Right Lower Abdominal Pain: Causes and When to Seek Help

Q: Right Lower Abdominal Pain: Causes and When to Seek Help

Hello： You can consult with a gastroenterologist or a colorectal specialist. <br>The specific causes should be assessed by a clinical physician. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-Shun.

Right lower abdominal pain?

Hello, Doctor: I have been experiencing abdominal pain for some time.
Initially, I thought it was menstrual pain caused by endometriosis, so I have been taking medication and receiving injections to stop my menstruation to alleviate the pain.
However, in the past two to three days, I have started to experience abdominal pain after dinner, which lasts until dawn.
During this time, the pain is so severe that I cannot sleep.
My abdomen feels bloated, and I have frequent urges to urinate and have a bowel movement, but usually, I can only urinate due to the intense abdominal pain preventing me from having a bowel movement.
The pain feels somewhat burning, sometimes sharp, sometimes bloated, and sometimes a dull ache.
Initially, the pain radiates to my right thigh, and then it develops a burning sensation.
It is difficult to pinpoint the exact location of the pain; it feels like the entire right side of my abdomen and the nerves in my right leg are affected.
I often have irregular meal patterns, usually only eating dinner, frequently having late-night snacks, and often going to bed around dawn.
I wonder if this is related.
Could this be chronic appendicitis? Which specialty should I consult for examination or diagnosis? Thank you, Doctor, for your patience in reading this.
I hope to receive some advice.
I have been staying up until 4 or 5 AM and only recently have I been unable to sleep until dawn due to the abdominal pain after dinner.

yvonne, 30~39 year old female. Ask Date: 2018/11/23

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: You can consult with a gastroenterologist or a colorectal specialist.
The specific causes should be assessed by a clinical physician.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2018/11/23

More Info

Understanding right lower abdominal pain can be quite complex, as it can stem from a variety of causes. Based on your description, it seems that you are experiencing significant discomfort that has been persistent and is affecting your quality of life, particularly your sleep. Let’s break down the potential causes and when you should seek medical help.

Possible Causes of Right Lower Abdominal Pain
1. Gastrointestinal Issues: Given your eating habits—irregular meal times and late-night snacking—gastrointestinal problems could be a significant factor. Conditions such as gastritis, irritable bowel syndrome (IBS), or even constipation can lead to abdominal pain, bloating, and changes in bowel habits. The pain you describe as burning or stabbing could be related to acid reflux or gastrointestinal irritation.

2. Appendicitis: While you mentioned the possibility of chronic appendicitis, it's important to note that appendicitis typically presents with acute pain that worsens over time. However, in some cases, it can present with intermittent pain. If you experience fever, nausea, or a significant change in pain intensity, this could warrant immediate medical attention.

3. Gynecological Issues: Since you have a history of endometriosis, it is crucial to consider that your pain could be related to this condition. Endometriosis can cause cyclical pain, but it can also lead to chronic pain that may not strictly align with your menstrual cycle. Other gynecological conditions, such as ovarian cysts or pelvic inflammatory disease, could also be contributing to your symptoms.

4. Urinary Tract Issues: The symptoms of frequent urination and discomfort could indicate a urinary tract infection (UTI) or bladder issues. These conditions can cause abdominal pain and may also lead to discomfort in the lower abdomen and back.

5. Nerve Pain: The radiation of pain to your thigh suggests that there may be nerve involvement. Conditions such as sciatica or other nerve entrapments can cause referred pain that feels like it originates from the abdomen.

When to Seek Help
Given the complexity of your symptoms and their impact on your daily life, it is advisable to seek medical attention. Here are some guidelines on when to see a doctor:
- Persistent Pain: If the pain continues to disrupt your sleep and daily activities, it’s time to consult a healthcare professional.

- Acute Changes: If you experience a sudden increase in pain intensity, fever, vomiting, or changes in bowel habits (such as severe constipation or diarrhea), seek immediate medical attention.

- Chronic Symptoms: If your symptoms have been ongoing for several weeks, it is essential to have a thorough evaluation.

Recommended Specialists
1. Gastroenterologist: Given your symptoms, a gastroenterologist would be well-suited to evaluate potential gastrointestinal issues. They may recommend tests such as an ultrasound, CT scan, or endoscopy to assess your digestive health.

2. Gynecologist: Since you have a history of endometriosis, consulting a gynecologist is crucial. They can perform pelvic examinations and imaging studies to rule out any gynecological conditions.

3. Urologist: If urinary symptoms persist, a urologist can help assess for any urinary tract issues.

Conclusion
In summary, your symptoms warrant a comprehensive evaluation by a healthcare professional. It’s essential to communicate all your symptoms clearly, including the nature of the pain, associated symptoms, and your eating and sleeping habits. This information will help your doctor determine the most appropriate diagnostic tests and treatment options. Remember, early intervention can lead to better outcomes, so don’t hesitate to seek help.

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