Shooting pain in the lower abdomen after examination. Pain after examination by a gynecologist

If your lower abdomen hurts, it can be caused by various reasons - from overeating to cancer. If discomfort appears frequently, the lower abdominal area pulls, tugs, fever, vomiting and diarrhea occur, you should consult a doctor.

There can be many causes of pain in the lower abdomen

Causes of pain in the lower abdomen

Acute or aching pain in the lower abdomen in a person develops due to problems with the digestive tract, against the background of gynecological and urological pathologies, sexually transmitted diseases, and infectious diseases.

Causes of pain from different sides

Pain in the lower abdomen as a sign of gastrointestinal diseases

Pathological processes in the organs of the digestive tract are accompanied by various types of pain syndrome. The disease occurs with severe dyspeptic disorders, weight loss against the background of poor appetite.

Severe pain in the lower abdomen on the right, which radiates to the leg, fever, diarrhea, vomiting are symptoms of acute appendicitis; without proper medical care, peritonitis develops.

A stomach ulcer is characterized by pain on the left side

Why do women experience pain?

Often nagging pain occurs during menstruation. In girls, unpleasant symptoms appear several days before the onset of bleeding, in women who have given birth - during or after the end.

A mild throbbing pain appears a few days after a medical or surgical abortion. But if the discomfort does not go away for a long time, intensifies, and is accompanied by a high temperature, you should consult a specialist - similar signs occur during infection.

Main reasons:

1. Dysmenorrhea is a cyclical pathological process, accompanied by constant pain, which intensifies when walking, nausea, migraines, frequent urination, and painful periods.
2. Endometriosis is the penetration of the endometrium into other organs, the lower abdomen hurts, shoots, pulls, discomfort increases during sex or immediately after it, when visiting the toilet. The pathology is accompanied by heavy menstrual bleeding; dark brown discharge appears at the beginning and at the end of menstruation.
3. Cystitis - the source of inflammation is localized in the bladder, nagging pain in the lower center intensifies during urination. Additional symptoms are pain, fever, weakness, urine becomes cloudy.
4. Inflammation of the appendages and uterus– develops against the background of infection with streptococci, staphylococci. Stylish one-sided pain syndrome of a pulling nature occurs with adnexitis, intensifies during sexual intercourse, vaginal discharge appears interspersed with pus, urination causes discomfort.
5. Adnexal torsion– the pathology develops against the background of adhesions, the pain syndrome covers the lower abdomen and lower back, intensifies during movement, upon palpation one can detect swelling, compaction along the localization of pain.
6. Rupture of the cyst - strong, cutting, prolonged pain that either subside or worsens, nausea, the skin becomes pale, weakness appears, and the temperature does not decrease after taking antipyretic drugs.
7. Uterine cancer is a dangerous, very common pathology; there is aching in the lower abdomen, the pain syndrome is weak, but constant and monotonous. Discharge with a putrid odor and uterine bleeding appear.
8. Ovarian cancer can occur without any special symptoms; mild pain on the lower side occurs after intense physical exertion.
9. Fibroids - if a neoplasm in the uterus reaches an impressive size, it begins to put pressure on the internal organs, the pain is of a pressing nature. When a knot forms, the discomfort is strong and cramping.

During ovulation, the follicle ruptures - aching pain appears in the lower abdomen; such symptoms should be taken into account when planning pregnancy.

Types of neoplasms in the uterus

Pain in the lower abdomen during pregnancy - how unsafe it is

A sudden attack of poly in expectant mothers can cause miscarriage, premature birth or complications during delivery. After 39 weeks, discomfort appears due to the divergence of the pelvic bones, which is normal.

Causes of pain:

1. Placental abruption – severe, sharp pain, bleeding, bloating, pallor of the epidermis. The development of pathology can be triggered by stress, excessive stress, and abdominal trauma.
2. Spontaneous abortion in the early stages is accompanied by a sharp dagger-like pain syndrome, bleeding appears, and muscle tone increases.
3. Pain after childbirth is normal; tissues are damaged and need time to recover.

Normal placenta and placenta with abruption

Causes of pain in men

Often the cause of nagging pain in the lower abdomen is sexually transmitted diseases; the discomfort intensifies after sex.

Why does the lower abdomen hurt in men:

1. Adenoma is a benign neoplasm of the prostate gland. The lumen of the urethra decreases, congestion develops, pain is localized in the very lower abdomen near the groin.
2. Orchiepididymitis - the focus of inflammation is located in the testicles and appendages, the pain is burning, one-sided.
3. Varicocele - the veins around the spermatic cord dilate, blood flow is disrupted, and the testicle begins to enlarge. Pain sensations radiate to the groin and pubic area, intensify with coughing and movement, and are often localized on the left side, but can also be bilateral.
4. Prostatitis is inflammation of the prostate gland. It occurs against the background of stagnation in the tissues; pathogenic microorganisms can also provoke the disease. The pain is cutting, intensifies with urination, excitement, potency worsens.

Any inflammatory process of a urological nature can cause impotence and infertility.

Prostatitis is a common cause of lower abdominal pain in men

Child's pain

In children, the cause of pain can be digestive problems, gastrointestinal diseases, and helminth infections.

Causes of discomfort:

1. Infants have colic and dysbacteriosis. The baby cries, refuses to eat, constantly moves his legs, tries to take a more comfortable position.
2. With obstruction, the temperature rises, stool stops, gases do not pass away, and severe pain appears in the lower abdomen.
3. Irritable bowel syndrome - pain syndrome is accompanied by stool disturbances; after defecation, the discomfort becomes weaker or disappears completely.

In preschoolers and schoolchildren, slight pain, slight tingling on the left or right, can be caused by physical or emotional overload, stress, if there are no additional dangerous symptoms. The child needs to be allowed to rest, get enough sleep, and you can drink herbal teas with a sedative effect.

What to do if your lower abdomen hurts?

It is impossible to independently determine the cause of pain in the lower abdomen, therefore, in case of severe or frequent attacks, you should call a doctor and provide the patient with all possible first aid. It is advisable not to take painkillers and laxatives before the doctor arrives, so as not to blur the symptoms, and limit food and liquid intake. No-Spa copes well with cramps in the side and abdominal pain, while it does not blur the clinical picture of the pathology.

How to reduce pain:

1. For colic, you can take No-shpa, drink mint or chamomile tea, and put a warm heating pad in the groin area.
2. During an attack of gastritis, warm milk with honey, Almagel, will help.
3. If there are signs of poisoning, you need to do a gastric lavage, take activated carbon, Smecta or other sorbent, drink more fluid to quickly cleanse the body of toxic substances.
4. During an attack of pancreatitis, you need to sit down and bend a little, try to breathe shallowly, superficially. You can’t eat, you need to drink 50 ml of water every half hour.
5. If the pain is caused by menstruation, you can take Analgin, No-shpa, drink warm tea with honey and lemon, hold a heating pad on your stomach for half an hour - but only if the discomfort is not caused by serious gynecological diseases.

No-spa will quickly relieve stomach cramps

From time to time, every person experiences pain in the lower abdomen - after lifting weights, heavy physical activity, overeating, or hypothermia. But if the pain syndrome appears frequently and is accompanied by dangerous symptoms, it is necessary to undergo an examination to identify the cause of the discomfort.

An examination by a gynecologist causes discomfort for most women. And many are alarmed by the symptoms that appear after such a diagnosis. Painful sensations inside the abdomen, which can have a different character and be accompanied by additional symptoms, are a reason for close attention.

Symptoms after examination by a doctor

A speculum can cause discomfort

Discomfort after the examination persists for several days, and this cannot be called a deviation from the norm. However, acute pain should alert the patient. Sometimes during an examination, doctors examine the condition of the cervix and vagina too roughly - this causes injury to the mucous membrane and some other disorders.

To understand why the lower abdomen hurts after an examination by a gynecologist, it is enough to study the manipulations performed by the doctor:

• using a gynecological speculum, a specialist examines the vagina and cervix - this instrument does not have sharp corners, but can damage the membrane if the woman’s muscles are too tense;
• during the examination, the doctor takes a smear from the mucous membrane in order to send it for tests, sometimes it is necessary to collect cells from the cervix, during which slight irritation of the organ also occurs;
• A bimanual examination is carried out with your hands, palpating the organ from the inside and outside of the abdomen - excessive pressure will result in painful sensations after a while.

Normally, the pain goes away after some time - 1-2 days, but this symptom cannot be ignored, since in some cases it indicates a disease.

Women who do not have regular sex life, as well as patients over 50-55 years of age, are especially susceptible to painful sensations. With age, the amount of lubrication decreases, the muscles weaken - this provokes unpleasant sensations.

