Right Lower Abdominal Pain and Anemia: Possible Causes

Fixed pain in the lower right abdomen + anemia?

Hello Doctor, I have been experiencing irritable bowel syndrome for about two years.
Although I have a regular bowel movement schedule, my stool often breaks apart in the toilet, and it is always brown in color.
I have seen a doctor about this before, so I am not too concerned.
However, about a month ago, I likely developed acute gastroenteritis, as I suddenly experienced severe abdominal cramps at night and felt the urge to use the restroom.
Due to work commitments, I held it for about twenty minutes, and when I finally went, I had diarrhea along with some bright red blood and mucus.

Afterward, I started taking traditional Chinese medicine and have been eating lighter meals, which improved my bowel movements somewhat.
I still have regular bowel movements at the same time each day, and my stool is more formed, but it varies each time: sometimes I have one or two hard pellets, other times I have soft stools due to pressure, and there have been several instances where I passed formed stool followed by loose stools.
Visually, everything appears to be brown.
In the past two months, I have started to notice some symptoms of anemia, such as dizziness, difficulty concentrating, and occasionally taking a deep breath.
Additionally, in the past week, I have begun to feel a dull pain in my lower right abdomen near the appendix, which feels like something is pulling at it.
The area of pain is small, and pressing on it does not cause discomfort.
I still have a good appetite and eat three meals a day, but the combination of the localized abdominal pain and anemia symptoms is concerning to me.

I am writing to ask what these symptoms might indicate.
Could it be simply intestinal inflammation or ulcers? I am currently 24 years old, do not smoke or drink alcohol, and I eat vegetables regularly, although I have a habit of drinking bubble tea about once every two days (I quit a month ago).
Thank you very much for your patience in reading this.

Mr. Zeng, 20~29 year old female. Ask Date: 2022/09/01

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please visit the gastroenterology outpatient clinic for examination/treatment.

Reply Date: 2022/09/01

More Info

Understanding right lower abdominal pain and anemia can be complex, especially when considering your history of irritable bowel syndrome (IBS) and recent gastrointestinal issues. Based on your description, several potential causes could be contributing to your symptoms.

Firstly, the acute gastrointestinal distress you experienced about a month ago, characterized by severe abdominal cramps and the presence of fresh red blood in your stool, raises concerns about possible gastrointestinal bleeding. This could be due to several factors, including hemorrhoids, anal fissures, or more serious conditions such as diverticulitis or inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. The fact that you have a history of IBS may complicate the picture, as IBS can sometimes coexist with other gastrointestinal disorders.

The presence of anemia, indicated by symptoms such as dizziness and difficulty concentrating, is particularly concerning in this context. Anemia can result from chronic blood loss, which may be linked to gastrointestinal issues. The fresh red blood in your stool is a red flag that should not be ignored, as it may suggest that there is active bleeding somewhere in your gastrointestinal tract. Additionally, the "dull pain" in your right lower abdomen, especially near the area of the appendix, could indicate appendicitis or other inflammatory processes in that region.

Given your symptoms, it is crucial to consider the following potential diagnoses:
1. Gastrointestinal Inflammation or Infection: Conditions such as gastroenteritis or colitis could lead to abdominal pain, changes in bowel habits, and the presence of blood in the stool. These conditions can also cause symptoms of anemia due to inflammation and potential bleeding.

2. Diverticulitis: This condition occurs when diverticula (small pouches) in the colon become inflamed or infected. It can cause localized pain, often in the lower left abdomen, but can sometimes present with right-sided pain, especially in individuals with anatomical variations.

3. Inflammatory Bowel Disease (IBD): Both Crohn's disease and ulcerative colitis can cause abdominal pain, diarrhea, and rectal bleeding. These conditions can also lead to anemia due to chronic inflammation and blood loss.

4. Appendicitis: Although your pain is described as dull and not severe, appendicitis can sometimes present with atypical symptoms. The presence of pain in the right lower quadrant, especially if it worsens, should be evaluated.

5. Hemorrhoids or Anal Fissures: These conditions can cause bright red blood in the stool and may lead to discomfort, especially during bowel movements.

Given your symptoms and medical history, it is essential to seek further evaluation from a healthcare provider. They may recommend diagnostic tests such as blood tests to check for anemia, stool tests to identify any infections or blood, and imaging studies like an abdominal ultrasound or CT scan to assess for any structural abnormalities or inflammation in the gastrointestinal tract.

In the meantime, it is crucial to monitor your symptoms closely. If you experience worsening pain, increased bleeding, or any new symptoms such as fever, nausea, or vomiting, you should seek immediate medical attention. Your health and well-being are paramount, and addressing these symptoms promptly can lead to better outcomes.
Lastly, while dietary changes and managing IBS symptoms are important, they should not replace the need for thorough medical evaluation when concerning symptoms arise. A balanced diet rich in iron and vitamins, along with adequate hydration, can support your overall health, but addressing the underlying causes of your symptoms is essential for long-term relief and recovery.

Similar Q&A

Understanding Right Lower Abdominal Pain: Causes and Symptoms

I occasionally experience pain in the lower right abdomen, and for the past few months, there has been blood in my stool. Additionally, I feel pain in the anus during bowel movements and have a decreased appetite.

Dr. Lin Minghui reply Gastroenterology and Hepatology
Frequent pain in the lower right abdomen, blood in the stool, and anal pain. It is recommended to undergo a colonoscopy or sigmoidoscopy, and to follow up with a gastroenterology clinic.

Understanding Right Lower Abdominal Pain: Causes and Concerns

Dear Doctor, I may have written a bit too much, but I hope you can patiently read through my previous symptoms. About two to three weeks ago, I started experiencing diarrhea (three to four times a day), often feeling a dull ache and bloating in my lower abdomen, as if my belt wa...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Right lower abdominal pain is often associated with colonic disorders. It is recommended to undergo a colon examination. Best regards, Dr. Chen Qifeng, Taoyuan General Hospital, Department of Health.

Understanding Nausea and Right Lower Abdominal Pain: Possible Causes

About a month ago, I suddenly vomited in the middle of the night and went to the emergency room (the doctor noted some pain when pressing on my lower right abdomen). In the following days, I experienced bloating after eating and cramping pain in the lower right abdomen. Recently,...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Chronic issues in the lower right abdomen include: fecal impaction and diverticulosis. Acute issues include: diverticulitis, appendicitis, and ovarian diseases. If necessary, consult a gastroenterologist or obstetrician-gynecologist for an accurate diagnosis. Changhua Hosp...

Understanding Right Abdominal Pain: Causes and When to Seek Help

Hello Doctor: My mother has experienced severe pain in the lower right abdomen twice in the past month, requiring pain relief injections to alleviate the pain. Although the severe pain has subsided, she now experiences a dull ache near the right side of her navel, sometimes exten...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello, the differential diagnoses for right lower abdominal pain include gastrointestinal, urinary tract, or gynecological infections. It is recommended to consult with a general internist, gastroenterologist, urologist, or obstetrician-gynecologist. Wishing you good health. Resp...