Hello doctor,
I have E.coli bacterial infection. I am taking Ciplox TZ and Nitrofurantoin. But after taking Nitro, I get pain in the stomach and the right side in the groin area. Also if I go for a walk for around 1 km, I feel pain in the groin area and cannot walk for more than two kilometers. I also have kidney stones on bilateral sides. I have a grade II fatty liver. Please advise.
Hello,
Welcome to icliniq.com.
You have bilateral renal pelvic obstruction due to stones with diabetes with urinary tract infection. The pain in the groin is due to pelvic renal calculi, the pain of which radiates to the groin. The infection needs to be treated with tablet Levoflox 500 mg once a day for 14 days along with injection Amikacin 500 mg twice a day for 14 days (if serum creatinine is less than 1.6 mg/dl) followed by clearance of stones bilaterally.
Otherwise, your infection does not get resolved as the pus is due to disease associated with stones. Your stomach upset and pain in the abdomen is due to Nitrofurantoin, which causes gastritis and acidity. Nitrofurantoin is not the right choice for treating such infection. It can be useful as maintenance therapy. Kindly get diabetes treated. Please check serum creatinine checked once you start injection Amikacin. The presence of stones prevents the total clearance of infection. Please get back to me if you have any more queries.
As mentioned in the CT, there are stones in both the kidneys which are causing minimal obstruction. There are three options to get rid of them.
1. PCNL/Miniperc- In this, the stones are removed through a small puncture in the back, which passes through kidney and enters renal pelvis and stones are crushed using laser or mechanical energy. This will clear the stones 100%.
2. RIRS- In this, stones are removed through natural urinary passage, ie penis. Here flexible utetetoscope and laser are used. It us the costliest of the three procedures. There are chances of kidney infection with this procedure, as high pressure irrigation is used during the procedure. Chances of clearance of stones is around 95%.
3. ESWL- This is an OPD procedures, wherein, the stones are crushed using focussed magnetic/water pressure waves. This us the least morbid of all, however chances of stone ckearance is only 60%.
Now you need to decide which one you want to opt.
Please note, there are always chance of recurrence, as stone formation in the majority cases is a metabolic problem, which needs to be tackled seperately based in stone analysis.
Hope my answer will help you in making the right choice.
Please feel free to contact again, if you have any more queries.
Regards,
Dr Bhat
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