Dangerous symptoms

Painful sensations after examination, especially acute pains that require medication and are difficult for women to tolerate, are a sign of inflammatory processes in the pelvic organs. During diagnosis, the doctor may suspect their presence or will definitely indicate a particular disease.

Symptoms may appear some time after examination. You should immediately contact a doctor if the patient’s condition worsens, weakness appears, blood pressure drops or rises, heavy bleeding occurs and the temperature rises.

Dangerous symptoms may be associated with damage to the ovarian cyst, but with an instrumental examination this is unlikely.

Acute pain sometimes develops in women with insufficiently strong pelvic muscles. This is a non-pathological condition, you just need to endure it and think about strengthening your muscles.

Features of examination during pregnancy

Gynecological examinations are carried out mainly in the early stages of pregnancy. The doctor must be extremely careful. If the patient feels severe discomfort, she can change the gynecologist. Intense manipulation can provoke uterine contractions and subsequent miscarriage. To prevent such a situation, it is important to warn the doctor about the presence of pregnancy before the examination.

Diagnosis of the condition

If the pain persists, the woman should consult a doctor. An ultrasound of the pelvic organs, a general analysis of urine and blood are prescribed. It is imperative to study the analyzes of smears taken earlier. It is advisable to carry out the procedure where the results are provided to the patient within a day.

If a routine examination does not reveal anything, it is necessary to undergo further diagnostics - an MRI of the pelvis and peritoneum, as well as a detailed blood test. Consultation with an oncologist and hematologist may be required.

How to relieve pain

To avoid painful sensations, you need to remember some rules:

• It is better to carry out hygiene procedures before visiting a doctor without soap, which can dry out the mucous membrane;
• to prevent pain during palpation, it is necessary to empty the bladder;
• to prevent the development of diseases, you must consult a doctor if any signs of disturbances appear;
• if pain does occur, but it is not associated with diseases, you can take No-Shpu or drotaverine, papaverine.

You can take 1 tablet of NSAIDs such as Nurofen or Tempalgin, however, if unpleasant symptoms persist, further use of such medications is prohibited.

Painful sensations without additional symptoms are in most cases a normal indicator after examination by a gynecologist. However, these signs may hide inflammatory processes and other disorders. It is important to monitor your condition and seek re-diagnosis if pain persists for more than 3-4 days.

Visiting a gynecologist remains one of the most disliked procedures for women of all ages. Almost half of them complain that after the examination they have various pains in the lower abdomen. Is this considered normal and how can you avoid such a reaction?

After an examination by a gynecologist, the lower abdomen hurts: normal or abnormal?

Quite often, women complain that after a gynecologist their lower abdomen hurts. This discomfort may last for several days after examination by a gynecologist. The pain is nagging or sharp in nature, which causes natural concern in the patient.

Such a reaction can actually be observed after taking it; it is caused by the peculiarities of the procedure being performed, the presence of pathologies or diseases in the woman, and the inexperience of the doctor.

During the examination, it is impossible to damage internal organs through negligence, even if the doctor performs the manipulations somewhat roughly (according to the patients).

Pain in the lower abdomen after a visit to the gynecologist is a fairly common occurrence.

What is included in a gynecological examination

Pain after examination by a gynecologist may be due to the specifics of the procedure, which takes about 10 minutes. It includes:

• Examination of the vagina and cervix using a special gynecological speculum. The tool has no sharp corners and is therefore safe. At the time of insertion, the woman may feel some discomfort, so you need to first relax the vaginal muscles.
• Taking a smear from the mucous membrane of the internal genital organs for further microbiological examination. Cytology of the cervix can also be performed - sampling of cells to determine their normal development and the absence of mutation processes.
• Bimanual examination. The doctor palpates the organs inside with one hand, and the outside of the abdomen with the other. This is how the correct location of organs and their development are determined.

Why does the lower abdomen feel tight after being examined by a gynecologist?

If your lower abdomen hurts after visiting a gynecologist, there may be several reasons for this:

• Presence of gynecological diseases, inflammatory processes. These include, for example, cervical erosion, ovarian cysts, endometriosis, inflammation of the appendages, etc. Before examination at rest, the pathology did not cause pain, but after palpation or insertion of a speculum, a characteristic symptom appears. If your stomach hurts inside after the gynecologist even on the second day, contact your doctor.
• Weak muscles of the pelvic organs. Manipulation with them causes pain.
• During the collection of biological material, intentional minor damage to the mucous membrane of the cervix is ​​carried out. This is somewhat painful and can also provoke bloody discharge.

For girls who are not sexually active, the examination can be carried out through the rectum.

Taking a smear and biomaterial can cause pain in the lower abdomen.

Weak muscles and pain in the lower abdomen after examination by a gynecologist

If, after an examination by a gynecologist, pain appears in the lower abdomen, it is worth answering the question of whether the vaginal muscles are sufficiently prepared. This problem is typical for women who have an irregular sex life and do not have additional stress, for example, in the gym.

The second category of women who may suffer from abdominal pain after examination by a gynecologist are mature patients. With age, muscle tissue loses its elasticity. Also, lack of lubrication in some cases leads to microtrauma of the mucous membrane.

Examination during pregnancy

Gynecological examination during pregnancy is carried out in the early stages. At the same time, it is carried out more carefully so as not to provoke contractions. In order for the doctor to take into account existing circumstances, during the consultation you need to warn him about your situation or suspicion of it.

If, after an examination by a gynecologist, a pregnant woman’s stomach or lower back hurts, this may be a reaction of the uterus to the manipulations being performed (it begins to contract). This condition is dangerous due to the possibility of spontaneous abortion (especially if the patient is stressed). In this case, you must immediately notify the doctor about the problem that has arisen.

Proper preparation for visiting a doctor will help you avoid pain during and after the procedure.

How to avoid pain after a gynecologist?

To eliminate pain in the lower abdomen after a gynecologist, you should adhere to the following recommendations:

• Before the examination, you should not perform hygiene procedures using soap. It dries out the mucous membrane and leads to injury.
• The uterus is located in close proximity to the bladder, so upon palpation it should be empty so as not to cause pain and discomfort.
• Consult a doctor promptly if there is the slightest deviation in your health: changes in discharge, pain during sex, bleeding, etc.

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The main cause of pain in the vagina is gynecological diseases. Although it is possible that the reason lies in other organs that are nearby. Such organs can be the intestines, bladder and even the spine. The characteristics are different: the pain cuts, pulls, aches, stabs and shoots in the vagina.

This symptom may be accompanied by others: pathological discharge, deterioration in general health, increased body temperature, bleeding, itching. The intensity can be of different strength and character. The perception of sensations plays an important role here. Each person has their own pain threshold.

Pain in the vagina is not always associated with pathology. The cause may be injury, individual structural characteristics, or natural changes in the body.

Classification of pain in the vagina

Temporary classification:

• One-time. Single pain attack;
• Recurrent. Repeats without cyclicity;
• Periodic. Manifests itself in a certain time algorithm;
• Constant.

Some diseases have a specific location. For example, bartholinitis, in which the entrance to the vagina hurts. The cause is inflammation of the Bartholin glands in the lower part of the vagina. In order to understand the cause of pain, you need to determine its nature.

Aching or stabbing pain is a manifestation of chronic inflammatory processes in the vagina and not only:

• Colpitis is inflammation of the vagina. It is a consequence of infection, injury or hormonal imbalance. The patient complains of heavy discharge, itching of the genitals and stabbing pain in the vagina;
• Bacterial vaginosis is the proliferation of opportunistic vaginal microflora and a lack of lactobacilli. The main symptom of the disease is copious discharge from the genital tract, which resembles the smell of fish. On examination there is no local focus of inflammation;
• Candidiasis, or thrush, is colpitis caused by the Candida microorganism. Complaints of severe itching, stabbing and shooting pain in the vagina, thick white discharge with a sour odor;
• Sexually transmitted diseases cause pain in the vagina, as well as purulent discharge, pain and burning during emptying of the bladder;
• Kraurosis of the vulva. Age-related changes manifest themselves in insufficient production of sex hormones, which causes a disruption in the process of vaginal hydration and leads to atrophy of the mucous membrane;

If the aching pain increases day by day, new symptoms are added and the condition worsens - this may be a manifestation of serious problems such as ectopic pregnancy.

