as gravel. Also PID is possible even if you are not sexually active. IBS, endometriosis too should be seriously looked into. A high WBC in urine and no infection can happen if the UTI is caused by an organism that does not show growth on normal cultures. Unidentifiable bacteria means the normal culture set by most labs cannot grow it. This needs special cultures which all labs may not be able to set up. Once the organism is identified then a sensitivity test is set up. This will give the antibiotic that the organism is sensitive to. Consult an urologist if possible and get the test repeated at a standard lab giving them the background. Tuberculosis of the gut and urinary and genital system often presents with symptoms like you are facing.
Please discuss this with your doctor. It’s a good idea to note everything down as you are doing. Please let me know if there is any thing else and do keep me posted. Take care!

[aurora1010]

My doctors said my urine tests showed no infection, just an elevated white blood cell count and slight inflammatory? No idea how that is different, but that is what I was told. Also, you mentioned "sludge" is that the same has "gravel"? Finally, another person had mentioned the possibility of pelvic inflammatory disease, could it be that even though I'm not sexually active?
Thank you so much for your comment, I am writing everything down for my doctors! I will keep you posted!

[aurora1010]

I haven't heard of that before, and yes I do have long periods, sometimes they last up to 15 days. Thank you so much for your help, I will definitely ask about that!

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Generally a pain like this is due to stones in the urinary system. Sludge too can cause similar pain and is difficult to detect on ultrasounds and CT scans. Cysts too can cause similar pain especially if there is a pedicle and a chance of torsion. If uterine fibroids have been ruled out then irritable bowel (IBS) and endometriosis both uterine and extra uterine as the cause of pain should be investigated. Bladder infections and UTI too should be looked into—maybe have been ruled out in your case. IBS can also cause pain in the gall bladder area.
If you can actually see the blood in urine, you should rule out clotting disorders including low platelet count. Gross hematuria visible to naked eye is also seen in kidney and bladder stones, cancer of kidney, sickle cell anemia, endometriosis and bladder infections.
A few other blood tests may be required apart from cystoscopy.
I think you should discuss these possibilities with your doctor. It is difficult to comment beyond this without examining. A comprehensive investigation is required keeping all the points in mind.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[stuck111]

Have your doctors considered endometriosis? I would recommend your gynecologist examine you, which may require a laparoscopy (day surgery with a quick recovery). It may be worth exploring especially if you have heavy or extended periods - which could also account for the mild anaemia. Just a thought.

Hope this helps.