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Pain while urinating, cloudy urine, constant thirst, ovarian cysts, constipation, diarrhea. What should I look for?

Jul 2012
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Practicing since : 1993
Answered : 1196 Questions
Strange changes over the past year (or so) that add up to... (I'm not sure but something feels wrong)
I am 28, female. Physically fit, healthy/conscious eater, weight 107, hight 5'1 and 1/2, non smoker. Never had surgery. Ethnicity - White.
Noticed drastic change in bowel/urine about a year and a half ago. More recently it hurts to pee (a few times so extremely painful I have screamed - which was unexpected). Cloudy pee. White 'pulp' like things. I drink a LOT of water yet constant thirst (maybe due to medicine I take daily - see below). And recently most concerning is the blood in both urine and bowel. Not always at the same time but definitely consistent enough to not just be 'a one off/random occurrence or 'hemroids' (*sp?)
Had a gyno/pap five months ago - everything clear.
Went to hospital last week (Sept 8/12) for "burst cysts" on my ovaries (first time for that)
Past Year : constipation/diarrhea - my whole life my metabolism has been fairly consistent (normal and often). Now its either one or the other. I went gluten free about a year ago (about 90% of the time - I do my best). Which has helped my pressure migraines (which became a bi-weekly thing and effected my life - mainly when air pressure changed). I saw a Dr about my intestinal concerns when they first alarmed me (about 10 months ago) and they said not to worry, probably IBS or 'roids' and to watch what I ate. Again, I eat well (as you can tell my by hight and weight ratio - something I work at, not just comes naturally). In total I've been to the doc (including gyno and hospital) 4 times this past year, each time my blood sample says no UI, no yeast infection, but ALL times I have had traces of blood and notable white blood cells. What this means, IDK. Without insurance it's hard to get a Dr who cares. In the last 6 months I have gotten weird tongue 'things'. Black (rotten-like) patches on my tongue that when I squeeze, come off like puss. As well as white or coated tongue patches - again sometimes squeezes off like puss. I'm not a hypocondriact but my body 'feels' different, as if something is wrong. Also - although my weight has not changed my stomach seems swollen. Again, beyond being gluten free, I eat a lot of friuts and veggies, keep low sodium, drink mainly XXXXXXX tea and water (occasional fruit juice that i water down but no sodas). In the past three months, period like cramping has been fairly consistent (through out the month not just PMS). My periods (when I do get them) are very light, despite having noticeable PMS. Was on the depo shot from age 17-22. Then switched to Oral birth control (has varied in type over the years)

I take 40mg of dexidrine a day for ADD (which I have been taking for over a decade, and have been re-diagnosed 4 times with different specialists)
And oral birth control. (also on since 17yrs old)
Maybe worth mentioning - in general I have chronic body pain, (ranging in numbness, swelling, extreme pain, migraines, less sever, aches). Started about 6 years ago and must have gotten progressively worse? I honestly can't remember, it's become such a part of my life that I forget what I was like before. As a struggling writing/filmmaker I haven't had the luxury to look into my back/body pain. When I can afford to, I can messages or the occasional acupuncture / adjustment (mainly from sites like Groupon - aka not professional specialists). Pain and symptoms change daily. On a pain scale of 1-10, I never go bellow a 5, and some days go above ten to a 17. Each day changes. Painful spasms that last more then two days (up to four sometimes) are the worst because I have no break or moment of release.
Obviously having ADD I have lack of concentration but it seems it has SIGNIFICANTLY gotten worse. And less energy.

My question is - if you can't address the possibilities online (understandably) - please tell me things to look into further online. ALSO please tell me what questions to as SPECIFICALLY if I invest in seeing a Dr to address my symptoms. I don't want to pay for a 'general' blood test or ultra sound. I want specially to know what I should be asking the Dr. to look into or test for.
Thank you.

