Right Lower Abdominal Pain: Possible Causes and Tests - Internal Medicine

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Right lower abdominal pain can be a concerning symptom, and understanding its potential causes is crucial for appropriate diagnosis and treatment. Given your description of localized pain upon pressure without any accompanying gastrointestinal symptoms, several possibilities should be considered.

1. Appendicitis: One of the most common causes of right lower abdominal pain is appendicitis, which is an inflammation of the appendix. This condition typically presents with pain that starts around the navel and then shifts to the right lower quadrant. Other symptoms may include nausea, vomiting, and fever, but it can sometimes present with minimal symptoms.

2. Ovarian Issues: In females, right lower abdominal pain can also be related to ovarian conditions such as ovarian cysts or torsion. These conditions can cause localized pain and may not always present with other gastrointestinal symptoms. A pelvic ultrasound is often used to evaluate the ovaries.

3. Musculoskeletal Pain: Since you mentioned that the pain is localized and occurs upon pressure, it could also be related to musculoskeletal issues, such as a muscle strain or ligament strain in the abdominal wall. This type of pain is usually reproducible with movement or palpation.

4. Hernia: An inguinal hernia can also present as localized pain in the right lower abdomen. This occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. Physical examination can help in diagnosing this condition.

5. Gastrointestinal Issues: While you mentioned no gastrointestinal symptoms, conditions such as diverticulitis or inflammatory bowel disease can sometimes present with localized pain without significant gastrointestinal distress. A CT scan of the abdomen may be warranted if these conditions are suspected.

6. Urinary Tract Issues: Although less common, urinary tract infections or kidney stones can cause referred pain to the lower abdomen. A urinalysis can help rule out these conditions.


Recommended Tests
Given the potential causes, the following tests may be recommended:
- Physical Examination: A thorough physical examination by a healthcare provider is essential to assess the location and nature of the pain.


- Ultrasound: A pelvic ultrasound can help evaluate for ovarian issues or other pelvic abnormalities.

- CT Scan: If appendicitis or other serious conditions are suspected, a CT scan of the abdomen may be necessary for a more detailed view.

- Urinalysis: To rule out urinary tract issues, a urinalysis can be helpful.

- Blood Tests: A complete blood count (CBC) may be performed to check for signs of infection or inflammation.


Conclusion
While right lower abdominal pain can stem from various causes, the absence of gastrointestinal symptoms narrows down the possibilities. It is essential to consult with a healthcare provider who can perform a physical examination and recommend appropriate imaging or laboratory tests based on your specific symptoms. Early diagnosis and treatment are key to managing any underlying conditions effectively. If the pain worsens or if you develop additional symptoms such as fever, nausea, or vomiting, seek medical attention promptly.