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What causes lower abdominal pain with increased urge to defecate?

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Posted on Wed, 3 May 2017
Question: 65 year old male. I have had lower abdominal pain for several days. Usually moderate, but sharp with bowel movements which are frequent, always necessary soon after eating. More frequent urination, and some discomfort between beneath testicles when sitting, and finishing urination. No fever, slight nausea, no vomiting.
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Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Most likely gastroenteritis with Mild urinary tract infection.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concern.

As per the history given by you most likely you are having gastroenteritis overlapping with urinary tract infectiion.
Trials have shown that in 86 per cent of elderly cases, UTI was part of other common diseases like gastroenteritis.


Lower abdominal pain with increased frequency with urge to defecate soon after eating is strongly suggestive of stomach infection termed medically as Gastroenteritis.Gastroenteritis means inflammation of mucosal lining of intestine mostly caused by virus but as Urinary tract is probably involved in your case it can be bacterial(Most common bacteria involved is Escherichia coli).
Discomfort beneath testicle with painful micturation is indicative of Urinary tract involvement and inflammation.

Initially i would recommend you to go for few basic investigations before starting antibiotics.

Stool routine and microscopy along with culture and sensitivity(cause of gastroenteritis).
Urine routine and microscopy(rule out UTI)
Complete blood count
Total and differential leucocyte counts.
Ultra sound abdomen and prostate( to rule out diverticulitis ,prostatitis or BHP).
These tests will rule out whether it's stomach,blood or urinary tract infection.

Gastroenteritis weekens our immune system and on top of that frequent stools causes dehydration .If proper hydration is not maintained then overlapping Urinary tract infection can develop due to colonisation of bacteria.

Treatment suggested-
Take Tab Nexium 40mg once daily along with 30mg Domperidome to help you with nausea.
For abdominal pain and spasms Take Dicyclomine 10 mg tablet along with anti inflammatory preferably Mefanemic acid.

As in both gastroenteritis and UTI spasm and inflammation of smooth muscles are involved treatment is more or less the same.

Antibiotic therapy should be started after results of investigations.However you can get a prescription for a broad spectrum antibacterial like Cefixime from your primary.
Some general precautions are-
Take plenty of water and electrolyte.
Eat boiled or easily digestible food.
Take plenty of probiotic rich food like yoghurt,Curd etc.
Drinks lots of juices especially orange and coconut water(Rich in potassium).
Take Metamucil daily for few days.It will increase bulk of stool.

I hope my answer would be helpful.
In case you need any other professional advice, I would be happy to help.

Regards.



Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Ramesh Kumar (2 hours later)
I have been unable to take Cefixime in the past because of a bad reaction. I have taken Azithromycin successfully in the past however. In fact I have a supply available to me at home. Will this work, and if so at what dosage? This is a very reassuring answer, and seems to be very accurate description of my problem. I will make arrangements for an examination, but will have to wait several days until my physician is available. Thank you.
doctor
Answered by Dr. Ramesh Kumar (15 minutes later)
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Thats good Azithromycin is also a broad spectrum antibiotic that can be used However my experience with Cephalosporins are quiet better.
Dosage should be either 500mg once a day or 250mg twice daily(Discuss with your primary).
As you have to wait for several day before examination you should better start therapy with azithromycin.
Along with it take a quality probiotic twice daily.
Rest follow everything i adviced above you will be fine in a day or two.

Please don't stop antibiotic therapy on your XXXXXXX take it either for 3 days or 5 days.
Get well soon.
Regards.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2691 Questions

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What causes lower abdominal pain with increased urge to defecate?

Brief Answer: Most likely gastroenteritis with Mild urinary tract infection. Detailed Answer: Hi, Thanks for choosing HealthcareMagic for your query. Have gone through your details and i appreciate your concern. As per the history given by you most likely you are having gastroenteritis overlapping with urinary tract infectiion. Trials have shown that in 86 per cent of elderly cases, UTI was part of other common diseases like gastroenteritis. Lower abdominal pain with increased frequency with urge to defecate soon after eating is strongly suggestive of stomach infection termed medically as Gastroenteritis.Gastroenteritis means inflammation of mucosal lining of intestine mostly caused by virus but as Urinary tract is probably involved in your case it can be bacterial(Most common bacteria involved is Escherichia coli). Discomfort beneath testicle with painful micturation is indicative of Urinary tract involvement and inflammation. Initially i would recommend you to go for few basic investigations before starting antibiotics. Stool routine and microscopy along with culture and sensitivity(cause of gastroenteritis). Urine routine and microscopy(rule out UTI) Complete blood count Total and differential leucocyte counts. Ultra sound abdomen and prostate( to rule out diverticulitis ,prostatitis or BHP). These tests will rule out whether it's stomach,blood or urinary tract infection. Gastroenteritis weekens our immune system and on top of that frequent stools causes dehydration .If proper hydration is not maintained then overlapping Urinary tract infection can develop due to colonisation of bacteria. Treatment suggested- Take Tab Nexium 40mg once daily along with 30mg Domperidome to help you with nausea. For abdominal pain and spasms Take Dicyclomine 10 mg tablet along with anti inflammatory preferably Mefanemic acid. As in both gastroenteritis and UTI spasm and inflammation of smooth muscles are involved treatment is more or less the same. Antibiotic therapy should be started after results of investigations.However you can get a prescription for a broad spectrum antibacterial like Cefixime from your primary. Some general precautions are- Take plenty of water and electrolyte. Eat boiled or easily digestible food. Take plenty of probiotic rich food like yoghurt,Curd etc. Drinks lots of juices especially orange and coconut water(Rich in potassium). Take Metamucil daily for few days.It will increase bulk of stool. I hope my answer would be helpful. In case you need any other professional advice, I would be happy to help. Regards.