Frequent Urination and Abdominal Discomfort: A Guide

Frequent urination with lower abdominal bloating?

I consulted a doctor because a few days ago I suddenly felt the urge to urinate frequently, and I experienced a sour sensation after urination, but without pain.
I wondered if it was related to menopause, but the symptoms persisted for two days.
On the third day, I began to feel mild bloating and pain in my lower abdomen, along with the urge to have a bowel movement or pass gas, but I was unable to do so.
That night, I drank a cup of soy milk and also consumed the soy pulp, which made it nearly impossible for me to sleep.
The bloating and pain in my lower abdomen worsened, and I felt like my intestines were constantly moving, along with the frequent urination.
The urine was still plentiful, and I experienced the sour sensation after urination, but there was a slight aching in my lower back on the right side.
The next morning, I visited a gastroenterology clinic where I was prescribed medication and asked to provide a urine sample.
After taking the medication, I experienced excessive gas that was extremely foul-smelling, and then all my symptoms improved significantly.
The doctor mentioned a high likelihood of urethritis and suggested that the abdominal bloating and pain might be due to a viral infection.
Three days later, I returned to check my urine test results, which showed 3+ protein, red ketones, and 22 red blood cells—abnormal findings.
The doctor diagnosed me with cystitis and advised me to continue taking the medication for another three days.
He asked if I often hold my urine, to which I replied that I do not have that habit.
He also inquired if I drink enough water, and I explained that I have a regular exercise routine and drink water normally.
He then suggested that it might be related to not cleaning properly after intimacy with my husband, but I assured him that I always clean thoroughly.
This left me confused about whether I truly have cystitis, as my research indicated that typical symptoms include burning and decreased urination, while I experience frequent urination, a sour and itchy sensation after urination, and abdominal bloating and pain.

What exactly is my condition? Should I get another urine test? How can I prevent this in the future? I am really puzzled and do not understand the cause.

Zhen, 50~59 year old female. Ask Date: 2016/02/29

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
Intra-abdominal infections include urinary tract infections, and enteritis can affect gastrointestinal motility.
2.
Symptoms such as frequent urination, dysuria, and signs of urinary tract infection are present.
It is recommended to monitor urine for improvement.
If proteinuria persists, a follow-up with a nephrologist is advised.
If hematuria continues, a consultation with a urologist to check for urinary stones is recommended.
Wishing you good health.

Reply Date: 2016/02/29

More Info

Frequent urination, abdominal discomfort, and associated symptoms can be quite distressing and may indicate underlying health issues. Based on your description, it seems you have experienced a combination of urinary and gastrointestinal symptoms, which can sometimes overlap. Let's break down your situation and provide some insights into potential causes, treatments, and preventive measures.

Understanding Your Symptoms
1. Frequent Urination: This can be caused by various factors, including urinary tract infections (UTIs), bladder irritation, or even hormonal changes, especially during perimenopause or menopause. The sensation of urinating frequently but with little output can be indicative of bladder inflammation or infection.

2. Abdominal Discomfort: The feeling of bloating and discomfort in the lower abdomen, especially when associated with a strong urge to defecate or pass gas, may suggest gastrointestinal issues. Conditions like constipation, irritable bowel syndrome (IBS), or even infections can lead to such symptoms.
3. Urinary Symptoms: The presence of protein and red blood cells in your urine, as indicated by your test results, suggests a possible bladder infection (cystitis) or other urinary tract issues. The fact that you experience a burning sensation after urination, even if it is not painful, can also align with these conditions.

Possible Diagnosis
Given your symptoms and the urine test results, it is plausible that you are experiencing a urinary tract infection, specifically cystitis. This condition can cause frequent urination, urgency, and discomfort in the lower abdomen. The presence of protein and blood in the urine further supports this diagnosis.
Additionally, the gastrointestinal symptoms you described, such as bloating and discomfort, could be related to dietary factors or an underlying condition like IBS, especially if you have a history of gastrointestinal issues.

Treatment Options
1. Antibiotics: If a UTI is confirmed, your doctor may prescribe antibiotics to clear the infection. It's crucial to complete the full course of antibiotics even if symptoms improve before finishing the medication.

2. Pain Management: Over-the-counter pain relievers may help alleviate discomfort. However, consult your physician before taking any new medications.

3. Dietary Adjustments: Keeping a food diary may help identify any dietary triggers that exacerbate your symptoms. Increasing fiber intake can help with constipation, while staying hydrated is essential for urinary health.

4. Probiotics: These can help restore the natural balance of bacteria in your gut and may be beneficial after antibiotic treatment.

Preventive Measures
1. Hydration: Drink plenty of water throughout the day to help flush out your urinary system and prevent infections.

2. Hygiene Practices: After sexual intercourse, urinate and clean the genital area to reduce the risk of introducing bacteria into the urinary tract.

3. Regular Bathroom Habits: Avoid holding in urine for extended periods, as this can increase the risk of infections.

4. Dietary Considerations: Avoid irritants such as caffeine, alcohol, and spicy foods if you notice they exacerbate your symptoms.

5. Regular Check-ups: If symptoms persist or recur, follow up with your healthcare provider for further evaluation and management.

Conclusion
Your symptoms of frequent urination, abdominal discomfort, and the findings from your urine test suggest a urinary tract infection, possibly accompanied by gastrointestinal issues. It is essential to follow your doctor's advice regarding treatment and to consider preventive measures to avoid future occurrences. If your symptoms do not improve or worsen, do not hesitate to seek further medical attention. Regular communication with your healthcare provider is key to managing your health effectively.

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