Posted Thu, 4 Oct 2012 in Urinary and Bladder Problems
Answered by Dr. Praveen Rodrigues 7 hours later
Hi there.
The XXXXXXX staff requested me to look into your problems & advise you accordingly. Basically, am a dermatologist & note with interest that of the many systems you have complained about, the skinseems to be one that is clear! I shall however aim to point you out in the right direction if you will bear with me awhile & answer the following questions to help me aid you better.
I do understand your problems largely began to flare-up 1-1 1/2 yrs ago. Was this around the time you started this Rayholmes productions by any chance?
I note (quoting you) you say "no break or moment of release". Could your entire problem perhaps boil down to the other catch 's' word..'stress'? We all have varying degrees & how one handles them is the only issue.
Are you married/single? Steady partner/friends with benefits? Sexually active? Any anal sex or insertion of devices? Perhaps (no sex) (not in the recent past )on account of time etc? Need to reassure you that others (except site administrator) cannot view your statements & hence you can speak openly & this would really help if you were comfortable
More specifically, are the 'white objects' in your urine 'mucus (like what one blows out of the nose) in consistency or hard/solid?
Is there blood in your urine only or is it also in your stools? Have both regions been assessed by the lab & is it something called 'microhematuria' in the urine & is it addressed as 'melena' or 'fresh blood' in the stools?
Dont worry we can address all these issues online & then some more...please do get back with answers' to these queries & can take it forward therafter..Cheers & look forward to your replies. & Yes will definitely give you a specific action plan & no need for things like general blood tests or fact, if my initial assumption about your condition is spot-on, doubt you will have to spend a cent. Cheers!
Above answer was peer-reviewed by
Follow-up: Pain while urinating, cloudy urine, constant thirst, ovarian cysts, constipation, diarrhea. What should I look for? 13 hours later
Thank you Doc, for getting back to me.

To answer your questions.

- Yes - The problems I am concerned with began a 1 1/2 ago.

- No - This was not around the same time I started Ray Holmes Productions. I started my LLC at age eighteen; anxious to finish high school and start my adult life in film, I formed this LLC to gain practical experience shooting my own personal films while simultaneously working my way up in a production company.

- No - My stress levels have NOT increased these past few years, quite the contrary actually. Moving past the immature teenage anxieties about being the next 'Quentin Tarantino' I have gratefully gained a more realistic, patient, mature, approach to having a career in film. I'm proud of my current and past accomplishments, and have great jobs along my way (including working with XXXXXXX Jobs at XXXXXXX running my own music company, traveling the world, etc.)

- Yes - I have a great support team. I'm very close with my family, especially my 4 younger sisters, ranging in ages 17-26. They are my best friends, we talk everyday, and see each other about 2-3 times a week (with the exception of my youngest sister, who is still in high school in CA and lives with our parents. But we also talk often). I also have a great (intimate) group of dear friends (choosing quality over quantity when it comes to relationships). And...

-Yes - I have a boyfriend. Who now supports me emotionally and financially (which is a big help living in NYC). We have been together for almost 4 years, and living together for 2. We are committed, monogamous, and still best friends. No stress about marriage or kids as we both feel we have a lot of growing to do still - as adults, as individuals, personal and professionally, and as a couple.

- No - I don't have anal sex. I have never tried it. - No - I don't put anything else up or in there, ever.

- The white pulp looking things in my pee - look like Tropicana Orange Juice, extra pulp, only clear/white. Sometimes my pee is clear (like it usually is). But sometimes its been really dark too. No smell, and again, I'm not dehydrated (a side effect of my Dex is constant consumption of water). Sometimes it also comes out looking like this (only in a clear, colorless cloudy form) WWW.WWWW.WW

- Notable - I DID have anxiety when I was a child/teen. Now knowing that I was ADD or dyslexic had a lot to do with that; not being able to focus on what I needed/wanted to focus on and learning differently them my peers. Since then however, I am better and enjoy continuing to grow as a person. However during those times in high school, I did turn to bulimia as a vice to 'control' (or not control) my body. 3 - 4 times a per week I would binge and purge. After figuring out ADD and starting Dexedrine (after trying others) my bulimia went from 2-3 times a week to once a month. By age 22, when I moved out and became more health conscious, I significantly cut down my sugar, carb, and gluten intake, which gave me the power and control to stop the binge and purge desire. Once or twice a year I slip up, but we are have our own 'work-in-progresses'. Surprisingly, I have never had a problem with acid reflex, not even in my current state. I mention this just in case I may have damaged something along the way or allowed myself to become more susceptible to... (whatever's going on).

