Right Lower Abdominal Pain: Causes and Next Steps - Gastroenterology and Hepatology

More Info

---

Understanding right lower abdominal pain can be complex, as it can stem from various underlying conditions. In your case, given the history of gastrointestinal evaluations, including a gastroscopy, colonoscopy, and abdominal ultrasound, it seems that some potential causes have already been ruled out or addressed. However, the persistent sensation of discomfort or a foreign body feeling in the right lower abdomen warrants further exploration.

The right lower quadrant of the abdomen is home to several vital organs, including parts of the intestines, the appendix, and in females, the ovaries and fallopian tubes. Given your previous findings of a 0.5 cm polyp that was removed and the diagnosis of moderate fatty liver disease, it is essential to consider how these conditions might relate to your current symptoms.

1. Fatty Liver Disease and Liver Function: Fatty liver disease can lead to inflammation of the liver (steatohepatitis), which may cause discomfort in the right upper quadrant, but it can sometimes radiate to the lower abdomen. Abnormal liver function tests (elevated GPT and GOT) indicate that there is some degree of liver inflammation or damage, which could contribute to abdominal discomfort. However, it is less common for liver issues to cause a sensation of a foreign body in the lower abdomen.

2. Gastrointestinal Issues: Since you have had a polyp removed, it is essential to consider other gastrointestinal issues that may not have been fully evaluated. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even residual effects from the polyp removal could lead to sensations of discomfort. Additionally, if there is any scarring or adhesions from previous surgeries, these could also contribute to abnormal sensations in the abdomen.

3. Renal Considerations: Given your inquiry about whether to see a nephrologist, it is worth considering kidney-related issues. Kidney stones or infections can sometimes present with referred pain in the lower abdomen. If you experience any urinary symptoms, such as changes in urination, pain during urination, or blood in the urine, it would be prudent to consult a nephrologist for further evaluation.

4. Gynecological Factors: If you are female, gynecological issues such as ovarian cysts, endometriosis, or pelvic inflammatory disease could also cause discomfort in the lower abdomen. These conditions can sometimes mimic gastrointestinal symptoms, so a gynecological evaluation may be warranted.

5. Next Steps: Given the complexity of your symptoms and the previous evaluations, it may be beneficial to follow up with your primary care physician or a gastroenterologist to discuss your ongoing symptoms. They may recommend further imaging studies, such as a CT scan or MRI, to get a clearer picture of the abdominal organs. Additionally, if you have not yet seen a gynecologist or nephrologist, it may be worthwhile to do so, especially if your symptoms persist or worsen.

In summary, while your liver condition may contribute to your symptoms, it is essential to consider a broader range of potential causes, including gastrointestinal, renal, and gynecological factors. A multidisciplinary approach involving your primary care physician, gastroenterologist, nephrologist, and possibly a gynecologist will provide the best chance of identifying the underlying cause of your discomfort and determining the appropriate treatment.