Nagging pain

• Drawing pain indicates disturbances in the structure of tissues, scarring or prolapse of organs. Weakened by childbirth and age-related changes, the muscles cannot hold the uterus and vagina in the desired position. The uterus descends, pulling the bladder with it and displacing the intestines, causing heaviness in the vagina. An advanced case is prolapse of the uterus and vagina, that is, prolapse.
• Another cause of pulling sensations is a benign formation in the uterus: fibroid or fibromyoma.
• During adolescence- This is a consequence of abnormal development of the genital organs. For example, atresia of the hymen. The vagina is closed tightly. The menstrual flow that appears has no outlet and accumulates inside.

Sharp or sharp pain

• This is a symptom of genital trauma. Bleeding may be accompanied, but in its absence there is a risk of internal hematoma or internal bleeding.
• Severe sudden pain may indicate ovarian apoplexy. Heavy lifting, extreme sex, or abdominal trauma lead to this problematic situation.
• Pronounced pain during menstruation and during sex are manifestations of endometriosis (a disease in which endometrial tissue grows outside the uterine cavity)
• Sharp pain, similar to contractions, accompanies vaginismus. The cause of this disease is not clear. When pressing on the vaginal walls, a strong muscle spasm occurs.

Pain during sex

Pain in the vagina during sex is a common cause of complaints and embarrassment for women. The intensity of these sensations varies and is sometimes accompanied by bleeding.

Causes:

1. The inability to penetrate the penis is a consequence of bartholinitis, endometriosis, and the presence of scars;
2. Negative sensations during deep contact are caused by benign tumors, cancer, or structural features of the internal genital organs.
3. Do not rule out a strong discrepancy in size, this is also possible;
4. Pain over the entire surface of the vagina. The cause of pain is movement and friction. Low lubrication due to lack of readiness for sexual intercourse or due to hormonal imbalance, age-related changes;
5. After operations, other medical procedures or severe inflammation, an adhesive process occurs. Touching such an area during sexual intercourse causes pain;
6. Touching the site of active inflammation causes it to begin to hurt.

Pain in the vagina of a pregnant woman

Pain in the vagina during pregnancy can be caused by one of the symptoms described above, but may also have its own specifics:

• Sprains are a normal process during the second half of pregnancy. The ligaments, which support all the internal organs of the pelvis, are stretched due to the growth of the fetus and increased pressure on them. The sensation of a sprain can be very sharp and painful. The vagina and perineum may hurt;
• Pressure of the uterus and fetus on underlying organs causes pain;
• during the birth process. Very strong bursting pain in the depths of the vagina. If dilatation is much ahead of the birth event, then a retaining ring - a pessary - is placed on the cervix. This device also brings discomfort, even pain.

Pain in the vagina during pregnancy is caused by the following factors:

• Sex may become painful due to some changes during pregnancy;
• A woman in this position is more susceptible to infections and disruption of the natural microflora of the vagina;
• An ectopic pregnancy is manifested by increased pain in the lower abdomen and perineum. Bleeding may begin. That is why it is important to visit an antenatal clinic immediately when pregnancy is detected.

Pain that radiates to the vagina

Sometimes unpleasant pain does not have a gynecological source. Then they say that it “gives” into the vagina. In such cases, this is a manifestation of diseases of nearby organs:

• With constipation, the intestines can cause lumbago in the vagina. Problems with stool will become an explanatory symptom;
• The bladder in its diseases can manifest itself as if the vagina hurts. Painful or difficult urination will be a clue to the diagnosis;
• A spine with lesions in its lower sections manifests itself as lumbago in the lower back, anus or vagina.

Diagnostics

In order to make an accurate diagnosis of pain in the vagina, the doctor carries out the following steps:

1. Conducts a survey. Based on complaints and explanations, the doctor can already assume the disease or the direction of further action;
2. An external examination and on a gynecological chair will help determine the presence of discharge and determine its nature, and in some cases, see the focus of the inflammatory process;
3. Laboratory tests are prescribed based on the suspected disease. General blood and urine tests will show the presence of inflammation in the body. A smear of discharge may contain the culprits of the disease - pathogenic microorganisms. Blood test for hormones if necessary. Blood from a vein for the presence of HIV, hepatitis and syphilis. Ultrasound of the pelvic organs;
4. Based on the data obtained, a diagnosis is made or additional studies are prescribed.

Treatment

We cannot talk about treating pain in the vagina. This is incorrect from a medical point of view, because pain is a symptom, not an independent disease. To treat, it is necessary to find the cause of the pain. Only a professional doctor, after the necessary research, can make a diagnosis and prescribe treatment.

Paying attention to your body is the most important factor protecting human health. Maintaining body hygiene, as well as hygiene of sexual relations, reduces the risk of infection. Self-medication by douching, applying heating pads and self-prescribing medications leads to many of the listed problems. A trip to the doctor's office is the shortest way to get rid of the disease.

Pain in the lower abdomen on the right. What could it be? Lower abdominal pain

on the right may indicate damage to organs located directly in the right iliac region. These are the final section of the small intestine (ileum) and the initial sections of the large intestine (cecum, appendix, ascending colon).

In women, pain in the right lower abdomen can occur due to gynecological pathology (right-sided damage to the uterine appendages - ovary and/or fallopian tube).

In addition, pain irradiates to this area in diseases of the urinary system (renal colic).

For correct diagnosis, the intensity of pain should be taken into account - sharp pain in the right lower abdomen, as a rule, indicates an acute process. In such cases, it is important to exclude pathologies that require emergency surgical intervention (acute appendicitis, termination of tubal pregnancy, torsion of the pedicle of an ovarian cyst, etc.).

Detailing the pain syndrome includes determining the nature of the pain. Cramping pain indicates contractions of smooth muscle muscles, and is especially characteristic of tubal pregnancy termination and renal colic.

The direction of pain irradiation is of great diagnostic importance. Pain in the lower abdomen on the right, caused by damage to the corresponding parts of the intestine, as a rule, does not radiate. In the case of renal colic, the pain radiates to the lower back, groin, and inner thigh. With gynecological problems, pain, in addition, often radiates to the sacrum and rectum.

Attention should be paid to factors that reduce and increase pain. Thus, in acute appendicitis and gynecological pathology, the pain syndrome is reduced with a gentle position of the patient in bed, and in the case of renal colic, the pain forces the patient to constantly move.

It is important to determine the initial localization of pain, since in many diseases the pain syndrome has a characteristic migration. So, in the case of acute appendicitis, it occurs in the central parts of the abdomen, and then moves to the right and down. In inflammatory diseases of the appendages, the pain is initially bilateral.

In addition, pay attention to the accompanying symptoms, such as nausea, vomiting, urination problems.

It is also necessary to find out the background to the onset of pain - have there been previously unpleasant sensations in this area, and does the patient have diagnosed diseases of the digestive tract, urinary system, or chronic gynecological pathology?

It is especially important to identify the circumstances preceding the onset of pain in women:1. Delayed menstruation is typical for termination of ectopic pregnancy.

2. Inflammation of the appendages is often preceded by manipulation of the uterus or hypothermia.
3.

Torsion of the pedicle of an ovarian cyst often occurs after physical strain.

Ovarian apoplexy is usually associated with ovulation.

A thorough analysis of symptoms and information about the onset of the disease allows us to make a preliminary diagnosis and determine treatment tactics.

Sharp pain in the lower abdomen on the right with acute appendicitis

appendicitis

– the first suspicion that arises from a doctor when a patient complains of a sharp pain in the lower abdomen on the right.

The fact is that acute appendicitis, which is an inflammation of the appendix of the cecum, is the most common disease in which sharp pain in this area is typical.

In classic acute appendicitis, pain occurs in the central part of the abdomen, and after 12-24 hours it moves down and to the right.

Sharp pain in the lower abdomen on the right with appendicitis can intensify and weaken, but once it occurs, it does not disappear. As a rule, pain intensifies when coughing and walking, weakens when lying on the sore (right) side.

Nausea and vomiting are possible (usually one-time), diarrhea is rare. Mild fever is typical.

If acute appendicitis is suspected, emergency medical care is required (surgery to remove the appendix), since delay threatens such serious complications as rupture or gangrene of the inflamed appendix with subsequent development of peritonitis.

Severe pain in the lower abdomen on the right in women

In women, severe pain in the lower abdomen on the right is primarily suspicious for the presence of gynecological pathology.

Sharp and/or cramping pain in the lower abdomen on the right in case of tubal pregnancy disorder

Ectopic

pregnancy

– a pathology in which the fertilized egg, for one reason or another, begins to develop outside the cavity

It ranks first in prevalence among gynecological diseases requiring emergency surgical intervention. Therefore, in all conditions that occur with the clinical picture of an acute abdomen in women of childbearing age, the possibility of ectopic pregnancy should be taken into account and a thorough differential diagnosis should be carried out.

