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Abdominal pain after drinking or eating, blood test showed elevated WBC, blood in urine. CT scan showed kidney stones. Should we run more tests?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
For the past 6 days my father has been having severe pain ( upper right abdomen) immediately after taking a sip of water or eating anything. He is 62 Yeats old and is in very good health, fit, 20 years of no smoking no prescription mess etc. Blood test revealed elevated white blood cells and urine analysis showed he has blood in his urine. He has chills and has been vomitting every day. X-ray revealed nothing but CT scan showed 2 kidney stones. 43 years ago he had a third of his stomach removed due to Ulcers and he says he feels like he may have an infection in his intestine. While I don't doubt that he does indeed have kidney stones, I am wondering why the pain is intensified so quick after eating, taking a sip of water- even chewing gum makes him double over with pain. After a IV dose of tortirol (sic?) He tried drinking lemon juice and the pain became so intense that he started vomitting again. After 6 days, I'm concerned that he hasn't eaten or had any water or liquid. Should we be asking the DR to run more tests? Also, for the past several months he has been experiencing extreme fatigue which is quite unusual for him as he has always been very energetic.
Posted Mon, 21 May 2012 in Digestion and Bowels
Answered by Dr. Ketan Vagholkar 13 hours later
Thanks for writing in.
From your history, it appears that your father have two surgical issues
1. Post gastrectomised state
2. Renal stones.
It is extremely likely that the stones may have arisen due to the post-gastrectomized state which happens due to metabolic changes due to removal of the stomach. This state also predisposes a person to intestinal infections.
And the last but the most important feature is a stomach ulcer which has high propensity for malignant (cancerous) change. In your father’s case, increasing fatigue could be an early sign. The symptoms which you have described are extremely suggestive of an ulcer in the stomach. It is best to get an endoscopy done and to obtain biopsies from the suspicious areas. You should do this at the earliest which will give your father a chance to undergo quick surgical treatment.
As far as the renal stones are concerned, they require regular assessment by Xray or CT scan to study the exact location and size of the stones and whether they are causing back pressure changes.
I hope I have addressed your concerns. I will be available for follow up queries.
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