Lower Abdominal Pain: Possible Causes and Diagnosis

Q: Lower Abdominal Pain: Possible Causes and Diagnosis

Hello： The symptoms you mentioned may be due to nerve root compression at the twelfth thoracic or first lumbar vertebra, which can cause neuropathic pain. <br>This is often observed during exertion or when there is an increase in abdominal pressure. <br>I recommend consulting a n

Lower abdominal pain?

Since I was in elementary school, I have experienced this symptom about 1 to 3 times a month.
It occurs when my pelvis tilts forward, and when I stretch, particularly when my lower abdomen is extended, I feel a sharp pain that runs from my navel to my genitals, which is excruciating.
It also hurts when I urinate, but as long as I avoid stretching my lower abdomen and urinating, I have no issues while sitting, standing, or doing other activities.
This symptom completely disappears after I sleep or after some time, but it reappears after a while.
I later observed that it tends to occur when I need to have a bowel movement and hold it in for too long, causing my abdomen to bloat for a period.
I also have irritable bowel syndrome, which often causes mild cramping in my lower abdomen and frequent urges to defecate.
I'm unsure if the symptom I described is related to this.
However, I hope the doctor can provide possible diagnoses or causes for my described symptoms.
Thank you.

Niming, 20~29 year old female. Ask Date: 2019/02/12

Dr. Jiang Junyi reply Neurology

Hello: The symptoms you mentioned may be due to nerve root compression at the twelfth thoracic or first lumbar vertebra, which can cause neuropathic pain.
This is often observed during exertion or when there is an increase in abdominal pressure.
I recommend consulting a neurologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2019/02/12

More Info

Understanding lower abdominal pain can be quite complex, as it can stem from a variety of causes, especially when considering the symptoms you've described. Your experience of severe pain in the lower abdomen, particularly when stretching or during urination, raises several possibilities that warrant further exploration.

Firstly, the pain you experience when stretching or bending forward could be related to musculoskeletal issues. Conditions such as muscle strain or ligamentous laxity can lead to discomfort during certain movements. However, given that you also experience pain during urination, it is essential to consider other potential causes.

The association of your symptoms with bowel movements and the fact that you have irritable bowel syndrome (IBS) could suggest a connection. IBS is known to cause abdominal pain, bloating, and changes in bowel habits. The pain you feel might be exacerbated by constipation, which is common in individuals with IBS. When stool builds up in the intestines, it can create pressure and lead to discomfort in the lower abdomen. This could explain why you notice the pain more when you have delayed bowel movements.

Additionally, the pain during urination could indicate a urinary tract issue. Conditions such as a urinary tract infection (UTI) or interstitial cystitis can cause significant discomfort during urination and may also lead to referred pain in the lower abdomen. It’s important to rule out these possibilities, especially if you notice any changes in your urinary habits or if you experience any additional symptoms like fever or unusual discharge.

Another potential cause to consider is pelvic floor dysfunction. This condition can occur when the muscles of the pelvic floor are too tight or too weak, leading to pain during certain activities, including stretching and urination. Pelvic floor dysfunction is often associated with IBS and can contribute to the symptoms you are experiencing.

Given your history of these symptoms since childhood, it would be prudent to consult with a healthcare provider who can perform a thorough evaluation. This may include a physical examination, urinalysis, and possibly imaging studies to assess for any underlying conditions. A referral to a gastroenterologist or a urologist may also be beneficial, depending on the findings.

In summary, the symptoms you describe could be related to a combination of factors, including IBS, musculoskeletal issues, urinary tract conditions, or pelvic floor dysfunction. It is crucial to seek medical advice to obtain a proper diagnosis and treatment plan tailored to your specific situation. Keeping a symptom diary that tracks your pain episodes, bowel habits, and any other related symptoms can also be helpful for your healthcare provider in determining the underlying cause of your discomfort.

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