Right Lower Abdominal Pain: Causes and Diagnosis - Gastroenterology and Hepatology

Right lower abdominal pain?

Hello, Dr.
Chen.
I would like to ask you about some recent health issues.
I've been experiencing intermittent pain in my lower right abdomen, located roughly on the right side of my belly, which usually lasts about an hour and is tolerable.
However, the most recent episode started when I woke up and was quite painful, to the point of sweating.
The pain persisted until noon, and I couldn't stand it anymore, so I bought some painkillers, which provided some relief.
I then went to the hospital and consulted a gastroenterologist, who ordered an abdominal ultrasound and an abdominal X-ray (just a plain X-ray, without any contrast agents).
When I asked the doctor what was wrong, he only mentioned that I had gas in my colon and prescribed medication for it.

I have a couple of questions:
1.
Can gas in the colon cause pain in the lower right abdomen? Additionally, during the ultrasound, the technician only mentioned that I have fatty liver (which I already suspected, as I am 180 cm tall, weigh 88 kg, and have a waist circumference over 100 cm).

2.
Can an ultrasound detect cancers of the liver, gallbladder, gastrointestinal tract, or kidneys? The doctor only mentioned that I have gas in my colon; does that mean there are no issues in other areas?

David, 40~49 year old female. Ask Date: 2012/08/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello David,
1.
Please check for any right kidney/ureter stones.

2.
A stool occult blood test should be performed.

3.
If symptoms persist, a non-invasive colonoscopy or related examinations should be conducted, as determined by a specialist.

4.
Ultrasound can visualize the liver, kidneys, and pancreas, but it cannot assess the gastrointestinal tract or ureters.

Changhua Hospital cares about your health.

Dr.
Shih-Tien Chen

Reply Date: 2012/08/11

More Info

Understanding right lower abdominal pain can be quite complex, as it can stem from various underlying conditions. Your experience of intermittent pain in the right lower abdomen, particularly when it escalates to a level that causes sweating and discomfort, warrants careful consideration.
1. Can gas in the colon cause right lower abdominal pain?
Yes, gas in the colon can indeed lead to discomfort and pain in the right lower abdomen. The intestines are highly sensitive to distension, and when gas accumulates, it can create pressure and pain. This is particularly true if the gas is trapped in the lower part of the colon, which can lead to localized pain. The pain may vary in intensity and can be relieved by passing gas or having a bowel movement.
2. What does an abdominal ultrasound reveal?
An abdominal ultrasound is a useful diagnostic tool that can help visualize various organs, including the liver, gallbladder, pancreas, kidneys, and intestines. However, while it can detect certain abnormalities, it is not the most sensitive test for all types of cancers. For instance, while it can identify liver lesions or gallstones, it may not always detect early-stage cancers in these organs.
In your case, the ultrasound indicated that you have fatty liver disease, which is common in individuals with a higher body mass index (BMI). Fatty liver itself is not immediately dangerous but can progress to more serious liver conditions if not managed properly.
3. Does a diagnosis of gas mean there are no other issues?
While your doctor concluded that you have gas in the colon and prescribed medication for it, this does not necessarily rule out other potential issues. The absence of findings on the ultrasound does not guarantee that there are no other underlying conditions, especially if your symptoms persist.
Other possible causes of right lower abdominal pain include appendicitis, ovarian issues (in females), diverticulitis, or even referred pain from other areas. If your symptoms continue or worsen, it would be prudent to follow up with your healthcare provider. They may recommend further imaging studies, such as a CT scan, which can provide a more detailed view of the abdominal organs and help identify any abnormalities that may not have been visible on the ultrasound.

4. Next Steps:
Given your symptoms and the recent findings, it would be wise to monitor your condition closely. If you experience any new symptoms, such as fever, persistent vomiting, changes in bowel habits, or if the pain becomes more severe, seek medical attention promptly. Additionally, consider discussing lifestyle modifications, including dietary changes and weight management, which can help alleviate symptoms related to fatty liver and gastrointestinal discomfort.

In summary, while gas in the colon can cause right lower abdominal pain, it is essential to remain vigilant and proactive about your health. Regular follow-ups with your healthcare provider and appropriate diagnostic tests can help ensure that any potential issues are identified and managed effectively.

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