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Suggest Treatment For Nausea, Lower Back Pain And Dark Colored Urine

Posted on Fri, 23 Jan 2015

Question: 21 year old female started having lower back pain 6 days ago, dark colored urine , constant nausea, went to urgent care twice, neg. for flu, started on antibotics, urine came back clear for bacteria, ran fever for 2 days, 101-103, still with nausea even with zofran.

Answered by Dr. Muhammed Aslam (52 minutes later)

Brief Answer:
kindly give few more details.

Detailed Answer:
Hello dear, welcome to HCM forum.
Thanks for posting to us.

Kindly give few more details so that I can guide you better.

Is this associated with increased frequency of urination or pain/burning sensation on urination?
Was the back pain central or more towards on side?
Apart from urine culture,have you done an urine microscopy? If, kindly upload reports; otherwise this has to be done.
When was the last menses?
Any significant past history like renal colic,vaginal discharge etc?

Kindly get back with details.
Thank you.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Muhammed Aslam (1 hour later)

I have had no burning or frequent urination I told the dr. it did not feel like any uti that I have had in the past, I have had several in my life. the pain is more across the lower back. they tested the urine the first time then took another one when I went back and they called today and said to stop taking the antibotic because nothing had grown. I started my period yesterday, no discharges noted , strong family history of kidney stones, I have never had one that I know of ,but my mom, grandmother and my mom's sister and 2 brothers have all had them .

Answered by Dr. Muhammed Aslam (57 minutes later)

Brief Answer:
renal/ureteric calculus to be ruled out.

Detailed Answer:
Hi dear, thanks for the information given.

From your description, two likely possibilities were UTI and ureteric calculus(stones).
As the culture revealed no growth and you have strong family history, calculus is a very likely possibility. Luminal obstruction by calculus can cause repeated vomiting by autonomic activation.

So in my opinion it is better to evaluate further rather than just continuing supportive treatment. After a careful abdominal examination, we need to have a urine microscopy (which may reveal RBCs and crystals) and an ultrasound scanning (which can reveal presence/site/size/obstruction). Ultrasound can also look for other possibilities like gynecological causes.

Meanwhile you drink plenty of oral fluids (in frequent small sips to avoid vomiting). Addition of antispasmodic agents like dicyclomine can control nausea better in this condition.

Hope now I have answered your query.
If you have no further questions, you can close the discussion and rate the answer.
Wishing for a faster cure.
Thank you.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D