Why does my lower abdomen hurt and I always want to pee?

Abdominal pain and the urge to urinate frequently are caused by urinary tract infection, which may also be accompanied by symptoms such as frequent urination, painful urination, and incomplete urination. This disease also reflects that infectious lesions may have occurred in the renal pelvis, bladder and other parts. During the illness, patients should pay attention to the cleanliness of the urethra and avoid sexual intercourse as much as possible.

Causes

More than 95% of urinary tract infections are caused by a single bacteria. Among them, 90% of outpatients and about 50% of inpatients are caused by Escherichia coli, which can be classified into 140 types of serotypes. The urinary infection-causing Escherichia coli is of the same type as the Escherichia coli isolated from the patient's feces, and is often seen in asymptomatic bacteriuria or uncomplicated urinary infection; Proteus, Clostridium difficile, Klebsiella pneumoniae, Pseudomonas aeruginosa, and fecal Streptococcus are seen in patients with reinfection, indwelling catheters, and complicated urinary tract infections; Candida albicans and Cryptococcus neoformans infections are often seen in patients with diabetes and those using glucocorticoids and immunosuppressants and after kidney transplantation; Staphylococcus aureus is often seen in bacteremia and sepsis caused by skin trauma and drug addicts; although viral and mycoplasma infections are rare, they have tended to increase in recent years. Various bacterial infections are seen in indwelling catheters, neurogenic bladder, stones, congenital malformations, and vaginal, intestinal, and urethral fistulas.

Clinical manifestations

1. Acute simple cystitis

The onset is sudden, and the onset in female patients is often related to sexual activity. The main manifestations are bladder irritation signs, namely frequent urination, urgency, pain when urinating, discomfort in the bladder area or perineum, and a burning sensation in the urethra; the degree of urinary frequency varies, and in severe cases, urge urinary incontinence may occur; the urine is turbid, there are white blood cells in the urine, terminal hematuria is common, and sometimes it is hematuria throughout the process, and even blood clots are discharged. Generally there are no obvious systemic infection symptoms, and the body temperature is normal or there is a low fever.

2. Acute simple pyelonephritis

(1) Urinary system symptoms include bladder irritation signs such as frequent urination, urgency, and pain during urination; hematuria; low back pain on the affected side or both sides; obvious tenderness or percussion pain at the costovertebral angle on the affected side;

(2) Symptoms of systemic infection such as chills, high fever, headache, nausea, vomiting, loss of appetite, etc. are often accompanied by increased white blood cell count and increased erythrocyte sedimentation rate.

3. Asymptomatic bacteriuria

Asymptomatic bacteriuria is a hidden urinary tract infection, which is more common in elderly women and pregnant women. Patients do not have any symptoms of urinary tract infection, and the incidence rate increases with age.

4. Complicated urinary tract infection

The clinical manifestations of complicated urinary tract infection vary greatly, and are often accompanied by other diseases that increase the risk of infection or treatment failure, with or without clinical symptoms (such as frequent urination, urgency, dysuria, dysuria, low back pain, costovertia angle tenderness, suprapubic pain and fever, etc.). Complicated urinary tract infections are often accompanied by other diseases, such as diabetes and renal failure; they also cause many sequelae, the most serious and fatal of which include urosepsis and renal failure. Renal failure can be divided into acute and chronic, reversible and irreversible.

diagnosis

1. Medical history collection

(1) Clinical manifestations: characteristics, duration, and associated symptoms of urinary tract infection;

(2) Past medical history, medication history, and related disease history to find possible causes of the disease, concomitant diseases, previous drug treatment history, and factors that may affect the development and outcome of the disease;

2. Physical examination

Includes examination of the urogenital organs; physical examination of the abdomen and kidney area. Pelvic and rectal examinations are helpful in identifying other concurrent diseases.