The most common location of ectopic pregnancy is the fallopian tubes. Violation of tubal pregnancy occurs, as a rule, in the early stages (5-6 weeks). In this case, either a rupture of the fallopian tube occurs, or a tubal abortion - the expulsion of the fertilized egg from the tube into the abdominal cavity.

If the right fallopian tube is damaged, one of the clinical manifestations of an interrupted tubal pregnancy will be severe pain in the lower abdomen on the right. During a tubal abortion, the pain is cramping in nature, and in the case of a ruptured tube, the pain syndrome is sometimes difficult to distinguish from the sharp pain characteristic of acute appendicitis.

However, unlike acute appendicitis, the pain syndrome during an interrupted ectopic pregnancy has a characteristic irradiation. The pain almost always radiates to the groin area, external genitalia and rectum.

In addition, anamnesis (delayed menstruation), as well as the presence of bloody discharge from the genital tract and the clinical picture of acute blood loss characteristic of an interrupted ectopic pregnancy should provide assistance in making a diagnosis:

• pale skin;
• rapid pulse;
• low blood pressure;
• dizziness (especially pronounced when changing body position).

If an interrupted ectopic pregnancy is suspected, urgent hospitalization is indicated (emergency surgery is necessary, otherwise the woman may die from blood loss).
Sharp pain in the lower abdomen on the right due to torsion of the pedicle of the right ovarian cyst

Torsion of the pedicle of the cyst (tumor

) usually occurs at a young age. The development of complications is facilitated by both the size of the neoplasm and various conditions accompanied by changes in intra-abdominal

pressure

and blood circulation in the tumor (increased physical activity, intestinal overcrowding or

Bladder

Pregnancy, sudden change in body weight, etc.).

When the leg of the right ovarian cyst is torsed, the pain in the lower abdomen on the right is so sharp that in some cases it leads to fainting. The pain intensifies with movement, so the patient tries to take a gentle position in bed.

At the height of pain, nausea and vomiting are possible, the temperature rises to low-grade levels (37-38 degrees Celsius). Characterized by increased heart rate, decreased blood pressure, and cold sweat. Stool disorders and urination disorders are common. Patients often complain of bloody discharge from the external genital tract.

Torsion of an ovarian cyst is a pathology that requires emergency surgical intervention, so if you suspect this disease, you should immediately seek help from a hospital.

Sharp pain in the lower abdomen on the right with apoplexy of the right ovary Ovarian apoplexy

(ovarian rupture, ovarian infarction,

hematoma

ovary) - acute violation of the integrity of the organ with

bleeding

into the abdominal cavity.

This pathology is most often right-sided, and the clinic strongly resembles an interrupted ectopic pregnancy. Ovarian apoplexy is relatively rare, and this circumstance increases the number of incorrect diagnoses.

Ovarian rupture with bleeding is found in 2% of all cases of transsections performed in connection with a diagnosis of acute appendicitis or ectopic pregnancy.

Sharp pain in the lower abdomen on the right with apoplexy of the right ovary resembles the pain syndrome in acute appendicitis. However, a distinctive sign of ovarian apoplexy will be characteristic irradiation (to the sacrum, rectum, thigh).

With severe bleeding, symptoms of acute anemia develop (rapid pulse, low blood pressure, dizziness, fainting), which never occur in acute appendicitis.

The greatest difficulty is the differential diagnosis between ovarian apoplexy and interruption of tubal pregnancy, since both pathologies are characterized by severe blood loss and similar directions of irradiation.

In such cases, one should take into account the fact that ovarian apoplexy most often occurs in the middle of the menstrual cycle (at the time of ovulation, or immediately after it), and interruption of a tubal pregnancy is characterized by a delay in menstruation. In difficult cases, rapid diagnosis of pregnancy is indicated.

Suspicion of ovarian apoplexy is an indication for emergency hospitalization. Medical tactics for this pathology are largely determined by the severity of bleeding: with minor blood loss, conservative treatment is carried out, and if there are signs of increasing anemia, emergency surgery is necessary.

Severe nagging or aching pain in the lower abdomen on the right with acute inflammation of the appendages

Severe nagging pain in the lower abdomen on the right occurs with acute inflammation of the appendages. In this case, the clinical picture is in many ways reminiscent of acute appendicitis.

In such cases, first of all, you should pay attention to the medical history, because often inflammation of the appendages develops as a complication of spontaneous abortion, or after various kinds of manipulations (uterine curettage, hysteroscopy).

Abdominal pain in the typical course of appendicitis, it occurs in the epigastrium (“under the stomach”) or in its central part, and only then goes down and to the right, while the pain in acute inflammation of the appendages is first bilateral, and then shifts towards a larger lesion.

Some help in diagnosis will be provided by the characteristic irradiation of pain, which, with acute inflammation of the appendages, radiates to the lower back, sacrum, inner thighs and, much less often, to the rectum.

The nature and irradiation of pain during acute inflammation of the appendages is similar to the pain syndrome during termination of a tubal pregnancy, torsion of the cyst leg and ovarian apoplexy.

Anamnesis data will also help here. Acute inflammation of the appendages most often develops immediately after the end of menstrual bleeding, while ovarian apoplexy occurs, as a rule, in the middle of the cycle, and interruption of a tubal pregnancy occurs against the background of delayed menstruation. Acute inflammation of the appendages is often preceded by hypothermia, and cyst torsion is often preceded by increased physical activity.

Pain in acute inflammation of the appendages is quite pronounced, but never reaches the same intensity as in gynecological disasters (ovarian rupture during apoplexy, cyst torsion with the development of peritonitis, tube rupture during ectopic pregnancy).

In addition, discharge during acute inflammation of the appendages from the very beginning is purulent or mucopurulent in nature.

Diagnosis is greatly facilitated in case of exacerbation of chronic inflammation of the appendages. Activation of the process is often associated with hypothermia, physical or nervous stress, and is accompanied by nonspecific symptoms, such as:

• appetite and sleep disorders;
• fast fatiguability;
• drowsiness;
• increased irritability;
• inadequate psychological reactions.

Acute inflammation of the appendages is an indication for treatment in a hospital, since untimely and/or inadequate treatment can lead to the development of complications such as purulent melting of the appendages with the development of peritonitis and sepsis.

The first sign of the onset of a purulent process is the appearance of chills with a rise in temperature to high numbers, and then a decrease to subfebrile (37-38o). Then symptoms of intoxication develop (sallow complexion, weakness, rapid pulse, low blood pressure, cold sweat).

In such cases, emergency surgery is indicated to avoid sepsis (blood poisoning) and death of the patient.

Drawing, aching or stabbing pain in the lower abdomen on the right with lesions
intestines

Drawing, aching or stabbing pain in the lower abdomen on the right is characteristic of lesions of the final part of the thin

intestines

(ileum) and the initial parts of the colon (cecum and ascending colon).

Repeated stabbing pain in the lower abdomen on the right with diverticulitis

Diverticula are sac-like formations of the intestinal wall that communicate with its lumen. Due to their structural features, intestinal contents often stagnate in diverticula, which contributes to the development of inflammation.

Repeated stabbing pain in the lower abdomen on the right occurs with inflammation of the diverticula of the final section of the small intestine (Meckel's diverticulum), as well as with diverticulitis of the cecum and ascending colon. Diverticula in these sections, as a rule, are single, and the clinical picture of their inflammation largely coincides with the clinical picture of acute appendicitis.

A characteristic feature of diverticulitis is a chronically relapsing course. Exacerbations often begin with constipation, which is followed by diarrhea.

If acute or chronic diverticulitis is suspected, careful examination and conservative treatment are indicated.

If left untreated, diverticulitis can lead to serious complications, such as suppuration and perforation with the development of peritonitis, and the formation of fistulas.

Therefore, if an attack of severe pain in the lower abdomen on the right is accompanied by symptoms of local peritonitis, such as muscle tension in the anterior abdominal wall, pain on percussion (tapping), a positive Shchetkin-Blumberg sign (increased pain when removing the hand after light pressure), emergency hospitalization is recommended to resolve the issue of surgical treatment.

Severe pain in the lower abdomen on the right side with Crohn's disease

Chronic inflammatory bowel disease –

Crohn's disease

In 20% of cases it is detected during surgery for acute appendicitis. The reason for frequent errors in diagnosis is the similarity of the clinical picture of these diseases.

The fact is that the inflammatory process in Crohn's disease is most often localized in the terminal ileum, and is manifested by sharp pain in the lower abdomen on the right, similar in nature to the pain syndrome in appendicitis.

