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Having pain in abdomen, have had visible peristalsis in RLQ and urinary frequency. Underlying cause?

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Practicing since : 2008
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Hi, I have been having pain in my upper abdomen and also in lower abdomen right next to belly button, both I can pinpoint. Has been going on since last year. Recently have had visible peristalsis in RLQ and now urinary frequency. Whole right side feels full. Twice i have woken up with cramps so bad I could barely breathe but they ultimately subsided. Other than those two times, pain is not unbearable. I have not been bothered much, or at least have been able to ignore it, but now the urgency to urinate is so annoying.
Posted Thu, 27 Jun 2013 in Medicines and Side Effects
Answered by Dr. Grzegorz Stanko 10 minutes later

Thank you for the query.

One side abdominal pain and frequent urinating indicates urinary tract issue. It can be urinary tract infection or urinary tract stones.
With an infection the pain is mild, starts gradually, fever and burning while urinating can be present.

Urinary tract stones give more sudden symptoms (the pain appears suddenly) and usually is very strong. It can radiate to the back or groin. Frequent urinating and burning or pain while urinating are also characteristic. Blood can appear in the urine. The pain can come and go.

I suggest you to visit your doctor and have abdominal ultrasound, urine analysis and urine culture test. In case of an infection, antibiotics might be necessary.
In case of stones, smooth muscle relaxing medicines should be prescribed.
In both conditions you should drink plenty of mineral water (like 2-3 liters/24 hours), have cranberries supplements. To help move stones down, you can try jumping, stairs running, jogging etc. Hot bath should help with the pain.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Having pain in abdomen, have had visible peristalsis in RLQ and urinary frequency. Underlying cause? 12 minutes later
I thought it might have been an infection so I did go to clinic and get antibiotics. Still is continuing. Abdominal US done in march was clear. I am just confused as to what could cause this to gradually get worse over a year. Would stones do this? All I hear about stones is how bad the pain is. But in the year this had happened I have only had bad pain twice, couple months apart. I exercise everyday so I would think any stone would have moved. The area next to my belly button feels harder than the left side and when pushed it is uncomfortable and radiates up into RUQ. I do not look bloated to someone else, prob wouldn't be able to tell but it feels full. I am young and healthy and can't think what this could be. I am trying to avoid very expensive tests, will this be the only option?
Answered by Dr. Grzegorz Stanko 6 hours later
You are young and healthy person indeed. That is why there is not much conditions which can cause symptoms mentioned by you. Urinary tract problem is the most probable at your age especially with urinating problems.

The main problem with stones is that it is hard to definitely diagnose them (only large stones are easy to diagnose, small are very hard). Most of the stones when causing the pain are invisible in the ultrasound. It is because during the pain, stone is in the ureter where it can not be seen with an ultrasound.

Moreover changes in urine analysis are not always present. Sometime the pain is the only indication of this condition. And the pain is not always the same. Some people have only minor pain and wont ever visit a doctor with it. Its because theirs stones are small and rounded (do not hurt urinary tract).
Some people have strong pains only occasionally. Strong pain appears when the stone has uneven surface and get stuck in the ureter.

Another hard thing with stones is that there is few types of them. Depending of the stone type, there are different factors causing theirs creation. Usually it is a diet, but what kind of products should be avoided can be definitely told only after the stone analysis. So the best solution is to catch the stone and send it for tests.

Of course your pain can be caused by some other condition and frequent urinating can be only a coincidence. At your age other possible conditions are ovarian cyst, umbilical hernia, urachus or inflammatory bowels disease.

Ovarian cyst can give pain and no other symptoms. Sometimes strange bleeding can appear, pain during intercourse, lack of menses. Ovarian cyst can be diagnosed by a gyneacologist with transvaginal ultrasound.

Umbilical hernia gives a lump present in the umbilicus. The lump can be painful or more visible when coughing.

Urachus is persisted connection between the umbilicus and urinary bladder. In such case some bad smelling discharge from the umbilicus should be present. It also causes recurring urinary tract infections.

Inflammatory bowels disease usually gives abdominal pain (can be present in every region), stool problems (diarrhea, constipation, blood in stool), weight loss, tiredness.

If any of mentioned conditions sound more possible than urinary tract problems you should:
- in case of umbilical hernia or urachus visit general surgeon for physical examination, in case of doubts, soft tissues ultrasound should be done
- in case of ovarian cyst, gynecologist should be visited
- in case of inflammatory bowels disease, gastroenterologist should be visited and colonoscopy done
- if urinary tract problem sounds most probable you should have at least urine analysis done (its not an expensive test); blood sugar level should be also checked (diabetes causes recurring infections)

Hope this will help.
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