Abdominal Discomfort: When to Seek Medical Attention

Q: Abdominal Discomfort: When to Seek Medical Attention

Hello： It is recommended to consult both a gastroenterologist and an obstetrician-gynecologist, as they may mutually influence each other. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

Abdominal discomfort and abdominal pain?

About four days ago, I started experiencing indigestion, followed by persistent and occasionally severe headaches and dizziness.
The next day, I began to feel intermittent dull or cramping pain in my abdomen.
The day before yesterday was the worst, with the most intense pain and the shortest intervals between pain episodes, especially when I stood up or turned over.
However, yesterday the symptoms significantly improved; I still experienced occasional pain, but it was not as severe as before, and the dizziness and headaches occurred only sporadically.
Today, the abdominal discomfort has mostly reduced to a dull and mild pain, and I no longer have headaches or dizziness.

During these four days, I have not experienced constipation, diarrhea, or vomiting (I had a couple of instances of nausea over the past two days, but on the worst day, I felt severe pain in my abdomen while straining during a bowel movement).
The pain location has been variable, with most of the discomfort being dull or mildly sharp cramping, primarily concentrated in the lower right abdomen.
A few days ago, pressing on the lower right area did not cause pain, but releasing the pressure resulted in rebound tenderness, which felt sharp or cramping.
Now, pressing on that area only elicits a mild dull sensation with slight sharpness, but I have a persistent dull feeling throughout my abdomen all day.

I have not experienced any fever, cold symptoms, or cough during these days.
A friend suggested it could be inflammation, and I found online that it might be related to issues with the uterus or ovaries.
Should I seek medical attention immediately? If so, which department should I consult? Thank you, doctor.

Liang Xiaojie, 10~19 year old female. Ask Date: 2016/08/22

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is recommended to consult both a gastroenterologist and an obstetrician-gynecologist, as they may mutually influence each other.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/08/22

More Info

When experiencing abdominal discomfort, especially with accompanying symptoms such as persistent headaches, dizziness, and localized pain, it is crucial to understand when to seek medical attention. Based on your description, it seems you have been dealing with a combination of digestive issues and abdominal pain that has fluctuated in intensity over the past few days.
Given that you have experienced significant pain, particularly in the right lower quadrant of your abdomen, and that the pain has changed in character—from severe to more manageable—there are several potential causes to consider. The right lower abdomen is particularly concerning for conditions such as appendicitis, ovarian issues (in females), or gastrointestinal problems like diverticulitis or inflammatory bowel disease. The presence of rebound tenderness (pain upon releasing pressure) can be indicative of an underlying inflammatory process, which may require immediate evaluation.

When to Seek Medical Attention
1. Severe or Worsening Pain: If the abdominal pain becomes severe or worsens, it is essential to seek medical attention immediately. This could indicate a serious condition that may require urgent intervention.

2. Persistent Symptoms: Since you have been experiencing these symptoms for several days, and they have not resolved completely, it is advisable to consult a healthcare provider. Even if the pain has decreased, the fact that it was severe and localized warrants further investigation.

3. Associated Symptoms: While you mentioned no fever, vomiting, or diarrhea, the presence of dizziness and headaches can complicate the clinical picture. These symptoms could be related to dehydration, pain, or even an underlying infection.

4. Changes in Bowel Habits: Although you have not experienced constipation or diarrhea, any significant changes in bowel habits or the presence of blood in the stool would necessitate immediate medical evaluation.

Recommended Medical Specialties
Given your symptoms, you should consider seeing a physician in one of the following specialties:
- Internal Medicine: An internist can evaluate your abdominal pain and associated symptoms, perform necessary examinations, and order diagnostic tests such as blood work, imaging studies (like an ultrasound or CT scan), and possibly refer you to a specialist if needed.

- Gastroenterology: If your symptoms are suspected to be related to gastrointestinal issues, a gastroenterologist can provide specialized care, including endoscopic evaluations if necessary.

- Obstetrics and Gynecology (OB/GYN): If there is a concern regarding ovarian or uterine issues, particularly given your mention of potential gynecological problems, an OB/GYN would be the appropriate specialist to consult.

Conclusion
In summary, while your symptoms have improved somewhat, the nature of your abdominal pain, particularly its localization and the history of severe discomfort, suggests that you should seek medical attention. It is better to err on the side of caution, especially with abdominal pain that has changed in intensity and character. A thorough evaluation by a healthcare professional will help determine the underlying cause of your symptoms and guide appropriate treatment. Remember, timely intervention can be crucial in managing potential health issues effectively.

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