Post-Meal Lower Abdominal Pain: Causes and When to Seek Help

Lower abdominal pain after eating?

Hello Doctor: Last week, I experienced a feeling of heaviness and pain in the upper abdomen (just above the navel) after eating, along with bloating and a sensation of heat in the stomach after meals.
When fasting, I did not have any particular sensations.
I saw a doctor last week and took medication.
Starting this Sunday, the discomfort shifted to the lower abdomen after meals, accompanied by heaviness in the upper right abdomen, and I immediately felt the urge to have a bowel movement after eating (the stool is still formed, but the urgency feels similar to diarrhea).
The stool color is dark brown, and occasionally there is a whitish, mucus-like substance on the surface.
Over the past few days, I have occasionally been awakened at night by dull pain in the lower abdomen, but it is not very severe—just a feeling of heaviness.
Lying flat is more comfortable, but lying on one side causes the heaviness to return (I’m not sure why my sleeping position affects this).
During the day, I often feel warm, but my actual body temperature is consistently around 36 degrees Celsius, which is normal.
Could this be a simple intestinal issue, or could it be related to the gallbladder, liver, or kidneys? Would an abdominal ultrasound provide clearer insights? I do not smoke or drink alcohol, I have a habit of drinking coffee, my diet is light, I rarely consume sweets, and my daily routine is normal without staying up late.
There is a family history of diabetes.
In my twenties, I had an ultrasound that diagnosed moderate fatty liver, and about five or six years ago, I underwent an endoscopy, which revealed a small polyp that the doctor said did not require treatment.
Thank you, Doctor, for taking the time to respond!

EL, 30~39 year old female. Ask Date: 2020/10/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be gastrointestinal dysfunction or a side effect of medication.
Further examinations such as ultrasound or stool occult blood tests can be conducted to rule out other possibilities.

Reply Date: 2020/10/27

More Info

Post-meal lower abdominal pain can arise from a variety of causes, and understanding these can help determine when to seek medical attention. Given your symptoms, it’s essential to consider both gastrointestinal and potential systemic issues.

Possible Causes of Post-Meal Lower Abdominal Pain
1. Gastrointestinal Disorders:
- Irritable Bowel Syndrome (IBS): Characterized by abdominal pain, bloating, and changes in bowel habits, IBS can cause discomfort after meals.

- Gastritis or Peptic Ulcer Disease: Inflammation of the stomach lining or ulcers can lead to pain after eating, especially if the meal is spicy or acidic.

- Gallbladder Issues: Conditions like gallstones can cause pain in the upper abdomen after fatty meals, which may radiate to the lower abdomen.

- Constipation: If you are experiencing a sensation of urgency to defecate, it could be related to constipation, which can cause discomfort and bloating.

- Food Intolerances: Lactose intolerance or gluten sensitivity can lead to gastrointestinal distress after consuming certain foods.

2. Infections:
- Gastroenteritis: An infection of the stomach and intestines can lead to pain, diarrhea, and other gastrointestinal symptoms.

- Urinary Tract Infection (UTI): Sometimes, UTIs can present with abdominal pain, especially if the bladder is irritated after eating.

3. Organ-related Issues:
- Liver or Pancreatic Disorders: Conditions affecting these organs can manifest as abdominal pain, particularly if there is inflammation or obstruction.

- Kidney Stones: While typically presenting with flank pain, kidney stones can cause referred pain to the lower abdomen.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Persistent or worsening pain that does not improve with over-the-counter medications.

- Significant changes in bowel habits, such as diarrhea or constipation lasting more than a few days.

- Presence of blood in stool or dark, tarry stools, which could indicate bleeding in the gastrointestinal tract.

- Fever, chills, or other systemic symptoms that suggest an infection.

- Unexplained weight loss or loss of appetite.

Diagnostic Considerations
Given your history of fatty liver and previous gastrointestinal issues, it would be prudent to undergo further evaluation. An abdominal ultrasound can be beneficial in visualizing the liver, gallbladder, and other abdominal organs to rule out structural abnormalities. Additionally, if your symptoms persist, further tests such as a CT scan or endoscopy may be warranted to investigate the underlying cause more thoroughly.

Conclusion
Your symptoms could be indicative of a range of gastrointestinal issues, and while some may be benign, others could require more urgent attention. It’s essential to maintain open communication with your healthcare provider and report any changes in your symptoms. Keeping a symptom diary, noting what you eat and how it affects your pain, can also be helpful for your doctor in diagnosing the issue. Given your family history of diabetes, it’s also wise to monitor your blood sugar levels, as metabolic issues can sometimes present with gastrointestinal symptoms.

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