Right Lower Abdominal Pain: When to Seek Gastroenterology Help - Gastroenterology and Hepatology

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Right lower abdominal pain can be a perplexing symptom, especially when it persists for an extended period, as you have described. Given that your pain has lasted for three weeks and is characterized by a dull ache with occasional pressure and a sensation of bloating, it is essential to consider various potential causes and when to seek further medical evaluation.

The right lower quadrant (RLQ) of the abdomen is home to several vital structures, including the appendix, parts of the intestines, and in females, the ovaries and fallopian tubes. Your symptoms could be indicative of several conditions, including but not limited to appendicitis, ovarian cysts, or even gastrointestinal issues such as irritable bowel syndrome (IBS) or chronic appendicitis.

1. Appendicitis: While your pain is not severe, chronic appendicitis can present with milder symptoms. The fact that you experience tenderness upon pressure could suggest inflammation. However, classic appendicitis typically involves more acute pain, fever, and changes in bowel habits.

2. Irritable Bowel Syndrome (IBS): Given your normal bowel movements and appetite, IBS could be a possibility, especially if you have experienced changes in your bowel habits or stress levels. IBS can cause bloating, discomfort, and changes in bowel habits, but it usually does not cause significant pain or pressure in one specific area.

3. Gynecological Issues: Since you mentioned having undergone a hemorrhoidectomy recently and that your gynecologist found no issues, it is still worth considering that some gynecological conditions can cause referred pain to the lower abdomen. Conditions such as ovarian cysts or endometriosis can sometimes present with similar symptoms.

4. Other Gastrointestinal Issues: Conditions like diverticulitis or inflammatory bowel disease (IBD) could also present with similar symptoms. However, these conditions often come with additional symptoms such as fever, significant changes in bowel habits, or weight loss.

Given that your symptoms have persisted for three weeks without significant improvement, and considering your recent surgical history, it would be prudent to seek further evaluation. You may consider visiting a gastroenterologist or a colorectal surgeon, as they can provide a comprehensive assessment of your gastrointestinal health. They may recommend imaging studies, such as a CT scan, to rule out appendicitis or other abdominal pathologies.

In summary, while your symptoms may not immediately suggest a severe condition, the duration and nature of your pain warrant further investigation. It is essential to communicate all your symptoms clearly to your healthcare provider, including any changes in your bowel habits, appetite, or associated symptoms like fever or weight loss. This information will help guide the appropriate diagnostic approach and treatment plan. If you experience any worsening of symptoms, such as increased pain, fever, or vomiting, seek medical attention promptly.