UTI? Kidney stone? Poltergeist in the bladder?

January 17, 2018 6:31 AM

I've been experiencing bladder pain for a couple of days. Never had a UTI or kidney stone before so I don't know if the pain is consistent with either of those things or something else (digestive/reproductive?). I'd be interested in hearing from people who've experienced this kind of pain before, and what the cause turned out to be.

This question is not a substitute for seeking medical care - I will definitely go to the doctor if it sounds like I need to go to the doctor. But NHS advice for UTIs is to leave them to clear up on their own and only see a doctor if you're a member of a specific category (children/elderly) or if it's persisted for more than a few days, so if this does indeed sound like a UTI I probably won't go to the doctor straight away. I'm asking because I feel more secure in seeking medical treatment when I already have an idea of what the possibilities are.

I am in the UK and can only access specialist services via a GP anyway, so suggestions along the lines of "just go see a urologist/other specialist" are not helpful as there isn't any way for me to do that within the medical system that we have here.

In terms of actual symptoms, I've had an aching kind of pain in what I think is my bladder (it's the same place where I feel pressure when I need to pee badly) for a day or two. It started the night before last, wasn't an issue yesterday during the day and then started up again last night and has been painful on and off ever since.

The pain is worst when I need to pee, and I'm feeling the aching pain as the primary "need to pee" feeling right now instead of the usual sensation of needing to pee. Weirdly, it also hurts a lot immediately after I've finished peeing. Sometimes the pain spreads to the urethra a bit, sometimes it doesn't. The whole lower front abdominal area down near my pubic bone feels tender on the inside but not tender to the touch.

There is no burning sensation while I'm peeing and no blood in my urine; the urine looks normal and is a normal colour when I pass it. The pain is entirely internal. It's also been hurting more when I have digestive stuff going on - gas/matter moving inside my bowel makes the bladder pain worse (it's definitely not gas/bowel pain - I have IBS and this feels very different to cramps from that).

It feels worse when I sit or lie in certain positions - sitting up is fine, lying on my back is okay, lying on my sides hurts quite a bit more. I've also had a a few episodes today (4-6) where the pain was suddenly significantly worse for a minute or two and then went back to normal (from a 2/3 to a 5/6 and then back again on the pain scale). During the worst of these, which happened in the middle of a meeting, I had trouble maintaining neutral business face due to the pain. Overall the pain has been waxing and waning all day.

I don't have any back/flank pain or pain anywhere else in my abdomen other than right down near the pubic bone. I've been peeing and drinking a normal amount for me (maybe peeing a little bit more than usual). I don't feel like I have a fever (this plus no burning pee makes me think it's maybe not a UTI?), but I've also been wrong about feeling like I have a fever vs actually having a fever before (in that I didn't think I had one but the thermometer said otherwise). I feel generally okay apart from this.

For context I am late 20s, female, I avoid alcohol and caffeine and eat mostly plants and whole grains. I almost certainly have PCOS based on my own & family history but have never had it diagnosed properly. Taking omeprazole for acid reflux and birth control, no other medications.

So: does any of this sound familiar? And if it does, what turned out to be the problem?

posted by terretu to Health & Fitness (16 answers total)

The one thing I'll tell you, from agonizing experience, is that pain from a kidney stone CAN be (but isn't always!!) all of these things:

1. episodic
2. referred to a completely other part of the down-the region, eg the lady bits, so you'll never know its origin until you're in the hospital screaming
3. not accompanied by fever
4. treatable (with dilaudid I think) in the moment
5. require surgery to fix

Drink a ton of water for now, but don't be surprised if you do have a kidney stone. Or it could be a UTI. Or it could be something else.

As for the idea to not treat a UTI... LOL WTF. Those hurt like bright blue blazes and I've always needed an antibiotic for them.
posted by fingersandtoes at 6:45 AM on January 17, 2018 [1 favorite]

Possibilities include acute urinary tract infection, pelvic inflammatory disease from STDs, ectopic pregnancy, uterine pathology such as fibroids, less likely ovarian problems such as ruptured ovarian cyst or ovarian torsion (those tend to have a lateralizing component and are not classically right down the midline, but next to it on one side or the other), renal (or more accurately, ureteral) stone located down near the bladder around the ureterovesicular junction, constipation, inflammatory bowel disease or other bowel causes.

