Lower Abdominal Pain: Gastrointestinal or Gynecological Issues?

Lower abdominal distension and pain below the navel?

Hello Doctor: During a meeting yesterday, I held my urine for a while, and after using the restroom, I clearly felt a bloating pain in my lower abdomen.
It's not extremely painful, just a slight discomfort.
I don't feel it when sitting, but if I engage my abdominal muscles, I experience the bloating pain again, concentrated just below the navel and on the right side; the left side feels fine.
Additionally, I have stomach pain and frequent urination, going to the restroom four times in an hour.
It shouldn't be a urinary tract infection, as there is no burning sensation.
I previously consulted a gynecologist, who advised me to take care of my gastrointestinal health, but I'm now uncertain whether this is a gynecological issue or a gastrointestinal problem.
Could you please help clarify this for me? Thank you.

zero zero, 20~29 year old female. Ask Date: 2018/08/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
It is recommended that you visit the outpatient clinic to have your urine checked to rule out any urinary tract infection issues.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/08/29

More Info

Understanding lower abdominal pain can be quite complex, especially when it involves potential gastrointestinal or gynecological issues. Based on your description, it seems that you are experiencing a combination of symptoms, including lower abdominal discomfort, gastric pain, and frequent urination. Let's break down these symptoms and explore possible causes and solutions.

Potential Causes of Lower Abdominal Pain
1. Gastrointestinal Issues:
- Irritable Bowel Syndrome (IBS): This is a common condition that can cause abdominal pain, bloating, and changes in bowel habits. Stress and dietary factors often exacerbate IBS symptoms.

- Constipation: If you have been experiencing irregular bowel movements, this could lead to abdominal discomfort and a feeling of fullness or pressure.

- Gastritis or Peptic Ulcers: Inflammation of the stomach lining or ulcers can cause gastric pain, which may be perceived as discomfort in the lower abdomen.

- Diverticulitis: This condition involves inflammation of small pouches that can form in the walls of the intestines, leading to pain, especially in the lower left abdomen.

2. Gynecological Issues:
- Ovarian Cysts: These fluid-filled sacs can cause discomfort, particularly if they rupture or become large.

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

- Pelvic Inflammatory Disease (PID): An infection of the reproductive organs can cause lower abdominal pain and may also lead to urinary symptoms.

- Fibroids: Non-cancerous growths in the uterus can lead to pressure and pain in the lower abdomen.

3. Urinary Issues:
- Bladder Irritation: Conditions such as interstitial cystitis can cause bladder pain and frequent urination without the typical symptoms of a urinary tract infection (UTI).

- Urinary Tract Infection (UTI): While you mentioned a lack of burning sensation, some UTIs can present with pressure and discomfort without classic symptoms.

Diagnostic Approach
Given the variety of potential causes, a thorough evaluation is essential. Here are some steps you might consider:
- Medical History and Physical Examination: A detailed history of your symptoms, including their onset, duration, and any associated factors (like diet or stress), is crucial. A physical exam can help identify areas of tenderness or other signs of underlying conditions.

- Laboratory Tests: Blood tests, urine analysis, and stool tests can help rule out infections or other systemic issues.
- Imaging Studies: An abdominal ultrasound or CT scan can provide visual insights into the organs in your lower abdomen, helping to identify cysts, fibroids, or other abnormalities.

Management Strategies
1. Dietary Adjustments: If IBS or gastritis is suspected, consider keeping a food diary to identify potential triggers. A diet high in fiber can help with constipation, while avoiding spicy or acidic foods may alleviate gastritis symptoms.

2. Stress Management: Since stress can exacerbate gastrointestinal symptoms, techniques such as mindfulness, yoga, or cognitive behavioral therapy may be beneficial.

3. Medication: Depending on the diagnosis, medications such as antacids, proton pump inhibitors, or anti-inflammatory drugs may be prescribed. If a gynecological issue is identified, hormonal treatments or pain management strategies may be necessary.

4. Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment as needed.

Conclusion
In summary, lower abdominal pain can stem from a variety of gastrointestinal or gynecological issues. Given your symptoms of discomfort, gastric pain, and frequent urination, it is advisable to consult with a healthcare provider who can conduct a thorough evaluation and guide you toward appropriate management. Keeping track of your symptoms and any changes can also be helpful in your discussions with your doctor. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek further medical advice.

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