Right Lower Abdominal Pain: When to See a Doctor and Which Specialist?

Right lower abdominal pain?

My menstrual cycle is regular, but I started experiencing pain in the lower right abdomen during the last two days of my period, which has persisted for four days.
I had similar symptoms last year (2016), and at that time, I consulted a gynecologist who arranged for an abdominal ultrasound, X-rays, and blood tests.
Besides uterine fibroids, no other abnormalities were found.
Since the pain has lasted several days this time, I would like to visit the hospital again.
Should I still see a gynecologist, or should I consult a different specialty?

Lin Xiao Li, 40~49 year old female. Ask Date: 2017/05/16

Dr. Chen Taicheng reply Family Medicine

There are many causes of right lower abdominal pain, such as appendicitis, kidney or ureteral stones, and gynecological issues (such as ovarian cysts, corpus luteum cysts, uterine fibroids, adenomyosis, pelvic inflammatory disease, and even pregnancy).
If you experience abdominal pain every time your menstrual period ends, it may be related to menstruation, caused by uterine contractions.
However, if this is a one-time occurrence, it is advisable to first visit a family medicine physician, gastroenterologist, or the emergency department to rule out general internal medicine issues and acute abdominal pain (for example, appendicitis may require surgery).
After that, gynecological and urological issues can be considered.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares about you.

Reply Date: 2017/05/16

More Info

When experiencing persistent right lower abdominal pain, especially if it coincides with your menstrual cycle, it is crucial to seek medical attention to determine the underlying cause. Given your previous history of similar symptoms and the investigations that were conducted, it is advisable to consider a few factors before deciding which specialist to consult.

Firstly, since you have a history of uterine fibroids, it is essential to revisit the gynecologist. Fibroids can sometimes cause pain, especially during menstruation, and their size or position may change over time, leading to new symptoms. A gynecologist can perform a pelvic examination and may recommend imaging studies such as an ultrasound to assess the current state of the fibroids and rule out any other gynecological issues, such as ovarian cysts or endometriosis, which can also cause similar pain.

However, if the pain is severe, persistent, or accompanied by other symptoms such as fever, vomiting, changes in bowel habits, or urinary issues, it may be prudent to consult a gastroenterologist. Conditions such as appendicitis, diverticulitis, or even gastrointestinal issues like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) could present with right lower abdominal pain. A gastroenterologist can perform necessary tests, including blood tests, stool tests, or imaging studies like a CT scan, to evaluate the gastrointestinal tract.

Additionally, if there are concerns about urinary tract issues, especially if you experience symptoms like painful urination or changes in urination patterns, a urologist may also be a suitable option. Conditions such as kidney stones or urinary tract infections can sometimes manifest as abdominal pain.

In summary, considering your history and the nature of your symptoms, starting with a gynecologist is a reasonable approach, especially since your symptoms align with your menstrual cycle. However, if your symptoms do not improve or worsen, or if you develop new symptoms, do not hesitate to seek a consultation with a gastroenterologist or urologist as needed.

It is also important to communicate clearly with your healthcare provider about the duration and intensity of your pain, any associated symptoms, and your medical history. This information will help them make a more accurate diagnosis and develop an appropriate treatment plan. Remember, timely medical intervention is key to managing any potential underlying conditions effectively.

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