I'm a doctor, but not your doctor. It certainly sounds a lot like a UTI, but there are some life-threatening and fertility-threatening causes on the list above. You should probably go get this checked out.
posted by killdevil at 6:47 AM on January 17, 2018

I just want to chime in and say that there is a natural alternative to antibiotics that's been shown to inhibit the growth of E. coli (the bacteria most commonly seen in UTI's) as effectively as an antibiotic but without any side effects. It's oil of oregano and for me, it clears up a UTI in one day (compared to 3 days with antibiotics). Since there is no downside you might as well try it and see if you get a quick improvement. Google or email me if you need to know how to take it.
posted by rada at 6:50 AM on January 17, 2018 [1 favorite]

I had my first UTI a few years ago, and dear god it was the most painful thing ever. It felt like I was peeing razor blades, broken glass, daggers and knives and nails and all the sharp things, every time I had to pee. I consider myself someone who has a high pain tolerance, and it made me yelp and shriek in pain on the toilet, every time. I didn't understand how it could feel like it did, and there not be shards of glass or metal in the toilet after. I didn't really have much discomfort, otherwise.

I am generally someone who eats plant based and likes to try "natural" things first, but the pain went from 0-60 fast, so I went to urgent care, and could not take the antibiotics fast enough.
posted by raztaj at 6:55 AM on January 17, 2018 [2 favorites]

The pain you experience from a UTI can be pretty variable. They are easy to clear up with a quick round of antibiotics and very easy to test for. They can also linger silently, causing you only moderate pain until they get worse. Cranberry juice can help, so drink some of that. You should see a doctor. I had a UTI that I barely noticed turn into a monster kidney infection when I was in my early 20s. Never again!
posted by pazazygeek at 7:00 AM on January 17, 2018 [1 favorite]

Do you have a fever? How does your urine smell?
posted by TwoStride at 7:14 AM on January 17, 2018 [1 favorite]

The NHS advice as I understand it is not 'wait and see if you don't know what's going on', it's 'if you know it's a UTI and you know it's mild, give it a couple of days first before getting antibiotics.' Given that you haven't had this before and so don't know what it is, and also have already given it a few days and it isn't obviously improving, I'd make a GP appointment now. It can take a couple of days to just get an appointment anyway and then they can take a few days to get test results back if they send off a urine sample. And if it's not a UTI they'll want to find out what it is, and the sooner they can get started on that the better.

(I had a UTI turn into a kidney infection and trust me, this is something you want to avoid if you can. Avoided making a GP appointment due to busy schedule, ended up at out-of-hours in agony at 11pm on a Saturday, would not recommend this approach.)
posted by Catseye at 7:29 AM on January 17, 2018 [15 favorites]

That sounds exactly like a UTI to me. I've had very mild ones clear up on their own (drinking ridiculous amounts of water and cranberry juice) but drugs work much better and soo quickly, and are required if it doesn't get better soon on its own. Untreated UTIs, besides being painful, can become something like a kidney infection which you Really do not want. Keep a close watch for fever, increased pain and other new symptoms if you decide to wait on seeing the doctor.

Go to the doctor if it doesn't start getting better soon. They'll do a quick urine test and give you magic pills if it's a UTI (and figure out what it is if not).

Watch out for yeast infections if you get UTI pills, though. The single-pill UTI treatment didn't cause problems for me but the multi-day type did. If you're prone to them, definitely ask about the single-pill option, which my doctor suggested to me for that reason.
posted by randomnity at 7:36 AM on January 17, 2018 [1 favorite]

Response by poster: Thanks for the advice everyone, I'll try and talk to a doctor tomorrow (I tried just now but they told me to call back in the morning). "Avoided making a GP appointment due to busy schedule" is definitely my general MO but equally I would like to retain the kidneys I already have.

