Right Abdominal Tightness: Causes and Solutions - Gastroenterology and Hepatology

Tightness in the right abdomen?

Hello Doctor: Since June of last year, I have been experiencing frequent tightness in my right abdomen.
I have undergone abdominal ultrasound, abdominal X-ray, and gastroscopy, all of which appeared normal.
Currently, the symptoms persist, sometimes less noticeable, but I often feel tightness in my lower right abdomen.
Occasionally, I also experience dull pain around my navel, and sometimes discomfort throughout my entire abdomen, along with feelings of nausea.
Additionally, my right side, including my lower back and shoulder blade, feels tense, and I only find relief while sleeping; however, the tightness in my right abdomen returns as soon as I wake up.
I am very worried and anxious about this.
My bowel movements are sometimes hard and dry, but I have been drinking unsweetened yogurt, eating oatmeal, and consuming fruits and vegetables to improve the situation.

Niming, 30~39 year old female. Ask Date: 2023/03/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

A colonoscopy and (out-of-pocket) computed tomography can be performed for examination.
If no abnormalities are found, local heat application and stretching exercises may be recommended.

Reply Date: 2023/03/11

More Info

Understanding right abdominal tightness can be complex, as it can stem from various underlying causes. Based on your description, it seems that you have been experiencing persistent tightness in the right side of your abdomen, along with occasional pain around the belly button, general discomfort throughout the abdomen, and nausea. Additionally, you mentioned that this tightness extends to your right side, including the back and shoulder blade area, and that it tends to improve during sleep but returns upon waking.
Given that you have already undergone abdominal ultrasound, X-rays, and gastroscopy, which have not revealed any significant abnormalities, it is essential to consider other potential causes. Here are some possibilities:
1. Musculoskeletal Issues: The tightness and discomfort you are experiencing could be related to muscle strain or tension in the abdominal wall or surrounding muscles. Activities that involve twisting or heavy lifting can lead to muscle strain, which may cause localized pain and tightness. Additionally, poor posture or prolonged sitting can contribute to muscle tension in the abdomen and back.

2. Gastrointestinal Disorders: Conditions such as irritable bowel syndrome (IBS) or functional dyspepsia could lead to symptoms like abdominal tightness, discomfort, and nausea. IBS is characterized by a combination of abdominal pain and changes in bowel habits, which could explain your experience of hard stools. The tightness could also be related to gas or bloating, which can occur with certain dietary choices.

3. Visceral Pain: Sometimes, pain from internal organs can manifest as tightness or discomfort in the abdominal wall. For instance, issues with the liver, gallbladder, or intestines can cause referred pain that may be felt as tightness in the abdomen. Although your imaging studies were normal, it may be worth discussing further evaluation of these organs with your healthcare provider.

4. Anxiety and Stress: Psychological factors can significantly impact physical health. Anxiety and stress can lead to muscle tension and exacerbate gastrointestinal symptoms, creating a cycle of discomfort. If you find that your symptoms worsen during stressful periods, it may be beneficial to explore stress management techniques or speak with a mental health professional.

5. Dietary Factors: You mentioned that you have been consuming yogurt, oatmeal, and fruits to improve your bowel movements. While these are generally healthy choices, it is essential to monitor how your body responds to different foods. Some individuals may have sensitivities to certain foods that can lead to bloating and discomfort. Keeping a food diary may help identify any triggers.

Given the complexity of your symptoms and their persistence, it is advisable to follow up with a healthcare provider who can conduct a thorough evaluation. They may recommend additional tests, such as a CT scan or MRI, to rule out any underlying conditions that may not have been visible on previous imaging. Furthermore, a referral to a gastroenterologist or a specialist in functional gastrointestinal disorders may provide additional insights and management strategies.

In the meantime, consider implementing lifestyle changes that may alleviate your symptoms. Regular physical activity, stress-reducing techniques such as yoga or meditation, and maintaining a balanced diet can all contribute to improved abdominal comfort. Additionally, staying hydrated and ensuring adequate fiber intake can help with bowel regularity.

In summary, while your symptoms are concerning, they can arise from various factors, including musculoskeletal issues, gastrointestinal disorders, psychological stress, and dietary habits. A comprehensive approach that includes medical evaluation and lifestyle modifications may help you find relief and improve your overall well-being.

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