Abdominal Discomfort: When to Seek Medical Advice

Abdominal discomfort?

Hello Doctor: I sometimes experience pain in my abdomen, specifically below the navel.
It's not typical stomach pain and it's not severe, so I'm unsure which specialty to consult or what kind of examination to undergo.
During a pelvic exam, the doctor mentioned endometriosis, and I'm uncertain if I should pursue further testing.
Additionally, I've noticed that for the past six months, two weeks before my menstrual cycle, my face becomes dry, rough, and flaky.
The doctor mentioned it could be due to allergic inflammation, but recently my skin has been reacting easily; it turns red and raises when I scratch it.
I'm not sure what to do about this.

nvsheng, 30~39 year old female. Ask Date: 2010/03/17

Dr. Huang Shaoxin reply Family Medicine

1.
Pain below the navel in the abdomen may be related to gas accumulation in the small intestine.
It is advisable to monitor the symptoms, and if they persist, a consultation with a gastroenterologist is recommended.
2.
Two weeks before menstruation, the skin may become dry, itchy, and rough, which is likely a skin texture issue (dry skin).
It is recommended to consult a dermatologist or an obstetrician-gynecologist.

Reply Date: 2010/03/17

More Info

When it comes to abdominal discomfort, particularly in the area below the navel, it's essential to approach the situation with a comprehensive understanding of potential underlying causes and the appropriate medical specialties to consult. Given your description of the pain as not being typical or severe, yet persistent enough to warrant concern, it is wise to seek further evaluation.

Understanding Abdominal Pain
Abdominal pain can arise from various sources, including gastrointestinal, gynecological, urinary, and even musculoskeletal issues. In your case, the mention of endometriosis (as indicated by your doctor) suggests that the pain could be related to gynecological conditions. Endometriosis occurs when tissue similar to the lining inside the uterus grows outside of it, leading to pain, especially during menstruation. This condition can also cause discomfort in the lower abdomen and may be associated with other symptoms, such as irregular menstrual cycles or changes in skin condition, as you described.

When to Seek Medical Advice
1. Persistent or Worsening Symptoms: If the abdominal pain persists, worsens, or is accompanied by other symptoms such as fever, vomiting, or changes in bowel habits, it is crucial to seek medical attention promptly.

2. Menstrual Cycle Changes: Given your mention of changes in your skin condition and the timing of your menstrual cycle, it may be beneficial to consult a gynecologist. They can evaluate whether your symptoms are related to hormonal changes or conditions like endometriosis.

3. Skin Reactions: The skin issues you described, such as dryness, roughness, and redness, could be indicative of an allergic reaction or dermatitis. Consulting a dermatologist may provide insights into whether these skin changes are related to hormonal fluctuations or other underlying conditions.

Recommended Steps
1. Consult a Gynecologist: Since you have already been diagnosed with endometriosis, it would be prudent to follow up with a gynecologist. They may recommend imaging studies, such as an ultrasound or MRI, to assess the extent of the endometriosis and its impact on surrounding organs.

2. Dermatological Evaluation: For the skin issues, a dermatologist can help determine if there is an allergic component or if the symptoms are related to hormonal changes. They may suggest treatments ranging from topical steroids to antihistamines, depending on the diagnosis.

3. Comprehensive Evaluation: If your symptoms do not improve or if new symptoms arise, consider a comprehensive evaluation that includes a gastroenterologist. They can rule out gastrointestinal issues that may contribute to your abdominal discomfort.

4. Lifestyle and Dietary Considerations: Sometimes, abdominal discomfort can be exacerbated by dietary choices or stress. Keeping a food diary and noting any correlations between your diet, menstrual cycle, and symptoms may provide valuable information for your healthcare providers.

Conclusion
In summary, while your abdominal discomfort may be linked to endometriosis, it is essential to consider a multidisciplinary approach to your symptoms. Consulting both a gynecologist and a dermatologist will provide a more comprehensive understanding of your health concerns. Additionally, maintaining open communication with your healthcare providers about any changes in your symptoms or new developments will ensure that you receive the most appropriate care. Remember, your health is paramount, and seeking timely medical advice is always a wise decision.

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