- When I said "no break or moment of release" I was speaking of the chronic body/back pain that has become part of my life. Not remembering how it started or when it became a consistent part of me, I can trace it back to about 6 years ago and continues to progressively worsen. As far as I know this issue is unrelated to the symptoms I am concerned about now. However, like the bulimic past, perhaps its worth bringing up. Due to my lack of medical insurance, I have not had the means to address this issue properly; be it a neurologist or other specialist. But my back issues definitely is a contestant, ongoing 'thing' i simply have dealt with and at this point accepted. Strange though it seems, a healthy person without an obvious reason would have such sever chronic pain. (Again - this pain differs each day, and each day different, unpredictable symptoms ranging in muscle swelling or sore muscles, numbness through out my back or other parts of my body including hands, feet, and face, and muscle spasms and including sciatic nerve). So, when I said 'no break or moment of release' I informing you of the only other major medical issue I have had. Also giving you an indication for my pain tolerance. Which has built quit an immunity for.

Last week when 'my cramps' (which have been on and off for the past few months) became hard to walk, and lasted 4 consecutive days, I went to the hospital. They did a vaginal ultrasound, and said, there was fluid blocking the view of my ovaries, thus it was most likely an ovarian cyst that had burst. They took a urine sample and said traces of blood, and a small increase of white blood cells but no infection indicated (like UTI) so no need for anti-biotics I have never had ovarian cysts before, and although apparently common, I was just had a physical three months ago and according to them everything was clear. No cysts, no HVP, no STD's, no HIV, no UTI, no yeast.

Sometimes (with things like my chronic back and body pain) I justify and say it must be related to my meds - After all taking Dexedrine for ten years must have side effects. But these most recent and very obvious symptoms seems to collective to justify as something of common knowledge.

A friend mentioned candida yeast. Told me to try the spit test. I did, mainly to humor her. I did it first thing upon waking up, I spat into a clean, filtered, room temp glass of water and waited 15 mins. When 15 minutes was up, my spit stayed on the top of the water, looking exactly the same as when I first spit. According to the test, this would mean I had candida yeast, but that doesn't make sense because a.) I was literally just checked buy two different doctors who would have seen something down there, b.) I would have noticed and c.) I have had a total of three yeast infections my whole life. Two cases of UTIs and two cases of hemorrhoids. So I know what those are like. I have had the flu, allergies, a cold, etc. This does not feel like any of that. This feels like a pile of obvious and growing warnings something in my body is off balance.

RE-CAP MY SYMPTOMS OF CONCERN: In the past year and a half I have experienced:

- Occasional but not consistent lower stomach/pelvic cramps - (unrelated to menstrual cycle)
- Consistent gradual swelling of stomach, lower abdomen / pelvic area. - (does not change with food consumption)
- Blood in urine. - (consistently inconsistent in the past 1.5 years) sometimes painful
- Pulpy or cloudy urine - (not consistent but increasingly so)
- Darkened stool, as well as blood some times when I wipe. - (consistently inconsistent in the past 1.5 yrs)
- Change in bowels from 'normal' to either diarrhea or constipation - always either-or, never regular like it was. (in past 1.5 yrs)
- The type of constipation is also abnormal for me, never experienced very painful constipation before. sometimes feels like i'm pushing a watermelon but it turns out to resemble like little cat-shits. When this happens I usually leave the bathroom feeling full and unfinished.
- Sometimes both urine or stool is SHOCKINGLY painful. And very unexpectedly. I feel fine until I start and then I left out a scream. And I feel my face instantly whiten.
- Increased fatigue - which is VERY odd for my personality in general.
- Lose of energy - also VERY odd for me.
- Harder to breath (this is very recent, most noticeably when I run, which I enjoy doing 1-3 times a week either at gym or outside)
- Increased lack of concentration. And if that's noticeable then it must be really bad.
- A few times the strange tongue thing, where a build up of white stuff or lumps around my tongue, and a few times mouth sores, not cold sores but like raw irritated, inflamed taste buds, and a few times (although not as recent) those black patches of 'dead' taste buds.
- NO fevers
- NO sign of allergies, or common cold, or flu.
- NO change in weight.

