Lower Abdominal Pain: Seeking the Right Specialist

Q: Lower Abdominal Pain: Seeking the Right Specialist

Dear Ms. <br>Emily： Issues related to the perineum and lower abdomen should indeed consider gynecological or urological problems. <br>Common concerns include infections, tumors, endometriosis, urinary tract stones, and inflammation of the bladder or urethra, among others; of cour

Lower abdominal pain?

Hello Doctor: For the past three years, I have been experiencing a vague stabbing and burning sensation in the area just above the genital region, as well as a tight feeling in both groins.
I have undergone a gynecological examination, hysterosalpingography, and ultrasound, all of which showed no abnormalities.
Urinalysis from the urology department also returned normal results.
I do not have symptoms of frequent urination or nocturia.
I am very distressed and would like to know which specialty I should consult to find the cause.
Thank you!

Emily, 30~39 year old female. Ask Date: 2022/01/10

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Emily: Issues related to the perineum and lower abdomen should indeed consider gynecological or urological problems.
Common concerns include infections, tumors, endometriosis, urinary tract stones, and inflammation of the bladder or urethra, among others; of course, there are also other rare conditions.
It is advisable to consult a trusted urologist for further evaluation.

Reply Date: 2022/01/10

More Info

When dealing with persistent lower abdominal pain, especially when accompanied by sensations such as burning or tightness in the groin area, it can be quite distressing. Given your history of evaluations by gynecologists and urologists, it seems that common gynecological and urinary tract issues have been ruled out. However, the ongoing discomfort suggests that further investigation is warranted.

First, it is essential to understand that lower abdominal pain can stem from various sources, including gastrointestinal, musculoskeletal, or even neurological origins. Since your gynecological and urological evaluations have not revealed any abnormalities, it may be beneficial to consider other specialties that could provide insight into your symptoms.

1. Gastroenterology: Since you are experiencing lower abdominal pain, it might be worthwhile to consult a gastroenterologist. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional gastrointestinal disorders could manifest as abdominal pain without obvious structural abnormalities. A gastroenterologist can perform further tests, such as a colonoscopy, to rule out conditions affecting the intestines.

2. Pain Management or Neurology: If gastrointestinal causes are ruled out, consider consulting a pain management specialist or a neurologist. Sometimes, nerve-related issues can cause pain in the abdominal region. Conditions like neuropathy or nerve entrapment could lead to sensations of burning or tightness. A neurologist can assess for any nerve-related issues that might be contributing to your symptoms.

3. Musculoskeletal Evaluation: It may also be beneficial to consult an orthopedic specialist or a physical therapist. Musculoskeletal pain can sometimes be referred to the abdominal area, especially if there are issues with the pelvic floor muscles or the lower back. A thorough physical examination may reveal tightness or dysfunction in the muscles that could be contributing to your discomfort.

4. Psychosomatic Considerations: Given that stress and anxiety can exacerbate physical symptoms, it might be helpful to consider a consultation with a mental health professional. They can help address any underlying anxiety or stress that may be contributing to your symptoms. Mind-body approaches, such as cognitive-behavioral therapy (CBT), can be effective in managing chronic pain.

5. Holistic Approaches: Lastly, exploring holistic or integrative medicine could provide additional relief. Practitioners in this field often consider the whole person, including lifestyle, diet, and emotional well-being. Techniques such as acupuncture, yoga, or dietary adjustments may help alleviate symptoms.

In summary, while your previous evaluations have not yielded a clear diagnosis, it is crucial to continue seeking answers. A multidisciplinary approach involving gastroenterology, pain management, musculoskeletal evaluation, and mental health support may provide a comprehensive understanding of your symptoms. Keep advocating for your health, and don't hesitate to seek further opinions until you find a resolution to your discomfort.

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