Right Lower Abdominal Pain: Causes and Concerns - Gastroenterology and Hepatology

Right lower abdominal pain?

Recently, I often experience sudden bloating and pain in my lower right abdomen (near the hip bone).
However, when I'm not moving, it just feels odd, and the pain only occurs when I move.
When I tap on my right abdomen, I hear a thumping sound, but there is no sound on the left side.
What could be the issue? I usually have a bowel movement every 1-2 days and have a history of hemorrhoids.
I also have anxiety disorder; could this be related?

Shu, 20~29 year old female. Ask Date: 2023/12/01

Dr. Lin Minghui reply Gastroenterology and Hepatology

There is a rumbling sound in the right side of the abdomen, accompanied by pain in the lower right abdomen.
Differential diagnoses include gynecological, urinary tract, and gastrointestinal issues.
Bowel movements occur once every one to two days, and there is a problem with hemorrhoids.
It is recommended to increase fiber intake, drink plenty of water, engage in appropriate exercise, and develop good bowel habits.
Additionally, anxiety disorders can sometimes lead to autonomic nervous system dysregulation, resulting in abdominal pain symptoms.
For those with severe anxiety, a consultation at a psychosomatic medicine clinic may be advisable.
If the symptoms in the lower right abdomen persist, follow-up examinations in an outpatient setting are recommended, and stool tests can be performed.
Best wishes for your health!

Reply Date: 2023/12/01

More Info

Right lower abdominal pain can be a concerning symptom, and understanding its potential causes is crucial for proper diagnosis and treatment. The right lower quadrant of the abdomen houses several important structures, including parts of the intestines, the appendix, and in females, the ovaries and fallopian tubes. Given your description of the pain being more pronounced during movement and accompanied by a "gurgling" sound, there are several possible explanations to consider.

Possible Causes of Right Lower Abdominal Pain
1. Appendicitis: One of the most common causes of acute right lower abdominal pain is appendicitis, which occurs when the appendix becomes inflamed. Symptoms typically include sharp pain that starts around the navel and then moves to the right lower abdomen, fever, nausea, and loss of appetite. If you experience these symptoms, it is essential to seek medical attention immediately.

2. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS), constipation, or even a bowel obstruction can lead to discomfort and pain in the lower abdomen. The "gurgling" sound you mentioned could indicate increased bowel activity, which may be associated with these conditions. Given your history of having hemorrhoids, it is possible that constipation could be contributing to your symptoms.

3. Musculoskeletal Pain: Sometimes, pain in the abdominal area can be related to muscle strain or injury, especially if you have recently engaged in physical activity or heavy lifting. This type of pain is often exacerbated by movement and can be localized to a specific area.

4. Gynecological Issues: In females, right lower abdominal pain can also be related to gynecological conditions such as ovarian cysts, ectopic pregnancy, or pelvic inflammatory disease. If you have any additional symptoms like irregular menstrual cycles or unusual discharge, it would be wise to consult a gynecologist.

5. Anxiety and Stress: Your mention of having anxiety is also relevant. Psychological factors can manifest as physical symptoms, including abdominal pain. Anxiety can lead to gastrointestinal distress, which may exacerbate feelings of discomfort or pain in the abdomen. Stress can also affect bowel habits, potentially leading to constipation or diarrhea.

Recommendations
Given the complexity of abdominal pain and the variety of potential causes, it is essential to approach this issue methodically:
- Consult a Healthcare Provider: Since your symptoms have been persistent, it is advisable to seek medical attention. A healthcare provider can perform a physical examination, order necessary imaging studies (like an ultrasound or CT scan), and conduct laboratory tests to rule out serious conditions.

- Monitor Symptoms: Keep a record of your symptoms, including when they occur, their intensity, and any accompanying signs (like fever, changes in bowel habits, or menstrual irregularities). This information can be invaluable for your healthcare provider.

- Manage Anxiety: If anxiety is a contributing factor, consider discussing this with a mental health professional. Techniques such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises can help manage anxiety and its physical manifestations.

- Dietary Considerations: Pay attention to your diet, as certain foods can exacerbate gastrointestinal symptoms. Staying hydrated and consuming a balanced diet rich in fiber can help alleviate constipation and promote regular bowel movements.

In conclusion, while right lower abdominal pain can stem from various causes, it is essential to approach the issue with a comprehensive perspective. By consulting with a healthcare provider and considering both physical and psychological factors, you can work towards identifying the underlying cause and finding appropriate treatment.

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