HOWEVER... beyond last weeks random 'cyst' incident. The following symptoms just LITERALLY started in the last three/four weeks.

1. Occasional random spouts of nausea - lasting on and off for a day or two, as if I took a vitamin on an empty stomach (which I don't. I do not take vitamins for that reason - they do not agree with me, even on a full stomach). This started about three weeks ago. (and no am not pregnant, today was first day of period, as scheduled).

2. Random bloodshot eyes. Like I've been in a pool for hours with my eyes open. Which I have not (I live in nyc). I am very cautious in general about germs (especially living in nyc). I wash my hands, careful to not touch my face. I take pride in my skin and skin care routine; investing in good, natural products. Non of my products, including cosmetic, have recently changed. I only occasionally wear makeup on occasion, as I work from home during the days. I've been forced to apply Visine, as sparingly as I can - I'm well aware of its 'addictive' qualities.

3. With that, I have also noticed an increase in blurred vision - again, this just started within the last month or so. I have a slight astigmatism and wear glasses when I read or am on the computer all day, otherwise I avoid wearing them. But literally just recently I noticed I can't see things I could the month before. I am either crazy or my body is telling me something is wrong.
Answered by Dr. Praveen Rodrigues 8 hours later
Hi there.
You sure re-inforced the fact that you are into script-writing & productions :)
Thanks for replying to all my queries.
To put things in perspective : NO..u are not 'crazy' but are 'concerned'. Understand your concern & will try to point you out in a direction i think will help you.
From all your clinical history, it does appear that a nephrologist is one doctor you first need to XXXXXXX Your symptoms could all boil down to having some sort of kidney or bladder stones/cysts in addition to the ovarian ones you mentioned & could account for the fluid in the pelvic region, bloating, nausea etc.
Next, must admit have never heard of the 'spit test' & these are at best anecdotal & if indeed you have candidiasis anywhere..oral, anal, vaginal, a simple 200mg fluconazole capsule coupled with a 2gm tinnidazole (can be got separately or as a kit) taken ONE time (stat) (single dose) should take care of the issue!
Once these two have been addressed, then invest in a good psychiatrist/psychologist/counsellor for a short period preferably one with neurological experience of ADD to round things off.
Now, i understand all this may cost & perhaps they will request tests i have a suggestion....countries like India, Far-East countries have good medical systems in place for 1/10th the cost & one can also get a 'holiday' to 'destress' & enjoy oneself. You admit to travelling the world so presume this is up your street. Perhaps you can make a film on 'medical tourism' (that's the catch phrase am told)!? You are welcome to travel to any destination. I am Bangalore based & the hospital i work at, has an active 'medical tourism' section that bring patients' in from all over the world & they get premium specialists' care under one roof. You are most welcome to send me your details if interested & shall pass it onto them.
At the end of the day, wish you well & do hope these issues get sorted out & am fairly certain, it is NOT life-threatening or sinister & wish you good health & a long fruitful life.
I have attempted to point you out in the best possible direction & do hope it is to your satisfaction & it all works out. I do hope i have helped you to make an 'informed' deciscion weighing all the pros & cons. Whatever path you choose to take, do hope it brings you health, wealth & happiness! Cheers & Godspeed!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venreologist XXXXXXX Hospital,
Bangalore, India.
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