Right Lower Abdominal Discomfort: Causes and Tests - Gastroenterology and Hepatology

Right lower abdominal pain?

Hello doctor, due to obesity, when I use the restroom, the flesh in my lower right abdomen rests against my thigh.
One day after using the restroom, I felt an uncomfortable sensation in my lower right abdomen that I can't quite describe, but there was no pain.
A few days later, while brisk walking at the gym, I noticed a sensation in my lower right abdomen that I also can't describe, which scared me, so I switched to walking slowly.
Later, when I touched my lower right abdomen, I found a small area that was indented, and now it feels a bit hard to the touch.
I would like to know what kind of examination I should undergo to understand what is happening in my lower right abdomen.
Thank you.

Pin, 20~29 year old female. Ask Date: 2022/09/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can seek medical attention for an examination and physical assessment by a physician.

Reply Date: 2022/09/27

More Info

Experiencing discomfort in the right lower abdomen can be concerning, especially when accompanied by changes in physical sensations or the presence of a hard area upon palpation. Given your description, there are several potential causes for your symptoms, and understanding these can help guide appropriate diagnostic tests and management strategies.

Possible Causes of Right Lower Abdominal Discomfort
1. Muscle Strain or Injury: The discomfort you feel could be due to a strain in the abdominal muscles, especially if you have recently increased your physical activity or changed your exercise routine. The hard area you feel might be a muscle knot or spasm.

2. Hernia: A hernia occurs when an internal organ or tissue bulges through a weak spot in the abdominal muscles. If you notice a hard area that feels different from the surrounding tissue, it could be indicative of a hernia, particularly an inguinal or femoral hernia.

3. Appendicitis: While you mentioned that there is no pain, appendicitis can sometimes present with discomfort rather than sharp pain, especially in the early stages. If the discomfort worsens or is accompanied by fever, nausea, or vomiting, immediate medical attention is necessary.

4. Ovarian Issues: In females, conditions such as ovarian cysts or other gynecological issues can cause discomfort in the lower abdomen. If you have a history of irregular menstrual cycles or other gynecological symptoms, this could be a consideration.

5. Gastrointestinal Issues: Conditions such as diverticulitis, inflammatory bowel disease (IBD), or even constipation can lead to discomfort in the lower abdomen.
6. Fatty Tissue or Lipoma: Sometimes, fatty tissue can form lumps under the skin, which may feel firm or hard. These are usually benign but can cause discomfort if they press on surrounding structures.

Recommended Diagnostic Tests
To determine the underlying cause of your discomfort, the following tests may be recommended:
1. Physical Examination: A thorough examination by a healthcare provider can help assess the area of discomfort and identify any abnormalities.

2. Ultrasound: An abdominal ultrasound is a non-invasive imaging technique that can help visualize structures in the abdomen, including the appendix, ovaries, and any potential hernias.

3. CT Scan: A CT scan of the abdomen can provide detailed images and help identify issues such as appendicitis, hernias, or other abdominal pathologies.

4. Blood Tests: Blood tests can help assess for signs of infection (elevated white blood cell count) or inflammation (elevated C-reactive protein).

5. MRI: If soft tissue evaluation is necessary, an MRI may be used, especially if there is a suspicion of a hernia or other soft tissue abnormalities.

Management Strategies
- Observation: If the discomfort is mild and not worsening, your healthcare provider may recommend a period of observation, especially if there are no alarming symptoms.

- Pain Management: Over-the-counter pain relievers may help alleviate discomfort.

- Physical Therapy: If muscle strain is suspected, physical therapy may be beneficial to strengthen the abdominal muscles and improve flexibility.

- Surgical Consultation: If a hernia or other surgical issue is suspected, a referral to a surgeon may be necessary for further evaluation and potential intervention.

Conclusion
Given your symptoms, it is essential to consult with a healthcare provider who can perform a physical examination and recommend appropriate tests based on your specific situation. Early diagnosis and management can help prevent complications and improve your overall well-being. If you notice any worsening of symptoms, such as increased pain, fever, or changes in bowel habits, seek medical attention promptly.

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