For the record: no fever, urine smells normal, and my fertility is not a concern as I don't intend to make use of it.
posted by terretu at 7:49 AM on January 17, 2018

I don't know what's available OTC in the UK, but in the US you can get OTC painkillers that are UTI specific -- this stuff. I would go to the doctor anyway, and I wouldn't start taking OTC painkillers until a doctor told me it was appropriate, but IME the linked stuff works great, if you don't mind peeing bright orange.
posted by LizardBreath at 7:54 AM on January 17, 2018

I've had both, once each. UTI was pretty much what raztaj described. I was overseas and went to Emergency because it wasn't getting better with copious water - something was Definitely Very Wrong. Antibiotics cleared it up within 24 hours (but the course was longer and I finished them). Wasn't the most painful thing ever, but quite uncomfortable.

Kidney stone for me presented as acute onset back pain (while sitting in a restaurant at dinner). I suddenly couldn't get comfortable no matter what I did. Sit, stand, lie down, heating pad, ice, nothing helped. Went to Emergency after several hours of this and the car ride or something jarred it loose and pain diminished, so left without being seen and voila, I passed the stone that night. Again, not the most painful thing ever, but memorable.

I drink a lot of water now.

Either way, I'd go to a doc. If you have access to NHS Direct or NHS 24, I'd give them a ring. They might be able to faciliate a test for a UTI, which is very rapid in terms of results. Sometimes antibiotics are the best answer, so don't be afraid to use them if needed.
posted by OneSmartMonkey at 7:58 AM on January 17, 2018

Don't take the OTC UTI pain reliever before your NHS appointment because it dyes your urine a screaming bright orange, which could interfere with the UTI test.

"Will AZO Urinary Pain Relief interfere with drug tests?

AZO Urinary Pain Relief may interfere with the reading of any colorimetric urine analysis (such as AZO Test Strips® ), as the active ingredient, an organic dye, will color the test pads and may make them difficult to read. If you are concerned about potential test interference, please contact your healthcare professional."

I suppose you guys don't have what is called in the USA "doc-in-a-boxes?" Little freestanding private clinics where you can drop in and exchange way too much money for a quick "am I gonna die" screening if you think you might have a UTI or the flu and you don't want to wait forever for your regular doc? It might be worth it to hit one up if they exist, just to see how much it might cost.

Drink water steadily, more than you normally would. Keep sipping and sipping and sipping all day.
posted by Don Pepino at 9:09 AM on January 17, 2018 [1 favorite]

This sounds like a bladder infection rather than a UTI to me, and I would see your GP.
posted by DarlingBri at 11:38 AM on January 17, 2018

I have had some success with cranberry juice for a UTI, as well as Vitamin C. Drink lots of water - it helps wash out any bacteria. Calling the doc was a good move, I hope you feel better soon.
posted by theora55 at 7:54 AM on January 18, 2018

It sounds very much like a UTI (a UTI or urinary tract infection is a generic term that includes both bladder and kidney infections). They don't always cause burning with urination or blood in the urine.

I personally always take phenazopyridine/pyridium, which is the generic name for the AZO pain reliever, immediately once I start to feel a UTI coming on. It does interfere with urinalysis results, but to me the feeling of the infection is so uncomfortable that it's difficult to focus on anything else until it's treated. Ideally you would get the urinalysis first but if you have to wait 12-24 hours and there's no way to get it done sooner, that's a lot of discomfort to go through in the meantime. Just remember that even if the pyridium does provide relief, you can't ignore things and move on - it is just a pain reliever and does not treat the infection, so you typically still need antibiotics.

No need for a specialist for this, any general doc should be able to take care of it.
posted by treehorn+bunny at 8:52 PM on January 18, 2018

If you decide to use Cranberry Juice, make sure it's the real thing. On our side of the pond we have bottles of cranberry mixed with apple and stuff (cranberry juice cocktail)

I don't know how good the evidence is on drinking cranberry juice, but can't hurt. More fluids. YAY
posted by kathrynm at 12:00 PM on January 21, 2018