Chronic Abdominal Pain: Causes and Next Steps - Gastroenterology and Hepatology

Q: Chronic Abdominal Pain: Causes and Next Steps

Hello： 1. <br>The retention of stool can lead to bloating, and excessive stool volume may cause abdominal pain. <br>Additionally, if there is a history of abdominal surgery, the possibility of intestinal adhesions should also be considered. <br>2. <br>To determine if the abdomina

Abdominal pain

Current status: I have not had my menstrual period for six months, and I have already ruled out conditions that should not be related to abdominal pain.
I am currently seeing an immunologist for issues unrelated to the abdomen and have tested positive for a suspected urinary tract infection, which is still under investigation.
Around the end of February, I experienced continuous dull abdominal pain for several days.
I consulted a doctor who, after examination, suggested that it was due to excessive stool, causing gastrointestinal discomfort.
At that time, I didn't think much of it and took medication for a few days without experiencing any urge to defecate.
After finishing the medication, I started to feel some urge, initially about 0-1 times a day, which gradually increased to at least once daily, and sometimes up to three times.
However, I still experience daily abdominal pain, which I generally attribute to constipation, but there are specific areas that hurt more, particularly in the lower right abdomen and just below the center of the chest, as well as on both sides of that point.
Sometimes the pain radiates downwards (towards the area near the uterus).
I'm unsure if the pain in that area is causing a misperception or if that area is genuinely painful.

I would like to ask: Can retained stool cause daily pain? Previously, aside from experiencing diarrhea from unclean food, I rarely had abdominal pain.
Now, I am having daily bowel movements, so why do I still experience abdominal pain every day? It has been two months of pain now.
During my visit to the immunologist, I raised this issue, and the doctor suggested that it could still be related to gastrointestinal problems, and also mentioned the possibility of a urinary tract infection or the absence of menstruation being a contributing factor.
I am currently taking a total of five different medications.
What I primarily want to know is whether retained stool can indeed cause this kind of pain.
If so, I will leave it be; if not, should I consult a gastroenterologist or address the gynecological issues first? Thank you for your assistance, doctor.

Niming, 20~29 year old female. Ask Date: 2021/04/25

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
The retention of stool can lead to bloating, and excessive stool volume may cause abdominal pain.
Additionally, if there is a history of abdominal surgery, the possibility of intestinal adhesions should also be considered.
2.
To determine if the abdominal pain is caused by retained stool, one can take a stool softener or a bowel cleansing agent to clear the stool completely and see if the pain persists.
It is advisable to consult a gastroenterologist for evaluation and treatment.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2021/04/25

More Info

Chronic abdominal pain can be a complex issue with various potential causes, and it is essential to approach it systematically to identify the underlying problem. Given your situation, where you have been experiencing persistent abdominal pain for two months, it is crucial to consider several factors that could contribute to your symptoms.

Firstly, the term "宿便" (stool retention or constipation) can indeed lead to abdominal discomfort, but it typically manifests as a feeling of fullness, bloating, or cramping rather than sharp or localized pain. If you are experiencing daily pain despite having regular bowel movements, it may suggest that the pain is not solely due to constipation. The pain you describe in the right lower abdomen and the area near the uterus could indicate several possibilities, including gastrointestinal issues, gynecological conditions, or even urinary tract problems.

1. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional dyspepsia can cause chronic abdominal pain. IBS, in particular, can lead to a combination of constipation and abdominal pain, often relieved by bowel movements. If your pain is associated with changes in bowel habits or is triggered by certain foods, this could be a consideration.

2. Gynecological Conditions: Given that you mentioned pain near the uterus, it is essential to consider gynecological issues such as endometriosis, ovarian cysts, or pelvic inflammatory disease (PID). Endometriosis can cause significant pain, especially during menstruation or ovulation, and may lead to chronic pelvic pain. If your menstrual cycle has been irregular or absent, this could further complicate the situation.

3. Urinary Tract Issues: A suspected urinary tract infection (UTI) can also cause abdominal pain, particularly if it involves the bladder or kidneys. Symptoms may include pain during urination, increased frequency, or urgency. If you are experiencing any urinary symptoms, it is essential to address this with your healthcare provider.

4. Psychosomatic Factors: Chronic pain can sometimes be exacerbated by psychological factors such as stress or anxiety. If you have a history of anxiety, it may contribute to the perception of pain or exacerbate existing conditions.

Given that you are already under the care of an immunologist and have ruled out some conditions, it may be beneficial to consult a gastroenterologist for a thorough evaluation of your gastrointestinal health. They may recommend further diagnostic tests, such as imaging studies (ultrasound, CT scan) or endoscopic procedures, to assess for any underlying gastrointestinal pathology.

Additionally, if you have not yet seen a gynecologist, it would be prudent to do so, especially considering your menstrual irregularities. They can perform a pelvic exam and possibly imaging studies to rule out any gynecological issues contributing to your pain.

In summary, while stool retention can cause discomfort, the persistent nature of your pain suggests that further investigation is warranted. It is advisable to follow up with both a gastroenterologist and a gynecologist to explore all potential causes of your symptoms comprehensively. Keeping a detailed symptom diary, including the timing, nature, and triggers of your pain, can also be helpful for your healthcare providers in diagnosing your condition.

Similar Q&A

Understanding Chronic Abdominal Pain: Possible Causes and Next Steps

Hello, doctor. For the past six months, I have frequently experienced abdominal bloating and pain accompanied by cold sweats, nausea, dizziness, and a feeling of wanting to vomit. The pain is not localized and can be felt from below the ribs to below the navel, often with a sensa...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Please discuss with a gastroenterologist and implement dietary control along with moderate exercise to reduce stress. An ultrasound examination may also be considered.

Chronic Abdominal Pain: Understanding Symptoms and Next Steps

I have been experiencing persistent pain in my lower abdomen, which includes cramping, dull pain, and sharp pain. Initially, the pain was localized in the lower abdomen, sometimes on the left side, sometimes on the right, and sometimes in the middle or around the bladder and uter...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: 1. Disorders of the small intestine are quite rare. If various examinations have been conducted and the diagnosis is irritable bowel syndrome, the next step is to adjust the medication. 2. Abdominal ultrasound primarily examines organs such as the liver, gallbladder, pancr...

Understanding Chronic Abdominal Pain: Causes and When to Seek Help

Hello Dr. Lin: My symptoms include occasional sharp pain on the right side of my abdomen near the navel. I previously consulted a gastroenterologist who suggested it might be small intestine inflammation, but this happens frequently! Could it be a case of habitual inflammation? I...

Dr. Lin Minghui reply Gastroenterology and Hepatology
1. Pain located to the right of the navel may have several possible causes, including gastroenteritis, intestinal disorders, pancreatitis, and tumors. If the pain is persistent, it is important to investigate the underlying cause, as conditions such as small intestine inflammatio...

Understanding Chronic Abdominal Pain: Possible Causes Beyond Stress

Dear Doctor: My husband has been experiencing frequent abdominal pain for over six months, to the point where he is unable to go to work. He is a mental health therapist, and his father is a retired internist. They have searched through almost all the major hospitals in Taichung ...

Dr. Su Baojia reply Gastroenterology and Hepatology
Other conditions such as localized enteritis, mesenteric lymphadenitis, mesenteric cysts, embolic multifocal arteritis, and arterial stenosis can also cause abdominal pain.