I am 25 years old and I  feel pain in the left side of my bladder. Sometimes, I feel like using the toilet but whenever I try, there is nothing. Could this be an underlying sign for a particular disease? What is the problem? 

Miriam, Kabeza

Dear Miriam,

How long have you been having this kind of pain? Is it recent or more than a week or so ago? Do you have the desire to go to the rest room more frequently than before? When feeling the need to visit the toilet is it very urgent? If the answer to all these questions is yes, then you have cystitis, also called infection of the urinary bladder.

Women are more prone to infections of the bladder due to multiple reasons. Small size of the urethra (tube connecting bladder to outside), blood flow during menstruation, poor genital hygiene and trauma during childbirth make women more susceptible to cystitis. Usually it manifests in pain, frequency and urgency to urinate, nausea and even vomiting. 

Sometimes stones in the bladder can also cause pain and infection.

The diagnosis is easily confirmed by getting a sample of urine examined microscopically which shows the germs. The sample should be of urine and passed first thing in the morning and should be collected after discarding the few drops passed initially. Treatment is by taking antibiotics like ciprofloxacin/norfloxacin for a week.

Drinking lots of water like eight to ten glasses per day is useful in preventing and treating bladder infections as well as stones because causative germs and any deposits of crystals are washed away by large quantity of urine passed.

But if you do not have other symptoms, there could be some other infection causing this pain. Pelvic infections in women can also mimic urinary infections. But in this case, there will be pain and at times a foul smelling or white coloured discharge from the vagina. One would also experience pain after intercourse in case of pelvic infection. But this is also treatable by suitable antibiotics.

Protozoal infections like amoebiasis or giardiasis can manifest, only as pain on the affected side of the colon. A stool test can confirm or exclude this condition. This is also a curable condition, for which one has to take an antiprotozoal drug like metronidazole or tinidazole for one week.

At times chronic constipation can also lead to pain in the lower abdomen, even on the left side, because that side is the last part of a large vowel. If loaded fecal matter is not passed out, it will cause pain and even nausea.

The best thing for you is to get your urine and stool sample tested to look for infections in either of them.  If they are negative, consider pelvic infection and get treatment for it.

Dr Rachna Pande is Specialist in Internal Medicine at Ruhengeri Hospital.