Taking a medical history can help in diagnosis. As a rule, the first sign of Crohn's disease is diarrhea with a tendency to become chronic. So an attack of severe pain in the lower abdomen on the right in this case is preceded by a fairly long (from several weeks to several months, and even years) period of unstable stool with a tendency to diarrhea.

In addition, Crohn's disease is not characterized by such signs of appendicitis as vomiting and migration of pain from the central areas of the abdomen to the right iliac region.

Without adequate treatment, Crohn's disease leads to serious complications, including perforation of the intestine, so symptoms of peritonitis are an indication for emergency surgical treatment of this pathology.

Drawing, aching and stabbing pain in the lower abdomen on the right with intestinal tumors

Nagging pain in the lower abdomen on the right can occur with both benign and malignant tumors of the final part of the small intestine and the initial parts of the large intestine.

The mechanism of pain is most often associated with the pressure of a growing tumor on surrounding tissues. The intestinal mesentery, rich in nerve endings, is especially sensitive to such pressure.

With predominantly endophytic growth (growth into the intestinal lumen), pain occurs with the development of inflammation, destruction of the tumor, or its growth through the intestinal wall into the surrounding tissue (observed in the late stages of malignant growth).

In addition to pain, tumors on the right side of the intestine are prone to bleeding, and over time lead to the development of chronic anemia.

Malignant growth is often accompanied by symptoms of cancer intoxication (exhaustion, increasing weakness, disturbances in mood, sleep and appetite).

If you suspect an intestinal tumor, a thorough examination in a hospital is necessary. Both malignant and benign tumors are subject to surgical removal.

Repeated pain in the lower abdomen on the right with acute mesadenitis

Mesadenitis –

inflammation of the lymph nodes

intestinal mesentery. The pain syndrome in this disease can be of varying intensity. The pain is most often localized in the lower abdomen on the right.

The clinical picture of acute mesadenitis consists of local manifestations of inflammation of the lymph nodes (periodic attacks of pain in the lower abdomen on the right) and general symptoms of the disease that caused mesadenitis.

Most often, mesadenitis is of tuberculous origin, and develops already with a full picture of the disease.

The following characteristic symptoms will help diagnose tuberculous mesadenitis:

• exhaustion;
• weakness;
• emotional lability;
• frequent increase in temperature to low-grade levels;
• high ESR.

Treatment of acute mesadenitis consists of treating the underlying disease that caused the pathology. Paroxysmal stabbing pain in the lower abdomen on the right with diseases
upper urinary tract Paroxysmal stabbing pain in the lower abdomen on the right is often found in diseases of the upper urinary tract. They are especially characteristic of the so-called renal colic, which most often accompanies urolithiasis.

Even experienced surgeons often have difficulty differentiating between renal colic and appendicitis.

The fact is that in some cases the pain with appendicitis is paroxysmal in nature, and with renal colic it often radiates along the ureters to the right iliac region.

Irradiation of pain to the groin can help in diagnosing diseases of the urinary system. Another characteristic feature of the pain syndrome in renal colic is the constant anxiety of the patient, who cannot find a gentle position in which the pain would be felt the least. It seems that changing the position of the body brings some relief to a patient with renal colic, while in the case of acute appendicitis the patient tries to lie motionless on the painful side, since unnecessary movements bring additional suffering.

In addition, the pain syndrome in renal colic is accompanied by various urination disorders (increased frequency and/or painful urination, sometimes visible blood in the urine).

And finally, an attack of renal colic is treated with antispasmodics and analgesics, which are practically useless in the case of acute appendicitis.

Suspicion of renal colic is an indication for hospitalization in a urological hospital for additional examination, the results of which will determine the medical tactics. In most cases, conservative treatment is indicated.

Dull periodic pain in the lower abdomen on the right during pregnancy Dull periodic pain in the lower abdomen on the right during pregnancy can be caused by physiological reasons.

In the first trimester, nagging or aching pain in the right lower abdomen is associated with the functioning of the corpus luteum of pregnancy in the right ovary.

Subsequently, periodically appearing pain in the lower abdomen on the right and left is caused by an enlargement of the uterus and stretching of its ligamentous apparatus.

This kind of pain always has a pulling or aching character; it is more pronounced during the first pregnancy, and never reaches a high degree of intensity.

In addition, pain caused by physiological causes does not have a characteristic irradiation and is not accompanied by any symptoms indicating dysfunction of the digestive and/or urinary systems. At the same time, the woman’s general condition does not suffer.

Cramping pain during pregnancy always indicates pathology, so in such cases it is necessary to seek medical help. In the initial period, severe cramping pain may indicate an ectopic pregnancy.

Sharp pain in the lower abdomen on the right may indicate a surgical pathology of the digestive tract (acute appendicitis, diverticulitis, inflammatory or space-occupying processes in the terminal part of the small intestine or the initial parts of the large intestine), gynecological problems (right-sided inflammation of the appendages or torsion of the pedicle of the right ovarian cyst) or damage to the urinary system (renal colic).

Diagnosis of acute pathological processes during pregnancy is especially difficult in the second half of pregnancy, due to the displacement of organs. Therefore, if sharp pain appears in the lower abdomen on the right, an urgent visit to the hospital is necessary.

Which doctor should I contact for pain in the right lower abdomen?

Pain in the lower abdomen on the right side can be caused by various reasons, so if they occur, you should consult doctors of various specialties. Moreover, you need to consult a doctor whose competence includes diagnosis and treatment of the disease that provoked the appearance of pain in the right lower abdomen. The choice of specialist to whom you should go for pain in the lower abdomen on the right is made depending on the nature of the pain syndrome and accompanying symptoms, since it is these characteristics that suggest the disease that provoked the pain.

Firstly, you should know that in case of acute severe pain in the lower abdomen on the right, which does not subside over time, but remains or intensifies, it is combined with elevated body temperature, a sharp deterioration in general well-being, severe weakness, vomiting that does not bring relief, headache, decreased blood pressure or fainting, you should immediately call an ambulance and be hospitalized in a hospital. This must be done because such a symptom complex indicates an acute emergency condition, which requires specialized medical care as soon as possible, since without treatment a person may die.

And you need to consult a doctor routinely for pain in the lower abdomen on the right in cases where the pain syndrome is provoked by diseases that are not life-threatening.

With intense, cramping pain in the lower abdomen on the right, which does not radiate to other parts of the body, but can simultaneously be felt in the lower abdomen on the left or in the navel area, is combined with constipation, diarrhea, frequent defecation of soft feces, bloating, flatulence, nausea, rumbling in the stomach - you need to see a doctor - gastroenterologist (make an appointment) or therapist (make an appointment), since such symptoms indicate intestinal diseases (colitis, enterocolitis, Crohn's disease, ulcerative colitis, diverticulitis, celiac disease, irritable bowel syndrome).

If a man or woman has a nagging pain in the lower abdomen on the right, which intensifies with sudden movements, stress or physical activity, becoming sharp, stabbing, but not combined with digestive disorders, general weakness, fever, which are actually isolated pains, then you should contact to the doctor- surgeon (make an appointment), since such symptoms indicate the formation of adhesions in the abdominal cavity, which can form after operations or inflammatory diseases of the stomach, intestines, pancreas, gall bladder, etc.

When a constant, dull, moderate pain appears in the lower abdomen on the right, in the middle of the abdomen or in the upper abdomen (it hurts in all areas at the same time, the pain does not radiate to them), which does not subside over time, is combined with vomiting, dry mouth, loss of appetite , surges in blood pressure, rapid heartbeat (up to 100 beats per minute) and breathing (40 breaths per minute) and elevated body temperature - you should consult a surgeon, since the symptom complex corresponds to mesadenitis (inflammation of the lymph nodes of the mesentery of the intestine).

When paroxysmal pain appears in the lower abdomen on the right, radiating to the groin and lower back, combined with urination disorders (blood in the urine, painful, frequent urination, etc.), forcing a person to constantly move, walk, looking for a position in which the pain will be not so strong - you should urgently contact a surgeon or urologist (make an appointment), since we are talking about renal colic due to urolithiasis. Also see a urologist or nephrologist (make an appointment) You should contact us if severe pain is localized in the center of the lower abdomen, radiates to the right in the lower abdomen, is combined with frequent and painful urination, and blood in the urine, since in this case it may be cystitis.

If a person experiences pain in the lower abdomen, mainly on the left or right, combined with frequent, loose and scanty stools, rumbling, bloating, painful bowel movements, lack of relief after defecation and possibly vomiting, then he needs to see a doctor - infectious disease specialist (sign up), since, most likely, we are talking about an intestinal infection.

