Sudden Severe Lower Abdominal Pain: Possible Causes and Solutions

Sudden severe pain in the lower abdomen?

Hello doctor, today around 7 PM, I suddenly experienced severe pain in my lower abdomen.
Due to the intensity of the pain, I took one dose of Eve.
Since the pain persisted, I checked the instructions for the pain medication, which indicated that adults should take two tablets at a time.
After half an hour, I took another one.
The pain has slightly improved, and I have passed gas twice.
I have felt nauseous twice as well, with pain on both sides of my lower abdomen and pelvic cavity.
There is no bleeding.
I had intercourse on February 4th, and my app indicates that my period is due in two days.
I have been experiencing a metallic taste in my vagina for several days.
What could this condition be?

Xuan, 10~19 year old female. Ask Date: 2018/02/12

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Today around 7 PM, I suddenly experienced severe pain in my lower abdomen.
Due to the intensity of the pain, I took one dose of Eve (a pain reliever).
Since the pain persisted, I checked the medication instructions, which indicate that adults should take two tablets at once.
After half an hour, I took another one.
The pain has slightly improved, and I have passed gas twice.
I have felt nauseous twice, and I am experiencing pain on both sides of my lower abdomen and pelvic cavity.
There is no bleeding.
On February 4th, I had intercourse, and my app indicates that my period is due in two days.
I have noticed a metallic taste in my vagina that has lasted for several days.

Answer: On February 12th, I experienced sudden severe pain in my lower abdomen.
I have passed gas twice and felt nauseous twice, with pain on both sides of my lower abdomen and pelvic cavity.
There is no bleeding.
After having intercourse on February 4th, my app indicates that my period is due on February 14th.
It would be best to consult a gynecologist and a gastroenterologist for a thorough examination.

Reply Date: 2018/02/12

More Info

Sudden severe lower abdominal pain can be alarming and may arise from various underlying conditions. Based on your description, it seems that you are experiencing significant discomfort in the lower abdomen, along with some gastrointestinal symptoms such as nausea and changes in bowel habits. It is important to consider several potential causes for your symptoms, as well as the appropriate steps to take.

Possible Causes
1. Gastrointestinal Issues: Conditions such as appendicitis, diverticulitis, or bowel obstruction can lead to sudden and severe abdominal pain. Appendicitis, for instance, typically presents with pain that starts around the navel and then shifts to the lower right abdomen, often accompanied by nausea and vomiting. Diverticulitis, which involves inflammation of pouches in the colon, can also cause similar symptoms, particularly in individuals over 40.

2. Gynecological Concerns: Given that you mentioned recent sexual activity and the timing of your menstrual cycle, it is crucial to consider gynecological issues. Conditions such as ovarian cysts, ectopic pregnancy, or pelvic inflammatory disease (PID) can cause severe lower abdominal pain. Ectopic pregnancy, in particular, is a medical emergency that occurs when a fertilized egg implants outside the uterus, often leading to severe pain and potentially life-threatening complications.

3. Urinary Tract Issues: Kidney stones or urinary tract infections (UTIs) can also manifest as lower abdominal pain. If the pain is accompanied by changes in urination or blood in the urine, these conditions should be considered.

4. Musculoskeletal Pain: Sometimes, pain in the lower abdomen can stem from muscle strain or injury, especially if there was any recent physical activity that could have led to such an injury.

Recommendations
1. Seek Medical Attention: Given the severity of your pain, the presence of nausea, and the potential for serious underlying conditions, it is advisable to seek medical attention promptly. A healthcare provider can perform a physical examination and may order imaging studies (such as an ultrasound or CT scan) to determine the cause of your symptoms.

2. Monitor Symptoms: Keep track of any additional symptoms that may arise, such as fever, changes in bowel habits, or any unusual discharge. This information can be helpful for your healthcare provider in making a diagnosis.

3. Avoid Self-Medication: While you have taken pain relief medication, it is essential to avoid taking additional medications without consulting a healthcare professional, as this can mask symptoms and complicate diagnosis.

4. Hydration and Rest: Ensure you stay hydrated and rest as much as possible while you seek medical care. Avoid solid foods if you are feeling nauseous, and consider a bland diet if you can tolerate it.

5. Consider Gynecological Evaluation: Given the timing of your symptoms with your menstrual cycle and the mention of a "metallic" taste, it may be beneficial to have a gynecological evaluation to rule out any reproductive health issues.

Conclusion
Sudden severe lower abdominal pain can arise from various causes, some of which may require immediate medical intervention. It is crucial to seek medical attention to determine the underlying cause and receive appropriate treatment. Do not hesitate to reach out to a healthcare provider, as timely intervention can be vital in managing potentially serious conditions.

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