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

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Right lower abdominal pain?


Hello Doctor: Recently, I have been experiencing pain in my lower right abdomen, particularly after urination or before and after passing gas.
The pain is located about a palm's distance to the right of my navel, near the hip bone, and is more intense right after urination.
It gradually becomes a dull ache but can last for about 30 minutes to an hour.
In the morning, especially after using the restroom, the pain is particularly severe, while I do not experience pain at other times during the day.
I recently had a health check-up, which showed elevated white blood cells in my urine, but no follow-up was recommended.
Could you please advise what this might indicate? Do I need to seek medical attention? Thank you.

Qingqing, 20~29 year old female. Ask Date: 2012/06/08

Dr. Chen Qifeng reply Gastroenterology and Hepatology


Hello: Please visit the Urology Department.
Best regards, Dr.
Chi-Feng Chen, Taoyuan General Hospital, Department of Health.

Reply Date: 2012/06/08

More Info


Right lower abdominal pain can be concerning, especially when it is associated with urinary symptoms. Based on your description, there are several potential causes for your symptoms, and it is important to consider both urinary and gastrointestinal issues.


Possible Causes
1. Urinary Tract Infection (UTI): Given that you have elevated white blood cells in your urine, a UTI is a strong possibility. UTIs can cause localized pain in the lower abdomen, particularly after urination. Symptoms may include a burning sensation during urination, increased frequency of urination, and lower abdominal discomfort.

2. Appendicitis: Although less likely if the pain is not severe and there are no other classic symptoms (like fever, nausea, or vomiting), appendicitis typically presents with pain in the right lower abdomen. If the pain worsens or is accompanied by other symptoms, this should be evaluated immediately.

3. Ovarian Issues: In females, conditions such as ovarian cysts or ovarian torsion can cause right-sided abdominal pain. If you experience any additional symptoms like changes in your menstrual cycle, nausea, or severe pain, it would be wise to consult a gynecologist.

4. Irritable Bowel Syndrome (IBS): If the pain is related to bowel movements or gas, IBS could be a consideration. This condition often presents with abdominal pain that is relieved by bowel movements and may be associated with changes in stool frequency or consistency.

5. Musculoskeletal Pain: Sometimes, pain in the lower abdomen can be referred from the back or pelvic region. If you have been engaging in activities that strain your abdominal muscles, this could also be a source of discomfort.


When to Seek Help
You should consider seeking medical attention if:
- The pain becomes severe or persistent.

- You develop additional symptoms such as fever, vomiting, or significant changes in bowel habits.

- You experience any unusual vaginal bleeding or discharge.

- Your pain is accompanied by difficulty urinating or blood in your urine.


Recommended Actions
1. Follow-Up with a Healthcare Provider: Given your elevated white blood cell count, it would be prudent to follow up with your healthcare provider. They may recommend a urine culture to confirm a UTI or further imaging studies to rule out other conditions.

2. Hydration and Symptom Management: In the meantime, ensure you are well-hydrated and consider over-the-counter pain relief if necessary, but avoid self-medicating without consulting a doctor.

3. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any associated activities or dietary changes. This information can be helpful for your healthcare provider.


Conclusion
While there are several potential causes for your right lower abdominal pain, the presence of elevated white blood cells in your urine suggests that a urinary tract infection may be a significant factor. It is essential to consult with a healthcare provider for a thorough evaluation and appropriate management. Early diagnosis and treatment can prevent complications and help alleviate your symptoms effectively.

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