Which Specialist to See for Persistent Abdominal and Urinary Discomfort?

If you are experiencing discomfort in various parts of your body, you should consider visiting a primary care physician or a general practitioner. They can evaluate your symptoms and refer you to the appropriate specialist if needed?

I have been experiencing persistent pain in my lower left abdomen for several days, especially at night, to the point where I can't sleep.
I also have frequent urination at night, and over the past month, my daytime urination has increased compared to before.
Additionally, I have some discomfort, along with digestive issues such as indigestion, nausea, abdominal bloating, and frequent burping.
I also suffer from chronic constipation and occasional migraines, typically located around my left temple, along with back pain.
I previously consulted a traditional Chinese medicine practitioner, who noted knocking pain in the kidney area on my back.
However, taking herbal medicine has not improved these various symptoms.
I have a heart valve prolapse, but aside from daily palpitations and chest tightness, my condition is stable.
I am unsure which specialty I should consult or what kind of health examinations could help improve my situation.
I would appreciate your assistance.
Thank you.

Ziyouye, 20~29 year old female. Ask Date: 2016/02/12

Dr. Wu Jiyu reply Internal Medicine

In response to your inquiry, it seems you may have some medical background.

1.
"Persistent left lower abdominal pain for several days, especially at night, to the point of being unable to sleep, with increased nocturia.
Recently (for about a month), daytime urinary frequency and volume have also increased." Additionally, "back pain and discomfort, previously evaluated by a traditional Chinese medicine practitioner, who noted knocking pain in the kidney area." - Consider consulting a nephrologist or urologist.
2.
"Experiencing digestive issues, including dyspepsia, acid reflux, abdominal bloating, frequent belching, and long-term constipation." - Consider consulting a gastroenterologist.
3.
"Also frequently experiencing migraines, typically located on the left temple." - Consider consulting a neurologist.
4.
Alternatively, you may first see a family medicine physician for an initial evaluation, who can then refer you to the appropriate specialist for further examination.
Thank you for your inquiry.
The nephrology department at Changhua Hospital is concerned about your health.

Reply Date: 2016/02/12

More Info

When dealing with persistent abdominal and urinary discomfort, especially in the context of multiple symptoms like frequent urination, digestive issues, and headaches, it's essential to approach the situation methodically. Given your mother's age and existing health conditions, including heart valve prolapse, a comprehensive evaluation is necessary to determine the underlying causes of her symptoms.

Choosing the Right Specialist
1. Primary Care Physician (PCP): The first step should be to consult with a primary care physician. They can conduct a thorough evaluation of her symptoms, review her medical history, and perform initial tests. A PCP can also coordinate care among specialists if needed.

2. Urologist: Given the urinary symptoms, particularly the increased frequency and discomfort, a urologist should be consulted. They specialize in urinary tract issues and can perform tests such as urinalysis, urine culture, and imaging studies to rule out infections, stones, or other urinary tract abnormalities.

3. Gastroenterologist: Since your mother is experiencing digestive issues like bloating, reflux, and constipation, a gastroenterologist would be beneficial. They can assess for gastrointestinal disorders, perform endoscopic evaluations if necessary, and recommend dietary changes or medications to alleviate her symptoms.

4. Cardiologist: Given her history of heart valve prolapse and symptoms of palpitations and chest discomfort, a cardiologist should also be involved in her care. They can evaluate her heart health and determine if her cardiac condition is contributing to her overall symptoms.

5. Neurologist: If headaches persist, particularly if they are unilateral and associated with other neurological symptoms, a neurologist may be warranted. They can assess for any underlying neurological conditions that may be causing the headaches.

Recommended Diagnostic Tests
1. Urinalysis and Urine Culture: These tests can help identify any urinary tract infections or abnormalities in the urine that could explain her urinary symptoms.

2. Abdominal Ultrasound: This non-invasive imaging can help visualize the kidneys, bladder, and other abdominal organs to check for stones, cysts, or other abnormalities.

3. CT Scan or MRI: If the ultrasound is inconclusive, a CT scan or MRI may be necessary to provide a more detailed view of the abdominal and pelvic organs.

4. Blood Tests: Comprehensive blood tests can assess kidney function, liver function, and electrolyte levels, which can provide insights into her overall health and help identify any underlying issues.

5. Endoscopy: If gastrointestinal issues persist, an upper endoscopy or colonoscopy may be necessary to visualize the digestive tract and identify any abnormalities.

Additional Considerations
- Lifestyle Modifications: Encourage your mother to maintain a healthy diet rich in fiber to help with constipation and digestive issues. Staying hydrated is also crucial for urinary health.

- Pain Management: Since she experiences significant discomfort, discussing pain management strategies with her healthcare providers is essential. This could include medications, physical therapy, or alternative therapies like acupuncture.

- Follow-Up Care: Regular follow-up appointments with her healthcare providers are crucial to monitor her symptoms and adjust treatment plans as necessary.

In summary, your mother should start with her primary care physician, who can guide her to the appropriate specialists based on her symptoms. A multidisciplinary approach involving a urologist, gastroenterologist, cardiologist, and possibly a neurologist will provide a comprehensive evaluation and management plan for her persistent abdominal and urinary discomfort.

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