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

Sharp pain below the navel?

A few days ago, I went out in the morning feeling fine, but when I returned home in the evening, I suddenly experienced a sharp pain in the lower abdomen, just below the navel.
The pain was intermittent and lasted for a long time.
I initially thought it was diarrhea, but there was also some discomfort around the anal area.
I couldn't go to the bathroom, and while I was fine when still, walking caused me to hunch over in pain, so I moved slowly.
Since it was evening, I went to bed, but when I woke up the next day, the pain was still there, albeit mild.
It wasn't menstrual pain because my periods are regular and haven't started yet.
Additionally, I usually experience lower back pain rather than abdominal pain.
I was concerned it might be appendicitis, but when I pressed on the lower right side of my abdomen, it didn't hurt.
Later, I applied peppermint oil on my stomach, which provided some relief, but on the third and fourth days, the pain persisted.
If I move my abdomen vigorously, it hurts, and I'm worried there might be internal bleeding.
What could these symptoms indicate? I plan to go to the hospital on Thursday afternoon.
Should I see a gynecologist, a gastroenterologist, or a family medicine doctor? P.S.
The pain has subsided now, but I'm still concerned and want to get checked out.

Hsuān, 20~29 year old female. Ask Date: 2016/03/02

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Miss Hsuan, your symptoms may indicate the presence of peritonitis.
We recommend that you seek evaluation from a gynecologist immediately for further examination.
Changhua Hospital is concerned about your health.

Reply Date: 2016/03/02

More Info

When experiencing lower abdominal pain, especially when it is sudden and severe, it is essential to understand the potential causes and when to seek medical help. Your symptoms, which include a stabbing pain below the navel that worsens with movement and a sensation of discomfort in the rectal area, could be indicative of several underlying conditions.
Given your description, the pain could be related to gastrointestinal issues, such as constipation, which can cause discomfort in the lower abdomen and may also lead to referred pain in the back. Other possibilities include appendicitis, although you mentioned that pressing on the right lower abdomen does not elicit pain, which is a common sign of appendicitis. However, it is important to note that not all patients present with classic symptoms.

Other potential causes of lower abdominal pain include:
1. Gastrointestinal Disorders: Conditions such as irritable bowel syndrome (IBS), diverticulitis, or even a bowel obstruction could lead to the symptoms you are experiencing. If there is a blockage, it may cause pain and discomfort, especially when moving.

2. Gynecological Issues: In women, lower abdominal pain can often be related to reproductive health issues, such as ovarian cysts, ectopic pregnancy, or pelvic inflammatory disease. Since you mentioned that your menstrual cycle is regular and you are not experiencing menstrual pain, these may be less likely, but they should still be considered.

3. Urinary Tract Issues: Conditions such as a urinary tract infection (UTI) or kidney stones can also cause lower abdominal pain and discomfort in the pelvic area.
4. Musculoskeletal Issues: Sometimes, pain can arise from muscle strain or injury, especially if you have been physically active or have changed your activity level recently.

Since your pain has subsided but you still have concerns, it is wise to seek medical attention. You mentioned that you have an appointment on Thursday, which is a good step. Given your symptoms, you may consider seeing a physician who specializes in either gastroenterology or gynecology, depending on your primary concerns.
- Gastroenterology: If you suspect that your symptoms are related to digestive issues, a gastroenterologist can perform tests such as an abdominal ultrasound or CT scan to rule out conditions like appendicitis, diverticulitis, or bowel obstruction.

- Gynecology: If there is any concern about reproductive health issues, a gynecologist can perform a pelvic exam and possibly an ultrasound to assess for any ovarian or uterine conditions.

- Family Medicine: A family medicine physician can also be a good starting point, as they can evaluate your symptoms and refer you to a specialist if necessary.

In summary, while your pain has diminished, it is essential to follow through with your medical appointment to ensure that any underlying issues are addressed. Your health and peace of mind are paramount, and a thorough evaluation will help clarify the cause of your symptoms. Remember to communicate all your symptoms clearly to your healthcare provider, including any changes in bowel habits, urinary symptoms, or any other relevant information, as this will aid in making an accurate diagnosis.

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