Persistent Right Abdominal Pain: When to Seek Surgical Evaluation - Surgery

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Persistent right abdominal pain can be a complex issue, especially when it has been ongoing for two years. Given the nature of your symptoms, it is essential to consider several potential causes and the appropriate steps for evaluation and management.

Firstly, the fact that your pain is localized to the right side of your abdomen and is associated with certain movements or actions, such as stretching your abdomen, suggests that it may be musculoskeletal in nature. This could involve the abdominal muscles or the fascia surrounding them. Conditions like muscle strain or myofascial pain syndrome can cause discomfort that may be exacerbated by certain movements or positions.
However, it is also crucial to rule out any underlying gastrointestinal or other systemic issues. Given your history of previous gastrointestinal evaluations, it may be beneficial to revisit this area, especially if your symptoms have changed or worsened. Conditions such as irritable bowel syndrome (IBS), hernias, or even issues related to the appendix (like chronic appendicitis) could present with similar symptoms.
In your case, since you mentioned that the pain is alleviated when you stretch your abdomen, it could indicate that the pain is related to tension or tightness in the abdominal wall. However, the fact that it has persisted for two years warrants further investigation.
To address your question about which specialist to see, I would recommend starting with a consultation with a gastroenterologist. They can perform a thorough evaluation, which may include imaging studies such as an ultrasound or CT scan, to assess for any gastrointestinal issues that may not have been identified in previous evaluations. If the gastroenterologist rules out gastrointestinal causes, they may refer you to a pain specialist or a physical therapist who specializes in musculoskeletal pain for further assessment and management.

In addition to seeking medical evaluation, there are some self-care strategies you might consider. Gentle stretching exercises, heat application, and over-the-counter pain relief medications may help alleviate discomfort. Keeping a pain diary to track your symptoms, triggers, and any associated factors can also provide valuable information for your healthcare provider.

In summary, while your symptoms may suggest a musculoskeletal origin, it is essential to rule out any gastrointestinal or other systemic issues. A gastroenterologist would be the appropriate specialist to start with, and they can guide you through the necessary evaluations and potential referrals to other specialists if needed. Persistent abdominal pain should not be ignored, and seeking timely medical advice is crucial for effective management and relief.