Lower Abdominal Discomfort: Is It Gallstones or Something Else?

Dull discomfort in the lower abdomen?

Hello Doctor: I would like to ask about my father.
Last week, he mentioned feeling a dull ache in his lower right abdomen (he had his appendix removed several years ago).
He visited a nearby clinic, and the doctor suggested it might be due to intestinal inflammation or gas.
Since his condition did not improve, he underwent an abdominal ultrasound, which revealed the presence of stones.
We are aware that he has stones in his body, as he previously underwent extracorporeal shock wave lithotripsy for urinary stones.
Now, my father is saying that the dull ache seems to have shifted to both lower quadrants.
I would like to ask the doctor if this could be related to the stones, or if he needs to go to the hospital for further examinations?

joey, 50~59 year old female. Ask Date: 2023/04/04

Dr. Hu Guozheng reply Gastroenterology and Hepatology

Hello, it is advisable to take the elderly to a gastroenterology or urology specialist for evaluation by a physician.
Thank you.

Reply Date: 2023/04/04

More Info

When considering the symptoms your father is experiencing, particularly the discomfort in the lower abdomen, it is essential to differentiate between potential causes, including gallstones, urinary stones, or other gastrointestinal issues. Given his medical history of appendectomy and previous urinary stones, a thorough evaluation is warranted.

Gallstones can indeed cause discomfort, typically presenting as pain in the right upper quadrant of the abdomen, but they can also lead to referred pain in other areas, including the lower abdomen. However, the fact that your father has previously experienced urinary stones raises the possibility that his current symptoms may be related to the urinary tract rather than the gallbladder.

The discomfort he is feeling could be attributed to several factors:
1. Urinary Stones: Since your father has a history of urinary stones, the discomfort could be due to the presence of stones in the urinary tract. Symptoms of urinary stones often include pain that can radiate to the lower abdomen, groin, or back. If the stones are moving or causing a blockage, this could lead to significant discomfort.

2. Gastrointestinal Issues: Conditions such as diverticulitis, irritable bowel syndrome (IBS), or even constipation can cause lower abdominal discomfort. If the ultrasound indicated gallstones, it is crucial to determine whether these stones are symptomatic or if they are merely incidental findings.

3. Inflammation or Infection: The initial diagnosis of intestinal inflammation or bloating could still be relevant. If there is an underlying infection or inflammatory condition, this could also contribute to the discomfort.

Given that your father's symptoms have changed and now seem to be shifting from the right lower abdomen to the left, it is advisable to seek further medical evaluation. Here are some steps you might consider:
- Follow-Up with a Specialist: Consulting a gastroenterologist or urologist may provide more targeted insights into whether the discomfort is related to gallstones or urinary stones. They may recommend imaging studies, such as a CT scan or MRI, to get a clearer picture of the situation.

- Urinalysis: A urinalysis can help determine if there are any signs of infection or the presence of urinary stones. If there are any abnormalities, further imaging studies may be warranted.

- Monitoring Symptoms: Keep a close watch on your father's symptoms. If he experiences severe pain, fever, or any signs of infection (such as chills or increased urination), it would be prudent to seek immediate medical attention.

- Dietary Considerations: While waiting for further evaluation, it may be beneficial for your father to maintain a balanced diet, avoiding excessive fats and processed foods, which can exacerbate gallbladder issues. Staying hydrated is also crucial, especially if urinary stones are a concern.

In conclusion, while gallstones can cause discomfort, the shifting nature of your father's symptoms and his history of urinary stones suggest that further evaluation is necessary to determine the exact cause of his discomfort. Engaging with healthcare professionals for a comprehensive assessment will help ensure that any underlying issues are appropriately addressed.

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