Lower Abdominal Pain: Causes and Treatment Options - Gastroenterology and Hepatology

Q: Lower Abdominal Pain: Causes and Treatment Options

Hello： There is a pulling sensation in the lower abdomen, which does not seem to be related to intestinal symptoms. <br>It is reasonable to suspect that a kidney stone may have dropped into the ureter. <br>It is recommended to consult a urologist. <br>Changhua Hospital cares abou

Lower abdominal pain?

Hello doctor, on the 15th of this month, I experienced discomfort in my stomach while going to bed at night.
It felt like there was some sour taste rising to my throat, and my mouth had a bitter taste with a slight bad breath.
I was burping frequently and had a bitter mouth.
I visited a traditional Chinese medicine practitioner who prescribed medication to suppress stomach acid.
After taking it for three days, I felt a tearing sensation in my lower abdomen, so I stopped the medication.

For the past few days, I've had occasional mild stabbing pains and itching just above my navel.
At night, I experience stomach rumbling and a feeling of heat inside.
About five centimeters below my navel, I sometimes feel a sensation of internal pressure when bending over.
There is also mild intermittent pain in the lower right quadrant of my abdomen, which varies in intensity and sometimes feels just warm.

On the 29th, I visited a gastroenterologist at a hospital and explained my symptoms, but the doctor seemed impatient and told me to take medication for seven days.
After taking the medication for two days, the feeling of heaviness and discomfort has improved significantly, and I am burping less.
However, the pain in my lower abdomen persists.

I am unsure which specialist to see next and am worried that ignoring this might worsen my condition.
I have a history of kidney stones and have undergone lithotripsy twice, the last time being six months ago, so I doubt it's a blockage.
What should I do now, doctor?

Niming, 20~29 year old female. Ask Date: 2017/03/31

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: There is a pulling sensation in the lower abdomen, which does not seem to be related to intestinal symptoms.
It is reasonable to suspect that a kidney stone may have dropped into the ureter.
It is recommended to consult a urologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/03/31

More Info

Lower abdominal pain can be a complex issue, as it may arise from various underlying conditions affecting different organ systems. Based on your symptoms and history, it is essential to consider several potential causes and treatment options.

Possible Causes of Lower Abdominal Pain
1. Gastrointestinal Issues: Conditions such as gastritis, peptic ulcers, or gastroesophageal reflux disease (GERD) can lead to discomfort in the abdominal area. The sensation of acid reflux you described, along with the bitter taste in your mouth and belching, suggests that your gastrointestinal tract may be involved.
2. Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder can cause abdominal pain, bloating, and changes in bowel habits. Stress and anxiety often exacerbate IBS symptoms, leading to discomfort that can be mistaken for other conditions.

3. Urinary Tract Issues: Given your history of kidney stones, it is crucial to rule out any urinary tract infections (UTIs) or complications from previous stones. Symptoms like pain in the lower abdomen, especially if localized to one side, could indicate a urinary issue.

4. Gynecological Concerns: In women, lower abdominal pain can also be related to gynecological issues such as ovarian cysts, endometriosis, or pelvic inflammatory disease. If you are female, these conditions should be considered, especially if the pain is cyclical or associated with your menstrual cycle.

5. Musculoskeletal Pain: Sometimes, pain in the lower abdomen can be referred from the lower back or pelvic region due to muscle strain or ligament issues. Activities that involve bending or lifting can exacerbate this type of pain.

Diagnostic Approach
Given the complexity of your symptoms, a thorough evaluation is necessary. Here are some steps you can take:
1. Follow-Up with a Gastroenterologist: Since you have already seen a gastroenterologist, it may be beneficial to return for further evaluation, especially if your symptoms persist despite medication. They may recommend additional tests such as an abdominal ultrasound or endoscopy to visualize the gastrointestinal tract better.

2. Consider a Urologist Consultation: Given your history of kidney stones, consulting a urologist could help rule out any urinary tract issues or complications from previous stones. A urinalysis and imaging studies may be warranted.

3. Gynecological Evaluation: If you are female, a visit to a gynecologist may be necessary to rule out any reproductive system-related issues.

4. Lifestyle and Dietary Modifications: In the meantime, consider keeping a symptom diary to track your pain, dietary habits, and any potential triggers. This information can be invaluable for your healthcare provider in determining the cause of your symptoms.

Treatment Options
1. Medications: Depending on the diagnosis, treatment may include antacids or proton pump inhibitors for acid-related issues, antibiotics for infections, or medications for IBS.
2. Dietary Changes: A diet low in irritants (like caffeine, alcohol, and spicy foods) and high in fiber can help manage gastrointestinal symptoms. Staying hydrated is also crucial, especially if you have a history of kidney stones.

3. Stress Management: Since anxiety and stress can exacerbate gastrointestinal symptoms, consider incorporating stress-reduction techniques such as mindfulness, yoga, or counseling.

4. Physical Therapy: If musculoskeletal issues are suspected, physical therapy may help alleviate pain through targeted exercises and stretches.

Conclusion
It is essential not to ignore persistent abdominal pain, as it can indicate underlying health issues that require attention. Given your symptoms and medical history, I recommend seeking further evaluation from specialists in gastroenterology, urology, or gynecology, depending on your specific circumstances. Early diagnosis and appropriate treatment can significantly improve your quality of life and prevent complications.

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