Persistent Lower Abdominal Pain: Possible Causes and Next Steps

I have had lower abdominal pain for a week?

Hello, Doctor.
I've been experiencing lower abdominal pain for a week.
I saw a doctor who mentioned it could be related to either my colon or ovaries, but he said the likelihood of it being a colon issue is low at my age.
I started menstruating at 13, and when I was 14, my period lasted for two weeks, but it hasn't happened since.
My menstrual cycle has always been irregular, sometimes early, sometimes late, or I might go one or two months without a period.
I've always had dysmenorrhea, but since I stopped drinking cold beverages in March of this year, my periods have remained irregular but without pain, just normal lower back discomfort.
Last month, my period suddenly lasted for two weeks, and I haven't had it this month yet.
Last week, I experienced severe lower abdominal pain that has persisted until today.
I consulted a doctor and took medication, but the pain continues, although the frequency has decreased.
The clinic doctor advised me to get imaging to check for tumors.
What is your opinion?

Xiao Fan, 10~19 year old female. Ask Date: 2016/07/25

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to diagnose based on the described symptoms.
If you continue to feel unwell, I recommend seeing a gynecologist or a gastroenterologist for a thorough examination.
Wishing you good health.

Reply Date: 2016/07/25

More Info

Persistent lower abdominal pain can be a complex issue, especially in young women, as it may stem from a variety of causes, both gynecological and gastrointestinal. Given your history of irregular menstrual cycles, dysmenorrhea (painful menstruation), and recent changes in your menstrual pattern, it is essential to consider both reproductive and non-reproductive factors.

Possible Causes of Lower Abdominal Pain
1. Gynecological Issues:
- Ovarian Cysts: These fluid-filled sacs can develop on the ovaries and may cause pain, especially if they rupture.

- Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside it, leading to significant pain, especially during menstruation.

- Pelvic Inflammatory Disease (PID): An infection of the reproductive organs can cause lower abdominal pain and is often associated with sexually transmitted infections.

- Uterine Fibroids: Non-cancerous growths in the uterus can lead to pain and heavy menstrual bleeding.

2. Gastrointestinal Issues:
- Irritable Bowel Syndrome (IBS): A functional gastrointestinal disorder that can cause abdominal pain, bloating, and changes in bowel habits.

- Appendicitis: Although less likely given your age, it is a serious condition that requires immediate attention.

- Diverticulitis: Inflammation of diverticula in the colon can cause significant pain, though it is more common in older adults.

3. Other Considerations:
- Urinary Tract Infections (UTIs): These can cause lower abdominal pain and may be accompanied by urinary symptoms.

- Musculoskeletal Pain: Sometimes, pain can arise from muscle strain or other musculoskeletal issues, especially if you have been active or have changed your physical activity levels.

Next Steps
1. Diagnostic Imaging: Since your doctor has suggested imaging to rule out tumors, a pelvic ultrasound would be a good first step. This non-invasive test can help visualize the ovaries, uterus, and surrounding structures to identify any abnormalities such as cysts or fibroids.

2. Blood Tests: A complete blood count (CBC) can help identify signs of infection or other underlying issues. Additionally, hormone levels may be checked to assess any irregularities that could be affecting your menstrual cycle.

3. Follow-Up with a Specialist: If the initial tests do not provide clear answers, consider consulting a gynecologist. They may recommend further evaluation, such as a laparoscopy, which allows for direct visualization of the pelvic organs.

4. Pain Management: While waiting for further evaluation, managing your pain is crucial. Over-the-counter pain relievers like ibuprofen or naproxen can help alleviate discomfort. However, consult your doctor before taking any medication, especially if you have other health conditions.

5. Monitor Symptoms: Keep a detailed diary of your symptoms, including the timing, intensity, and any associated factors (like diet or stress). This information can be invaluable for your healthcare provider in diagnosing the issue.

Conclusion
Persistent lower abdominal pain warrants thorough investigation, especially given your history of irregular menstruation and significant pain. While there are many potential causes, a systematic approach involving imaging, blood tests, and possibly a referral to a specialist will help clarify the situation. Remember, it’s essential to communicate openly with your healthcare provider about your symptoms and any changes you notice. Your health and well-being are paramount, and addressing these concerns promptly is crucial for effective management.

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