Right Lower Abdominal Pain: Is It IBS or Something More Serious?

Abdominal inquiry?

Hello, doctor.
I would like to ask you about my recent symptoms.
I've been experiencing bloating and gurgling sounds concentrated in my lower right abdomen.
I can distinctly feel the movement of food through the lower right abdomen when I eat, and it often gurgles (light pressure causes a sensation of gas).
This has occurred frequently over the past year, about 3-4 times.
When a doctor performed a physical examination and pressed on the area near the appendix and groin, it was quite painful.
I would like to know if irritable bowel syndrome could potentially cause pain in the same area? I'm very concerned about whether this could be a serious condition.

M, 30~39 year old female. Ask Date: 2021/08/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

Since the pain is not localized to a specific area, further examination may be necessary.

Reply Date: 2021/08/24

More Info

Understanding right lower abdominal pain can be quite complex, especially when considering conditions like Irritable Bowel Syndrome (IBS) versus more serious issues. Based on your description, it sounds like you are experiencing a combination of symptoms that could be indicative of several gastrointestinal conditions.

Firstly, IBS is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). It is important to note that IBS can cause localized pain, including in the right lower abdomen, particularly if there is an association with gas and bloating. The "gurgling" sounds you describe could be related to increased intestinal activity, which is common in IBS.

However, the fact that you experience significant pain upon palpation of the right lower abdomen, particularly near the area of the appendix (where the cecum is located), raises some concerns. While you mentioned that you have had these symptoms recurring over the past year, it is crucial to consider other potential causes of right lower abdominal pain, especially if the pain is severe or worsening.

Some serious conditions that could present with similar symptoms include:
1. Appendicitis: Even if you have had an appendectomy in the past, it is possible to develop complications such as an abscess or residual appendiceal tissue that could cause pain.

2. Diverticulitis: This condition involves inflammation of diverticula (small pouches that can form in the colon) and can cause localized pain, often in the lower left abdomen, but can also present in the right lower quadrant.

3. Ovarian Issues: In females, conditions such as ovarian cysts or ectopic pregnancy can cause pain in the lower abdomen, particularly on one side.

4. Hernias: An inguinal or femoral hernia could also present with pain in the lower abdomen, especially if there is a bulge or discomfort when straining or lifting.

5. Infections: Gastrointestinal infections or urinary tract infections can also cause localized pain and discomfort.

Given your symptoms, it is advisable to seek further evaluation from a healthcare provider. Diagnostic tests such as blood tests, imaging studies (like an ultrasound or CT scan), and possibly endoscopic examinations may be warranted to rule out any serious underlying conditions.
In summary, while IBS could explain some of your symptoms, the localized pain and the nature of your discomfort warrant a thorough investigation to rule out more serious conditions. It is always better to err on the side of caution when it comes to abdominal pain, especially if it is persistent or severe. Please consult with your healthcare provider for a comprehensive evaluation and appropriate management.

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