Persistent Right Lower Abdominal Pain: Causes and Urgency

Persistent dull pain in the lower right abdomen?

Hello Doctor, I am currently studying in the UK.
Due to the tiered healthcare system in the UK, it takes a long time to wait for referrals, so I am asking here.
Thank you very much for your response.
I have been experiencing pain in my lower right abdomen for nearly a week.
The location is from just below the navel to above the pubic bone, and it feels like a dull ache.
It initially started with my menstrual period, and I thought it was one of the symptoms of menstrual discomfort, so I didn't pay much attention to it for the first two or three days.
However, this time the menstrual flow was very light, and I also experienced chills and body aches.
After my period ended on the fourth day, the pain in my lower right abdomen has persisted until now.
Over the past two days, the intensity of the pain has occasionally increased; I have woken up in the morning due to the pain, which then becomes a mild dull ache after enduring it.
In the evening, the pain intensifies again, and after about twenty minutes, the symptoms slightly alleviate.
Could you please advise what might be causing this? Is there an urgency to this situation? Since I will be returning to Taiwan in three to four months, I really need your opinion as a basis for considering whether to seek medical attention in the UK or wait until I return to Taiwan.
Thank you.

An An, 20~29 year old female. Ask Date: 2011/08/04

Dr. Zhan Deqin reply Family Medicine

Hello, thank you for your inquiry.
I would like to respond to your question and provide the following advice: The differential diagnosis of abdominal pain is quite extensive and complex.
Emergency signs of abdominal pain include persistent pain, fever, and unstable vital signs (such as blood pressure, heart rate, and pulse), as well as significant tenderness and rebound tenderness during physical examination.
Based on your description, further observation may be necessary.
If discomfort persists, it is advisable to consult a family medicine physician for a reevaluation through a physical examination.
Finally, I wish you safety and happiness!

Reply Date: 2011/08/04

More Info

Persistent right lower abdominal pain can be concerning, especially when it lasts for an extended period and is accompanied by other symptoms. Given your description, there are several potential causes to consider, and it’s important to evaluate the urgency of your situation.

Possible Causes
1. Appendicitis: One of the most common causes of right lower abdominal pain is appendicitis. This condition typically presents with sharp pain that starts around the navel and then moves to the right lower quadrant. It can be accompanied by nausea, vomiting, and fever. If the pain worsens or is accompanied by these symptoms, it may require immediate medical attention.

2. Ovarian Issues: Since you mentioned that your pain began around the time of your menstrual period, it’s possible that the pain could be related to ovarian issues such as ovarian cysts or even ectopic pregnancy (if there is a chance of pregnancy). Ovarian cysts can cause dull or sharp pain and may lead to complications if they rupture.

3. Gastrointestinal Problems: Conditions such as diverticulitis, inflammatory bowel disease (IBD), or even constipation can cause localized pain in the lower abdomen. If you have experienced changes in bowel habits or any gastrointestinal symptoms, these could be contributing factors.

4. Musculoskeletal Issues: Sometimes, pain in the lower abdomen can be referred pain from the back or pelvic region. If you have been physically active or have had any injuries, this could be a possibility.

5. Urinary Tract Issues: Infections or stones in the urinary tract can also cause pain in the lower abdomen. Symptoms may include painful urination, frequent urination, or blood in the urine.

Urgency of the Situation
Given that your pain has persisted for nearly a week and has been fluctuating in intensity, it is advisable to seek medical attention. While some causes of abdominal pain are benign, others can be serious and require prompt treatment. The presence of additional symptoms such as chills, bone pain, or changes in menstrual flow (like very light bleeding) could indicate an underlying issue that needs to be addressed.

Recommendations
1. Seek Medical Attention: Given the duration and nature of your pain, it would be prudent to consult a healthcare provider as soon as possible. If you experience worsening symptoms, such as severe pain, fever, or vomiting, consider going to an emergency department.

2. Document Symptoms: Keep a record of your symptoms, including the intensity of the pain, any associated symptoms (like nausea or changes in bowel habits), and any factors that seem to alleviate or worsen the pain. This information will be helpful for your healthcare provider.

3. Consider Your Options: Since you mentioned the potential delay in the UK healthcare system, weigh the benefits of seeking care there versus returning to Taiwan. If you feel that your symptoms are worsening or if you have concerns about the potential seriousness of your condition, it may be worth seeking immediate care in the UK.

4. Avoid Self-Diagnosis: While it’s helpful to understand potential causes, avoid jumping to conclusions without a professional evaluation. Many conditions can present similarly, and a healthcare provider can perform the necessary examinations and tests to determine the exact cause of your pain.

In conclusion, while there are several potential causes for your right lower abdominal pain, the persistence and fluctuation in intensity warrant a thorough evaluation. Prioritize seeking medical attention to ensure that any serious conditions are ruled out, and take care of your health during your time abroad.

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