Periodic pulling, dull, aching pain in the lower abdomen on the right, radiating to the groin, combined with a protrusion in the area of ​​the right inguinal fold, aggravated by physical activity, not combined with any other symptoms, require contacting a surgeon, since the symptom complex indicates inguinal hernia.

If a woman develops sudden, severe, paroxysmal pain in the lower abdomen on the right and left, after some time shifting to the right, or if a dull, aching pain develops in the right half of the lower abdomen after stress, hypothermia, or physical activity, then it is necessary to consult a doctor - gynecologist (make an appointment), since most likely we are talking about inflammation of the uterine appendages (ovary and fallopian tubes) - adnexitis or salpingo-oophoritis. Concomitant symptoms of inflammation of the uterine appendages are the spread of pain to the sacrum, lower back, groin or rectum, as well as pain during urination, irregular menstrual cycle, short temper, irritability, increased fatigue, inflammatory discharge (greenish, yellowish, grayish, with bubbles, flakes, pus, mucus, etc.) or increased body temperature.

If a woman periodically experiences nagging pain in the lower abdomen on the right, often provoked by sexual intercourse, combined with intermenstrual bleeding or prolongation of the menstrual cycle, then she should consult a gynecologist, since such symptoms lead the doctor to believe that there is an ovarian cyst or cystoma.

In women, nagging, aching, dull pain in the lower abdomen on the right, intensifying during menstruation, spreading to the lower back, tailbone, sacrum or rectum, combined with periodic bleeding, frequent trips to the toilet to urinate, the presence of clots in the menstrual blood, requires contacting a gynecologist, so how such symptoms indicate the presence of a neoplasm of the genital organs (fibroids, polyps, etc.).

When pain appears in a man’s lower abdomen on the right, if it radiates to the right side, perineum, lower back, is combined with difficulty urinating (slow urination, frequent trips to the toilet, etc.) and erectile dysfunction, possibly with blood in the urine, you should consult a urologist, since such symptoms indicate the presence of prostatitis or prostate adenoma.

If pain in the lower abdomen on the right persistently does not go away, is present almost constantly, is combined with a sharp deterioration in well-being, causeless weight loss, perversion of taste, persistent constipation, unpleasant discomfort in the abdomen, bloating and flatulence that cannot be treated, then you should consult a doctor - oncologist (make an appointment).

What tests can doctors prescribe for pain in the lower abdomen on the right?

Since pain in the lower abdomen on the right is provoked by various diseases, the doctor for this syndrome can prescribe various tests and examinations necessary to identify the pathology that provokes the pain syndrome. The list of tests and examinations is determined by the nature of the pain and accompanying symptoms, which suggest a disease causing the pain syndrome.

When a man or woman periodically experiences pain in the lower abdomen on the right, which does not radiate to other parts of the body, but can simultaneously be felt in the left lower abdomen, in the navel area, combined with constipation, diarrhea, frequent defecation of soft feces, bloating, flatulence, nausea, rumbling in the stomach, the doctor may prescribe the following tests and examinations:

• General blood analysis;
• Analysis of stool for worm eggs;
• Scatological analysis of stool;
• Stool analysis for dysbacteriosis;
• Stool culture or blood test for clostridia;
• Ultrasound of the abdominal organs (make an appointment);
• Colonoscopy (make an appointment)/sigmoidoscopy (sign up);
• Irrigoscopy (x-ray of the intestine with contrast) (make an appointment);
• Computer or Magnetic resonance imaging (sign up);
• Stool analysis for calprotectin;
• Blood test for the presence of antineutrophil cytoplasmic antibodies;
• Blood test for the presence of antibodies to Saccharomycetes.

The doctor does not immediately prescribe the entire list of examinations and tests, but first of all selects those that make it possible to make a diagnosis in most cases, namely: a general blood test, stool tests for worm eggs and scatology, ultrasound of the abdominal organs and colonoscopy/sigmoidoscopy. Irrigoscopy and tomography may be prescribed additionally if there is doubt about the diagnosis. Blood and stool tests for clostridium are prescribed only in cases where there is a suspicion that colitis is caused by taking

antibiotics

Fecal tests for calprotectin, blood tests for antibodies to Saccharomyces and antineutrophil cytoplasmic antibodies are prescribed only if Crohn's disease or ulcerative colitis is suspected.

If a person experiences dull moderate pain, localized simultaneously in the lower right, lower left abdomen or navel area (or in any one of these areas), which does not subside over time, combined with vomiting, dry mouth, loss of appetite, surges in blood pressure, rapid heart rate (up to 100 beats per minute) and breathing (40 breaths per minute) and elevated body temperature, then the doctor prescribes the following tests and examinations to identify and distinguish mesadenitis from other diseases of the abdominal organs:

• General blood analysis;
• General urine analysis;
• Biochemical blood test (bilirubin, urea, creatinine, total protein, amylase, AST, ALT, alkaline phosphatase, LDH);
• Fecal occult blood test;
• Scatological analysis of stool;
• Mantoux test, diaskintest or blood test for the presence of Mycobacterium tuberculosis;
• Blood test for antibodies to hepatitis A, B, C viruses (ELISA method);
• Blood culture for sterility;
• Blood test for the presence of Epstein-Barr virus, enteroviruses, yersinia, streptococci, staphylococci, campylobacter, salmonella (sign up), Escherichia coli by PCR method;
• Tests for ascariasis, enterobiasis, opisthorchiasis, giardiasis;
• Ultrasound of the abdominal organs;
• Abdominal X-ray (make an appointment);
• Colonoscopy;
• Computed or magnetic resonance imaging;
• Diagnostic laparoscopy (make an appointment) with the collection of pieces of tissue from inflamed lymph nodes for histological examination.

In practice, the doctor usually immediately prescribes almost all studies, except for abdominal x-rays, colonoscopy, tomography and diagnostic laparoscopy, since these methods are used only when necessary, when the results of studies already done do not completely clear the picture of the disease.

If a person has paroxysmal pain in the lower abdomen on the right, radiating to the groin and lower back, combined with urination disorders (blood in the urine, pain when urinating, frequent trips to the toilet, etc.), forcing the person to move persistently, as he cannot find a position in which the pain will subside a little, then the doctor prescribes the following tests and examinations:

• General urine analysis;
• General blood analysis;
• Kidney ultrasound (sign up) and bladder;
• Cystoscopy (make an appointment);
• Urography (x-ray of the urinary system with the introduction of a contrast agent) (sign up);
• Renal scintigraphy (sign up) and urinary tract;
• CT scan.

Usually, the doctor first prescribes a general blood and urine test, ultrasound of the kidneys and bladder, and urography, since these are the studies that help identify nephrolithiasis. However, if the clinical picture remains unclear, then either scintigraphy, computed tomography, or cystoscopy is prescribed. Instead of urography, computed tomography can be performed immediately (if technically possible).

When the pain is localized in the pubic and urethral area or in the center of the lower abdomen, spreads to the lower right side of the abdomen, is accompanied by frequent and painful urination, blood or cloudy urine, the doctor suspects cystitis and prescribes the following tests and examinations:

• General blood analysis;
• General urine analysis;
• Urinalysis according to Nechiporenko (sign up);
• Biochemical urine analysis (creatinine, salts, etc.);
• Bacteriological culture of urine to identify the causative agent of the inflammatory process;
• Blood and scraping from the urethra to identify pathogens of sexually transmitted infections ( gonorrhea (sign up), chlamydia (sign up), gardnerellosis, ureaplasmosis (sign up), mycoplasmosis (sign up), candidiasis, trichomoniasis);
• Uroflowmetry (study of urine flow) (sign up);
• Ultrasound of the bladder and kidneys;
• Cystoscopy.

First of all, various urine tests, bacteriological cultures, or scraping or blood tests for the presence of pathogens are usually prescribed

sexually transmitted infections (sign up)

Ultrasound of the bladder (sign up)

and kidneys. All other studies are usually prescribed as additional ones, when the clinical picture is not entirely clear.

If pain appears in the lower abdomen on the right and, possibly, simultaneously on the left, in combination with frequent, loose and scanty stools, rumbling, bloating, painful bowel movements, lack of relief after defecation and sometimes vomiting, the doctor prescribes the following tests and examinations:

• Bacteriological culture of feces, vomit or washing water to identify the causative agent of intestinal infection;
• Blood test for the presence of antibodies to pathogens of intestinal infections (Salmonella, Shigella, Vibrio cholerae, rotavirus, etc.) using ELISA and RNGA methods;
• Analysis for the detection of DNA of pathogens of intestinal infections using PCR in feces, vomit, washing water, blood;
• Colonoscopy or sigmoidoscopy;
• Irrigoscopy.

