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Dr. Natasha
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11662
Experience:  American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
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I have had pressure/pain on both sides of my lower back for

Resolved Question:

I have had pressure/pain on both sides of my lower back for the past year. The pain is worse at night. My dr found microscopic blood in my urine and referred me to a urologist. Two appointments later, blood both times, a clean CT of my kidneys and scope of my bladder. I am a 39 yr old healthy woman, non-smoker, social drinker. I am active and drink a lot of water. the pain seems to be worse and today I woke up feeling nauseated, bloated, and generally unwell. Any ideas?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Natasha replied 2 years ago.

Welcome to JA. Thank you for your question. In order to help you find an answer, could you please answer the following?


Any other medical problems or medications?
How long as this been going on?
Any other symptoms?

Is it both sides?

Customer: replied 2 years ago.
No
Approx one year, off and on
None
Yes
Expert:  Dr. Natasha replied 2 years ago.
does it seem to radiates down the legs?
any burning at all in your abdomen?
any previous abdominal surgeries?
Customer: replied 2 years ago.
No
No
No
Expert:  Dr. Natasha replied 2 years ago.
what kind of work do you do?
Customer: replied 2 years ago.
I am a personal assistant. My responsibilities are varied.
Expert:  Dr. Natasha replied 2 years ago.
Well, the fact that you had a negative CT scan means that there is no obvious masses in your abdomen or back which is causing the symptoms.
The bloating and nausea, however, suggest a possible GI cause for your symptoms and the fact that it is worse at night implies that this could be reflux. When you lie down at night, fluid refluxes from your stomach and into your esophagus. People usually complain of burning, but others notice a chronic cough, changes in voice, bloating, nausea and back pain.
I would suggest trying to take some pepcid (over the counter) and seeing if maalox helps when you have the symptoms.
Eat small frequent meals and do not eat less than 3 hours prior to going to bed.
You may also want to get your gallbladder ultrasounded because the symptoms of gallbladder disease and reflux frequently overlap- so it is also appropriate to consider this as a possibility.

I hope this helps!


Warm regards.

Customer: replied 2 years ago.
I have had the lower back pain for over one year with no additional GI symptoms until today. I don't understand how they can be related. I am more concerned about a correlation between the blood in my urine and the lower back pain.
Expert:  Dr. Natasha replied 2 years ago.
Well, they would need to do a biopsy of the kidneys to see what is going on if the scope has been negative. Kidney disease does not usually cause back pain unless you have polycystic kidney disease. They should have picked this up on CT , but you may need an ultrasound to be sure.
If these studies are negative, then the kidneys (and bleeding) are not the source of your pain and you need to broaden your net, so to speak, to find out what is doing it.
It would not hurt to try the antacid as suggested anyway...


Warm regards.

Customer: replied 2 years ago.
Relist: Answer quality.
Suggestion to "broaden my net"was very vague. I feel that's an easy answer to give and not worth my $55.
Expert:  Dr. Natasha replied 2 years ago.
Hi I see that you relisted the question.
I understand your frustation and I am trying to help you with the information you have provided me.
In sum- kidney pathology will not cause lower back pain unless you have infection or polycystic kidney disease. You need a kidney ultrasound.

Other causes for lower back pain would be GI- you need to consider reflux and gallbladder disease

Finally, you need to consider musculo-skeletal causes like herniated disc, nerve compression, etc. - which is why I asked you what you did for work and if you have pain radiating down the legs (less likely)

Since you are female, gynceological pathology is also a possibility and getting an ultrasound of your pelvis to evaluate your ovaries and uterus is an important part of your work up.

This microscopic hematuria can be a complete red herring in regards XXXXX XXXXX cause of your back pain.

So- this is my advice
1. Try the antacids. No harm in trying, may make you feel better. Then your investigation is done.
2. Get a pelvic ultrasound to rule out pelvic pathology
3. Get an ultrasound of your gallbladder to rule out gallstones
4. You can consider getting a biopsy of the kidneys, but this is contraversial in patients who do not have signs of glomerular bleeding (red blood cell casts in the urine- would have been reported and you would have been told of this)
5. If all of these are negative, you can consider a MRI of the lumbar spine, but I don't think that this is the cause of your pain.

This is what I meant by broadening the net


Warm regards.




Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11662
Experience: American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
Dr. Natasha and 8 other Medical Specialists are ready to help you
Expert:  Dr. Natasha replied 2 years ago.
Let me know if there is anything else I can help you with. I want to make sure that you are satisfied with this interaction...

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