I have been having right side back and flank pain

Patient

Q: I have been having right side back and flank pain since 2013. It used to be intermittent. Since the beginning of this year the pain has been constant. My blood pressure is high even though I have never had an issue before. I can't eat anything, food repulses me and I'm always nauseous. I have a low grade fever, diarrhea with lots of mucus in it. I have been vomiting on and off and recently it has blood in it. I'm bloating, feel weak and get the sweats sometimes. I'm 31 yo and am diabetic. My diabetes is well controlled up until I couldn't stomach anything. Also lately my hair has been falling out in clumps. The doctor told me my pain is muscular and I know it's not. Also my blood and urine tests come back normal with the exception of when I had a kidney infection a month ago. I also have a dry cough. Help please. I want my life back.

Doctor

A:   Hi.
Thanks for your query.

Read and understood your problems.
The pain in right side back and flank which has increased since 1 year. Now that even the blood pressure is elevated.
Also noted your history of diarrhea with mucous, nausea, bloating, fever, weakness and sweating sometimes.
This along with other symptoms of hair fall, controlled diabetes, Doctors telling the problems be related to the muscular pain also noted along with the medicines history.

My Thoughts:
Since you have an atypical symptom complex, the causes of the pain in the back and the flank needs to be investigated well.
The symptoms related to the abdomen can be due to the gastroenteritis or IBS; for this to say as IBS (irritable bowel syndrome, you need all the investigations to be essentially normal. Hence, you should go all the investigations of blood, urine and stool, Colonoscopy, upper GI Endoscopy, CT scan of the abdomen.
If there is any positive finding, one can always take a proper guided treatment.
If all the investigations are normal take probiotic and symptomatic treatment till you get results.
The Problem of the back and flank pain if not amenable to any treatment till now since it is so long, it is better to get an MRI of the spine and abdomen at this level to probably find an appropriate diagnosis and treatment.

I hope the kidney infection is now under control, although this too is one of the most important reasons for the pains in back and flank.

Dry cough may be due to GERD associated with your intestinal problems.

I hope this answer helps you get your doubts cleared and get an early and proper diagnosis with a definite plan

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