Chronic Right Lower Abdominal Pain: Is It a Gallbladder Issue?

Persistent dull pain in the lower right abdomen for more than one year, occurring periodically?

Hello Doctor, I have been experiencing a mild dull pain in my lower right abdomen for over a year now, which occurs every 1-2 days, usually about 6 hours after eating.
The episodes last approximately 30 minutes to 1 hour.
During these episodes, I feel bloating and pain when I inhale or press on the lower right abdomen, and occasionally the pain shifts to the middle of my abdomen.
My stools are mostly yellow, loose, and float on the water like egg drop soup.
I often feel gurgling in my stomach and have frequent flatulence.
I would like to ask if there is a problem with my gallbladder?

Mr. Feng, 20~29 year old female. Ask Date: 2022/02/15

Dr. Chen Shidian reply Gastroenterology and Hepatology

Not related to the gallbladder (which is located in the right upper abdomen); it may be an issue with digestive motility.
If still concerned, a fecal occult blood test can be performed first.

Reply Date: 2022/02/15

More Info

Chronic right lower abdominal pain can be quite distressing, especially when it has persisted for over a year. Based on your description, there are several potential causes for your symptoms, and while gallbladder issues could be one of them, it’s important to consider a broader differential diagnosis.

Gallbladder problems, such as gallstones or cholecystitis, typically present with pain in the right upper quadrant, especially after meals, particularly fatty meals. However, the pain can sometimes radiate to the right lower abdomen or even the back. The fact that your pain occurs about six hours after eating and is associated with bloating and gas could suggest a gastrointestinal issue rather than a primary gallbladder problem.
Your symptoms of intermittent dull pain, bloating, and changes in bowel habits (yellow, floating stools) could indicate several conditions, including:
1. Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder is characterized by abdominal pain and changes in bowel habits. Symptoms can include bloating, gas, and altered stool consistency. The pain often improves after a bowel movement.

2. Gastroenteritis or Food Intolerance: If you have recently changed your diet or consumed foods that are difficult to digest, this could lead to symptoms like bloating and abdominal pain.

3. Biliary Colic: If you have gallstones, they can intermittently obstruct the bile duct, leading to pain that may not be constant but occurs after meals.

4. Appendicitis: Although this is less likely given the chronic nature of your symptoms, it is worth noting that appendicitis can sometimes present with pain in the right lower quadrant.

5. Diverticulitis: This condition, which involves inflammation of diverticula in the colon, can cause localized pain and changes in bowel habits.

6. Pancreatitis: Although typically presenting with upper abdominal pain, pancreatitis can sometimes cause pain that radiates to the lower abdomen.

Given your symptoms, it would be prudent to undergo further evaluation. Here are some steps you might consider:
- Consult a Gastroenterologist: A specialist can perform a thorough evaluation, including a detailed history and physical examination, to assess your symptoms more comprehensively.

- Imaging Studies: An abdominal ultrasound or CT scan can help visualize the gallbladder, liver, and other abdominal organs to rule out gallstones or other structural abnormalities.

- Laboratory Tests: Blood tests can assess liver function, pancreatic enzymes, and other markers that may indicate inflammation or infection.

- Dietary Review: Keeping a food diary to track what you eat and any associated symptoms can help identify potential food intolerances or triggers.

- Trial of Medications: Depending on the findings, your doctor may recommend medications to manage symptoms, such as antispasmodics for IBS or dietary changes.

In conclusion, while gallbladder issues could be a possibility, your symptoms suggest that a broader evaluation is necessary to identify the underlying cause of your chronic right lower abdominal pain. It’s essential to work closely with your healthcare provider to determine the best course of action for your specific situation.

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