Abdominal Tightness and Pain: Causes and Solutions - Gastroenterology and Hepatology

Abdominal pain with a feeling of tightness?

Hello doctor, I have been experiencing abdominal discomfort for a long time, and recently it has intensified.
I feel tightness in the right side of my abdomen, as if something is being squeezed inside.
Sometimes, the area around my stomach feels like a hard ball, and my belly button area is also tight and hard.
The lower right abdomen is persistently tense, and I even feel pain there.
Additionally, I have soreness in my right shoulder blade and right back.
During my last few menstrual periods, the tightness in my lower right abdomen seems to be associated with pain, whereas it didn't used to hurt as much during my periods.

According to my medical records, I had an ultrasound in June last year that showed mild fatty liver, and in July, I underwent an endoscopy that revealed mild gastroesophageal reflux.
In October, I visited a gynecologist for an ultrasound and CA-125 test, both of which were normal.
In February of this year, I had an X-ray that showed some gas in the lower right abdomen, but it appeared to be okay.
I have been taking medication from both Western and Chinese medicine for a long time without improvement, which is quite frustrating.

Since receiving the vaccine, I have been experiencing joint pain and need to take one pill of Biologics daily.
I have normal blood and urine tests every three months, but the immunological and rheumatological tests show abnormal results: Anti-Cell Ab Positive, ANA 1:160, RF, IgG was originally 8.9 and recently 5.3, Mi-2α +, Positive SAE1 +/-, Borderline.

Niming, 30~39 year old female. Ask Date: 2023/04/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please discuss with an immunologist or gastroenterologist whether there is an autoimmune enteritis and consider medication and dietary adjustments.

Reply Date: 2023/04/25

More Info

Understanding abdominal tightness and pain can be quite complex, as these symptoms can arise from a variety of causes, both physical and psychological. Based on your description, it seems you are experiencing significant discomfort in your right lower abdomen, which is accompanied by tightness and pain that radiates to your right shoulder blade and back. Additionally, you mentioned that this discomfort has intensified during your menstrual periods, which could suggest a connection to your reproductive system.

Possible Causes
1. Gastrointestinal Issues: Given your history of mild fatty liver and gastroesophageal reflux disease (GERD), it is possible that your abdominal symptoms could be related to gastrointestinal problems. Conditions such as irritable bowel syndrome (IBS), which can cause abdominal pain, bloating, and changes in bowel habits, could be a factor. The presence of gas in your right lower abdomen, as noted in your recent X-ray, may also indicate an underlying digestive issue.

2. Gynecological Factors: Since you mentioned that the pain seems to intensify during your menstrual cycle, it is important to consider gynecological conditions. Endometriosis, for example, can cause significant pain and discomfort in the lower abdomen, especially during menstruation. Other conditions like ovarian cysts or pelvic inflammatory disease (PID) could also contribute to your symptoms.

3. Musculoskeletal Pain: The pain radiating to your right shoulder and back could suggest a musculoskeletal issue. Conditions such as muscle strain or referred pain from the abdomen to the back can occur, especially if there has been any physical activity or strain in that area.
4. Psychological Factors: Anxiety and stress can manifest physically, leading to muscle tension and abdominal discomfort. If you are experiencing anxiety, it could exacerbate your perception of pain and discomfort in the abdomen.

Diagnostic Approach
Given the complexity of your symptoms and the fact that previous imaging and tests have not provided a clear diagnosis, it may be beneficial to pursue further evaluation. Here are some steps you might consider:
- Consult a Gastroenterologist: Since you have already seen multiple specialists, a gastroenterologist may help explore any underlying gastrointestinal disorders further. They might recommend additional tests, such as a colonoscopy or more advanced imaging studies.

- Gynecological Evaluation: A thorough evaluation by a gynecologist is essential, especially if endometriosis or other reproductive issues are suspected. They may suggest a pelvic ultrasound or laparoscopy for a more definitive diagnosis.

- Pain Management Specialist: If musculoskeletal pain is suspected, consulting a pain management specialist or a physical therapist could provide relief through targeted therapies.

- Psychological Support: If anxiety is a contributing factor, speaking with a mental health professional could be beneficial. Techniques such as cognitive-behavioral therapy (CBT) or mindfulness can help manage anxiety and its physical manifestations.

Treatment Options
1. Medications: Depending on the diagnosis, treatment may include medications such as antacids for GERD, anti-inflammatory drugs for musculoskeletal pain, or hormonal treatments for gynecological issues.

2. Lifestyle Modifications: Dietary changes, regular exercise, and stress management techniques can significantly impact gastrointestinal health and overall well-being.

3. Physical Therapy: Engaging in physical therapy may help alleviate musculoskeletal pain and improve abdominal tightness through targeted exercises and stretches.

4. Regular Monitoring: Given your autoimmune markers, it may be wise to have regular follow-ups with your healthcare provider to monitor any changes in your condition.

Conclusion
In summary, the symptoms you are experiencing could stem from a combination of gastrointestinal, gynecological, musculoskeletal, and psychological factors. A multidisciplinary approach involving various specialists may be necessary to pinpoint the exact cause and develop an effective treatment plan. It is crucial to advocate for your health and seek further evaluations until you find relief from your symptoms.

Similar Q&A

Understanding Abdominal Tightness: Causes and Treatment Options

Since June of last year, I've been experiencing tightness and pain in the muscles on both sides of my abdomen near the navel and along the sides of my ribs. The pain feels like it's coming from the muscles rather than being an internal pain. When sitting, the muscles on...

Dr. Chen Shidian reply Gastroenterology and Hepatology
There is a higher likelihood of neuromuscular issues. It is important to move around regularly, maintain proper posture while sitting, use correct lifting techniques, and avoid prolonged periods of sitting.

Understanding Abdominal Discomfort: Possible Causes and Solutions

About two weeks ago (on June 24), I experienced a dull pain in my left abdomen that lasted for approximately 20 minutes and then subsided. However, after this symptom resolved, I began to feel tightness in my lower back on both sides, with the left side being more pronounced. The...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: You have abdominal pain, pain on both sides of the lower back, occasional diarrhea with changes in stool color. X-rays show no bowel obstruction, and urinalysis is normal. Differential diagnoses for the right lower abdominal pain include gastroenteritis, colitis, appendici...

Understanding Right Abdominal Tightness: Causes and Solutions

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 f...

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.

Understanding Morning Abdominal Tightness and Pain: Causes and Solutions

Experiencing tightness and soreness in the upper abdomen on both sides during the night until morning, along with occasional back pain, could be related to several factors. It may be due to poor sleeping posture, muscle strain, or gastrointestinal issues such as acid reflux or ga...

Dr. Hu Guozheng reply Gastroenterology and Hepatology
Please observe for any accompanying discomfort and then consult and evaluate at the outpatient clinic. Thank you.