Right Lower Abdominal Pain: Causes and Concerns - Gastroenterology and Hepatology

Pain extending down from the right lower abdomen to the pelvic area?

Hello doctor, for the past week, I've been experiencing some pain around my right lower abdomen and pelvic area.
The pain is constant and feels like a dull ache (especially noticeable when pressed).
Upon careful examination, I can feel a slight swelling (in a narrow, elongated shape) extending from the right pelvic area down through the right lower abdomen, where there is also noticeable gastrointestinal motility and bowel sounds.
Sometimes, I even feel sensations similar to intestinal spasms.
My bowel movements have been normal so far (yellow in color, occasional loose stools), but the stools have become thinner.
Could this possibly indicate a serious condition, such as diverticulitis or a hernia (there are no visible lumps)? I've been under a lot of stress lately, but I felt more relaxed after completing a project yesterday; however, the abdominal discomfort has not subsided.
A week ago, I visited a clinic and was prescribed some pain relievers, stomach medication, and antispasmodics, but after three days of taking them, there has been no significant improvement.
I'm a bit worried...

Luka, 20~29 year old female. Ask Date: 2021/03/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

If the medication does not improve your condition, you should visit the hospital for an examination.

Reply Date: 2021/03/24

More Info

Understanding right lower abdominal pain can be quite complex, as it can stem from various causes, some of which may require immediate medical attention. Based on your description, it seems you are experiencing persistent discomfort in the right lower abdomen, accompanied by a sensation of swelling and abnormal bowel activity. Let's break down the potential causes and concerns associated with your symptoms.

Possible Causes of Right Lower Abdominal Pain
1. Appendicitis: One of the most common causes of right lower abdominal pain is appendicitis, which occurs when the appendix becomes inflamed. Symptoms typically include sharp pain that starts around the navel and then moves to the lower right abdomen, along with nausea, vomiting, and fever.

2. Ovarian Issues: In females, conditions such as ovarian cysts or ectopic pregnancy can cause pain in the right lower abdomen. These conditions may also present with additional symptoms like irregular menstrual cycles or unusual discharge.

3. Hernia: An inguinal hernia can occur when tissue protrudes through a weak spot in the abdominal muscles. This may not always be visible externally but can cause localized pain and discomfort, especially when lifting or straining.

4. Diverticulitis: This condition arises when diverticula (small pouches) in the colon become inflamed or infected. Symptoms may include abdominal pain, fever, and changes in bowel habits.

5. Gastrointestinal Issues: Conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even constipation can lead to discomfort and altered bowel movements. The sensation of bowel movement irregularities, such as thinner stools, can be indicative of underlying gastrointestinal issues.

6. Musculoskeletal Pain: Sometimes, pain in the abdominal area can be referred from musculoskeletal issues, such as muscle strains or ligament injuries, especially if there has been recent physical activity or heavy lifting.

Psychological Factors
You mentioned experiencing increased stress recently, which can exacerbate gastrointestinal symptoms. Stress and anxiety can lead to heightened sensitivity to pain and discomfort, as well as changes in bowel habits. The gut-brain connection is well-documented, and psychological stress can manifest physically, leading to symptoms such as abdominal pain and altered bowel function.

When to Seek Medical Attention
Given that your symptoms have persisted for over a week without significant improvement despite medication, it is crucial to follow up with your healthcare provider. They may recommend further diagnostic tests, such as imaging studies (ultrasound or CT scan), to rule out serious conditions like appendicitis or diverticulitis.
Additionally, if you experience any of the following symptoms, seek immediate medical attention:
- Severe abdominal pain that worsens
- Fever or chills
- Persistent vomiting
- Blood in your stool
- Unexplained weight loss

Conclusion
While there are many potential causes for your right lower abdominal pain, it is essential to approach this symptom with caution. The combination of your symptoms, including the sensation of swelling and changes in bowel habits, warrants further investigation to rule out any serious conditions. Stress can certainly play a role in exacerbating gastrointestinal symptoms, but it is vital to ensure that there are no underlying physical issues that need to be addressed. Please consult with your healthcare provider for a thorough evaluation and appropriate management of your symptoms.

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