Most often, the doctor prescribes a bacteriological culture or blood test for pathogens of intestinal infections. Colonoscopy and irrigoscopy are prescribed only if damage to the intestinal wall is suspected.

For periodic dull, pulling, aching pain in the lower abdomen on the right, radiating to the groin, combined with a protrusion in the area of ​​the right inguinal fold, the doctor prescribes only Ultrasound (sign up), since this is quite enough to diagnose a hernia.

When in the lower right part of the abdomen there are periodic nagging pains that intensify or appear with sudden movements, stress or physical activity, at moments of intensification they become sharp and stabbing, but are not combined with digestive disorders, elevated temperature and seem to be isolated from other symptoms , the doctor prescribes a general blood test, a general urinalysis, an ultrasound of the abdominal organs, an x-ray with contrast, or a tomography. Other studies, as a rule, are not prescribed, since these are quite sufficient to identify adhesions formed in the abdominal cavity after operations or inflammatory processes.

When a woman has severe paroxysmal pain in the lower abdomen on the right, which arose suddenly, and at first it was localized on both the right and left, and then shifted to the right, or if, after stress, hypothermia, or physical activity, a dull, aching pain appears in the right half of the lower abdomen ( (both types of pain may be combined with pain spreading to the sacrum, lower back, groin or rectum, as well as pain when urinating, irregular menstrual cycle, short temper, increased fatigue or elevated body temperature), the doctor may order the following tests and examinations to identify the causes inflammation of the uterine appendages:

• General blood analysis;
• General urine analysis;
• Vaginal flora smear (sign up);
• Analysis of blood, vaginal discharge and scraping from the urethra for genital infections (for chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonas, gonococci, Candida fungi);
• Tests for the presence of viruses - herpes virus types 1 and 2, human papillomavirus (sign up), cytomegalovirus (sign up), Epstein-Barr virus;
• Blood test for syphilis (sign up);
• Bacteriological culture of vaginal discharge;
• Ultrasound of the pelvic organs (sign up);
• Hysterosalpingography (sign up).

First of all, an ultrasound of the pelvic organs, a smear of vaginal flora, as well as a general blood and urine test are prescribed. These examinations may be sufficient to diagnose adnexitis or salpingoophoritis and identify the cause of inflammation. If it is not possible to understand what triggered the inflammation of the uterine appendages, then the doctor will prescribe additional tests and examinations listed in the list above.

When a woman has a nagging pain in the lower abdomen on the right, which occurs sporadically, especially often provoked by sexual intercourse, combined with intermenstrual bleeding or prolongation of the cycle, the doctor usually prescribes an ultrasound of the pelvic organs and a smear from the vagina for flora, as she suspects an ovarian cyst. In addition, for ovarian cysts, the doctor may order a blood test to measure the concentration of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and prolactin (sign up).

If a woman experiences nagging, aching, dull pain in the lower abdomen on the right, which intensifies during menstruation or physical activity, extends to the lower back, tailbone, sacrum or rectum, and is combined with episodic bleeding, frequent urination, and clots in menstrual blood, the doctor will prescribe an ultrasound of the organs. pelvis, hysteroscopy (make an appointment), and, if possible, computed tomography or magnetic resonance imaging. Additionally, to assess the general condition of the body, a general and biochemical blood test, a general urinalysis, a coagulogram, a blood test for sex hormones (LH, FSH, testosterone, etc.) may be prescribed.

If a man experiences pain in the lower abdomen on the right, combined with pain in the perineum, radiating to the right side and lower back, which is accompanied by difficulty urinating, erectile dysfunction, then the doctor prescribes the following tests and examinations:

• General urine analysis;
• General blood analysis;
• Palpation of the prostate through the anus with a finger;
• Ultrasound of the prostate gland (make an appointment);
• Microscopy of prostate secretion;
• Bacteriological culture of urine, prostate secretion and urethral smear to identify the causative microbe and its sensitivity to antibiotics;
• Analysis of prostate secretions (sign up), a smear from the urethra or blood for sexually transmitted infections (chlamydia, candidiasis, ureaplasmosis, mycoplasmosis, trichomoniasis, gonorrhea, bacteroides);
• Blood test for syphilis;
• Blood test for sex hormones and tumor markers (sex hormone binding globulin, testosterone, prostate-specific antigen).

As a rule, the doctor first prescribes an ultrasound of the prostate gland, palpation of the prostate with a finger, microscopy of prostate secretions, a smear from the urethra, and a general analysis of urine and blood. These examinations allow in most cases to make a diagnosis and prescribe treatment. But if the examinations were not enough for an accurate diagnosis, the doctor additionally prescribes other tests from the specified list.

If a person has persistent, persistent pain in the lower abdomen on the right, which is combined with a sharp deterioration in health, causeless weight loss, perversion of taste, persistent constipation, bloating and flatulence, then the doctor prescribes a wide range of examinations - x-ray (sign up) and ultrasound of the abdominal organs, computed or magnetic resonance imaging, general and biochemical blood and urine tests, colonoscopy, sigmoidoscopy, etc. If a tumor is detected using these methods, the oncologist may prescribe blood test for tumor markers (sign up), a list of which will be selected by a specialist depending on the type of neoplasm and the affected organ.

ATTENTION! The information posted on our website is for reference or popular information and is provided to a wide range of readers for discussion. Prescription of medications should be carried out only by a qualified specialist, based on the medical history and diagnostic results.

1 Gynecological causes of pain

Pain in the lower abdomen in women often occurs with various diseases of the reproductive system. If a neoplasm or twisting of the right ovary, uterus, or pedicle of a fallopian tube cyst occurs, pain occurs. In the groin area on the side of torsion or neoplasm due to the development of necrosis and ischemic disorders, stabbing pain in the lower abdomen is noted. They have a paroxysmal character. Usually brown clots are not released. Discomfortable sensations develop if the cyst has reached a significant size.

Often pain in the lower abdomen on the right increases gradually. Urgent surgical treatment is required if indicated. If dysmenorrhea occurs - painful periods, then girls begin to feel pain in the right lower abdomen.

Pain can also be caused by an ectopic pregnancy. This situation is very difficult to recognize at an early stage. If the fertilized egg develops in the right fallopian tube, then painful sensations arise on the right side. In the pelvic region and lower abdomen there is acute stabbing or nagging pain.

This characteristic symptom is accompanied by fainting, dizziness, and low blood pressure in a woman. Brown spotting bloody discharge appears from the vagina. If the fallopian tube ruptures in the right side, acute pain is felt in the abdomen, which extends to the rectum. As a result of bleeding, there is a direct threat to the life of the pregnant woman. Immediate medical attention and urgent surgical intervention are required.

The next reason is endometriosis, or the proliferation of cells lining the uterine cavity outside the organ. With this pathology, there may also be pain in the right lower abdomen. The endometrium - the inner lining of the uterus - begins to migrate throughout the body. Epithelial cells move to the intestines, ovaries, breast tissue and nipple, and the mucous membrane of the eye. The first symptom that forces the patient to go to the doctor is pain on the right side in women. Most often this is associated with the menstrual cycle.

2 Gastrointestinal diseases

When the appendix is ​​inflamed, paroxysmal stabbing or aching pain of unclear localization appears first above the navel, after which it moves to the ilioinguinal region on the right and becomes permanent. As the disease progresses, it becomes pressing, bursting or burning. If the patient lies on his left side, the sharp pain in the lower abdomen intensifies, severe vomiting, chills, and loss of appetite appear. Antispasmodic and analgesic drugs are contraindicated.

Dangerous symptoms of peritonitis - inflammation of the abdominal wall - are severe pain and fever. Gradually increasing abdominal pain spreads to the soft tissues of the abdominal cavity. The patient needs urgent medical attention as there is a risk of severe complications.

A strangulated hernia of the abdominal wall, in addition to abdominal pain, has other symptoms. Eventration develops acutely - a defect in the peritoneum; a diverticulum of the membrane suddenly appears in the lower abdomen, that is, a protrusion of the hernia. Characterized by circulatory disorders in the strangulated organ, bloating and asymmetry of the abdomen on the right side, dry tongue, tachycardia, sudden sharp pain in the affected area, radiating to the groin area. During exacerbation of the disease, the anterior wall of the peritoneum is tense. If a hernia is strangulated, emergency surgery is indicated.

Inflammation of the gallbladder, or acute calculous cholecystitis, most often develops completely suddenly due to a decrease in bile production and overstretching of the gallbladder. Typically, intense pain on the right side radiating to the right shoulder blade occurs at night. Repeated vomiting does not bring any relief. A serious sign is a rapid pulse. Under the right costal arch there are sharp painful sensations of a cramping nature. Pain in the lower abdomen on the right radiates to the neck, shoulder, collarbone, and under the shoulder blade.

