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

Q: Right Lower Abdominal Pain: Causes and Concerns

Hello： Appendicitis, diverticulitis, or ascending colitis are all possibilities. <br>If the condition does not improve, it is recommended to consult a gastroenterologist for a more accurate clinical assessment. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-Sh

Dull pain in the lower right abdomen?

From February 23 to 28, I traveled to mainland China.
On the evening of the 27th, I started feeling unwell, experiencing dizziness, nausea, followed by diarrhea and vomiting, along with a fever.
After returning to Taiwan, I saw a doctor on the 29th, initially thinking it was gastroenteritis, as the doctor pressed on my abdomen.
At that time, I felt pain when pressing on the upper abdomen, but not in the lower right abdomen.
After taking medication, everything returned to normal by March 1; I had no vomiting, diarrhea, or fever.
However, starting on the 2nd, I began to experience pain in the lower right abdomen, which hurt even without any movement, especially when I hit a pothole while riding my bike.
In the following days, I didn't feel anything under normal conditions, but I experienced pain when jumping or exerting my abdomen, and pressing on my abdomen while lying down was extremely painful.
I researched acute appendicitis online, which mentioned pain that is unbearable, but my situation doesn't seem to fit the description of acute appendicitis.
Could it possibly be chronic appendicitis or other factors?

Xiao Jiang, 10~19 year old female. Ask Date: 2016/03/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Appendicitis, diverticulitis, or ascending colitis are all possibilities.
If the condition does not improve, it is recommended to consult a gastroenterologist for a more accurate clinical assessment.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2016/03/06

More Info

Understanding right lower abdominal pain can be quite complex, as it can stem from a variety of causes, ranging from benign to more serious conditions. Based on your description, it seems that your symptoms began after a trip where you experienced gastrointestinal distress, including dizziness, nausea, diarrhea, vomiting, and fever. After returning home, you initially felt better but then started experiencing pain in the right lower abdomen, particularly when engaging in certain movements or activities.

Possible Causes of Right Lower Abdominal Pain
1. Gastrointestinal Issues: Given your recent history of gastrointestinal symptoms, it's possible that you may have had a viral or bacterial infection that caused inflammation in your digestive tract. This could lead to residual pain even after the acute symptoms have resolved. Conditions such as gastroenteritis can sometimes lead to lingering discomfort.

2. Appendicitis: While you mentioned that your pain does not seem to fit the classic presentation of acute appendicitis (which typically involves severe pain that worsens over time), it is still worth considering. Appendicitis can sometimes present with milder symptoms, especially in its early stages or in certain populations. Chronic appendicitis, although rare, can also occur and may present with intermittent pain.

3. Musculoskeletal Pain: The pain you describe, particularly when moving or engaging in activities like riding a bike, could be related to a musculoskeletal issue. Strain or injury to the muscles or ligaments in the abdominal area can cause localized pain, especially if you have been engaging in activities that put stress on these muscles.

4. Hernia: Another possibility is an inguinal or abdominal hernia, which can cause pain in the lower abdomen, especially when straining or lifting. Hernias can sometimes be asymptomatic until they become aggravated.

5. Gynecological Issues: In females, right lower abdominal pain can also be related to gynecological conditions such as ovarian cysts, ectopic pregnancy, or pelvic inflammatory disease. If you have any menstrual irregularities or other gynecological symptoms, it would be prudent to consider these possibilities.

6. Urinary Tract Issues: Conditions such as a urinary tract infection or kidney stones can also cause pain in the lower abdomen, particularly if the pain radiates to the back or sides.

Importance of Medical Evaluation
Given the complexity of abdominal pain and the potential for serious underlying conditions, it is crucial to seek medical evaluation if your symptoms persist or worsen. A healthcare provider may recommend imaging studies such as an ultrasound or CT scan to assess for any structural abnormalities. Blood tests may also be necessary to check for signs of infection or inflammation.

Anxiety and Pain Perception
You mentioned experiencing anxiety, which can indeed influence pain perception. Anxiety can heighten sensitivity to pain and may lead to a cycle of increased discomfort and worry. It's essential to address both the physical and psychological aspects of your health. Techniques such as mindfulness, relaxation exercises, and cognitive-behavioral strategies can be beneficial in managing anxiety and its impact on pain.

Conclusion
In summary, right lower abdominal pain can arise from various causes, including gastrointestinal issues, musculoskeletal strain, hernias, gynecological conditions, and urinary tract problems. Given your recent history of gastrointestinal symptoms, it would be wise to follow up with your healthcare provider for a thorough evaluation. They can help determine the underlying cause of your pain and recommend appropriate treatment. Additionally, managing anxiety can play a significant role in your overall well-being and pain management.

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