The attack often lasts more than six hours. Severe morphological changes occur in the abdominal cavity. All body systems are deeply affected by toxins. Body temperature rises, weakness and chills are noted.

If the cause of pain is hepatitis, then a striking symptom during an exacerbation is a moderate dull pain in the right hypochondrium, which occurs due to stretching of the liver capsule and severe liver damage. The pain syndrome is constant or episodic. Damage to liver cells occurs. Products of bile metabolism enter the blood. As a result of a violation of the outflow of bile into the intestines, an increased level of bilirubin and jaundice develop - a characteristic staining of the whites of the eyes, skin, and mucous tissues.

Biliary dyskinesia, or impaired motility of the gallbladder, brings short-term dull, aching painful sensations in the right hypochondrium, which radiate to the arm, sternum, and back. If the stomach hurts on the right, then this is a clear sign of pathology. The patient needs medical attention. When problems with the biliary tract worsen, attacks of cramping, acute and unbearable pain are pronounced. They significantly reduce the quality of life. Congestive circulatory disorders, belching, and poor appetite are observed. To get rid of painful attacks of biliary tract pathology, antispasmodic drugs are used.

The next reason is cholelithiasis. With it, the patient experiences tension in the anterior wall of the abdominal cavity and a feeling of a penetrating wound on the right.

Cholecystectomy - removal of the gallbladder as a source of stone formation - is a radical solution to the problem. The most common cause of pain on the right side of the abdomen after this operation is pathology of the colon. Constipation is the main cause of pain on the right side. It is necessary to treat the colon and restore its functions. Constipation can have a different nature, so after colonoscopy of the large intestine, treatment programs are selected individually.

Chronic gastritis can also cause pain. Often, abdominal pain occurs in the right hypochondrium, which is a sign of inflammation of the gastric mucosa. After eating, the patient is constantly bothered by an uncomfortable feeling of fullness in the stomach. A feeling of fullness, heaviness and aching pain in the epigastric region can completely deprive the patient of peace. It is enough to cleanse the stomach to get rid of the painful sensations during an attack. Gastritis pain in the abdomen is strictly localized and moderate in nature. The inflamed digestive organ needs a gentle regimen. If the pathology of the gastric mucosa worsens, then severe pain occurs in the lower abdomen on the right. This is a clear sign that the patient needs to see a gastroenterologist.

With a duodenal ulcer, healing alternates with seasonal exacerbations, often causing pain in the right hypochondrium. Under the influence of hydrochloric acid, tissue damage occurs. Ulcers form - red rounded depressions. There are intense night pains. During the period of remission, the inflamed areas slowly heal and scar tissue forms. If you delay treatment, new ulcers form, the muscular and submucosal layers of the intestinal tube can be affected by the pathological process.

In acute pancreatitis, during physical exertion the patient experiences stabbing pain in the right hypochondrium or throughout the entire abdominal cavity. Often there is a girdling nature of the painful sensations. They decrease when the body bends forward. Characterized by loss of appetite, a sharp decrease in body weight, and an aversion to fatty foods. Necrosis of gland tissue and the occurrence of diabetes mellitus are a consequence of complications of acute pancreatitis.

Chronic enteritis is also characterized by painful sensations in the lower abdomen on the right when the right iliac region is affected - part of the small intestine. Drawing, aching or dull pain accompanies signs of indigestion. They occur before the process of defecation, during intense exercise, and a couple of hours after eating. Characterized by constant drowsiness and pronounced weakness.

3 Pathologies of the urinary system

Right-sided abdominal pain is observed with renal colic, pyelonephritis, inflammation of the bladder, and kidney tumors. Most often, the cause of painful sensations in the right side of the abdomen is urolithiasis.

A comprehensive diagnosis will help you understand the causes of discomfort. Ultrasound, X-ray diagnostics with a contrast agent, clinical tests make it possible to identify pathology.

4 Disorders of the musculoskeletal system

The next reason is spinal osteochondrosis. Up to 15% of patients with lumbar osteochondrosis experience pain on the right side of the abdomen, since the nerve roots are pinched and blood circulation is impaired. Quite often, neurological diseases have similar symptoms as a result of radicular syndrome.

The cause of dull pain on the right side of the abdomen is often degenerative changes in the thoracic spine. This disease simulates gastrointestinal pathology.

It is almost impossible to tolerate if the patient is bothered by constant pain in the lower abdomen on the right. It is necessary to consult a doctor in a timely manner, because many different ailments are associated with such a symptom.

5 Diagnosis of diseases

At the earliest stage, completely safe, timely screening diagnostics are carried out. After studying the results of the examination, an experienced doctor will figure out why the stomach hurts on the right side, determine the type of disease, and select the optimal methods of treating the underlying disease.

You should not try to treat yourself if your lower abdomen hurts on the right.

After consulting a specialist, you need to undergo an examination and begin the prescribed treatment course.

Pain in the lower abdomen causes great concern in women, because it is difficult to recognize what caused it. Namely, eliminating the cause of pain in the lower abdomen on the right in women is the most important thing in this case, so it is often necessary to consult a specialist.

But it is important to understand what such pains are. Let's look at the main reasons why the lower abdomen on the right side hurts in women, which can mean pain in the lower right side.

Character, symptoms and types

Pain in women in the lower abdomen on the right is constant and periodic, sharp, dull, aching, pulling, burning, cutting, and so on.

They can often be accompanied by other symptoms. These include diarrhea, nausea, vomiting, general weakness, fever, decreased blood pressure, and so on.

The location of pain may change, they can radiate to the thigh, sacrum, lower back, and occupy the entire abdominal space.

Often pain in the lower right abdomen in women is associated with gynecological causes.

If the sensations arise sharply and intensely, we are probably talking about an acute pathology.

If the problem is chronic, the pain is usually slow and nagging.

Read on the pages of our website everything about the treatment of colpitis in women! You will learn about the most effective drugs and doctors' recommendations.

In the next article we will talk about the symptoms of chronic adnexitis and how the disease is treated in the acute stage.

How to cure bacterial urethritis in women? We invite you to familiarize yourself with modern treatment methods and preventive measures here: back to contents

Diseases that may cause pain

The first suspicion when severe pain appears on the right side of the lower abdomen in a woman is gynecological diseases, but the problem may lie elsewhere. It is necessary to highlight the following popular reasons for this trouble:

• If a sharp cramping pain occurs in the lower abdomen on the right, a woman Possible abnormal tubal pregnancy.

  This condition requires immediate surgical intervention.

  Since the cause is quite common, all patients of childbearing age who complain of pain are diagnosed with ectopic pregnancy.

  The condition is usually accompanied by additional symptoms, such as delayed menstruation, bloody discharge, pale skin, rapid pulse, decreased blood pressure. If the operation is done later than necessary, the woman may lose a lot of blood.

• Torsion or similar deviation of the cyst pedicle. A pressing issue for young women. Additionally, it makes itself felt by nausea, fever, problems with urination, and bleeding. If there is even the slightest suspicion of this condition, go to the doctor as soon as possible.
• Ovarian apoplexy. This term refers to damage to the lining of the ovary, which is characterized by bleeding in the internal area of ​​the abdomen. Symptoms may be the same as with an ectopic pregnancy.

With this disease, colic radiates to the thigh, sacrum and rectum. The pulse may increase, blood pressure may decrease, and fainting may occur. If the bleeding is severe, surgery is necessary.

• Inflammation of the appendages. It can provoke aching, pulling, and stabbing pain in the lower abdomen on the right in women. The symptoms are similar to acute appendicitis, so only a doctor can make a diagnosis. The disease can worsen as a result of hypothermia. The chronic form is usually easier to diagnose.
• Intestinal pathologies. Painful sensations of a cutting or pulling nature in the very bottom of the right side of the abdomen are possible in the presence of certain disorders in certain parts of the large intestine and in the lower part of the small intestine.
• Acute appendicitis. Usually this reason is one of the first to be assumed. The pain in women in this case will be sharp and sharp, they are localized in the very lower part of the lower abdomen on the right. In the classic version of an acute attack, discomfort usually occurs in the center of the abdomen, and then moves to the right and down.

Vomiting and nausea, stomach upset and mild fever may occur. If acute appendicitis has been detected, surgery must be performed as soon as possible, otherwise serious consequences are possible.

• Diverticulitis. This condition is characterized by colic in the lower right abdomen. If there is a suspicion of an acute form or an exacerbation of a chronic one, timely treatment is especially important. In some cases, immediate hospitalization with surgery is required.
• Crohn's disease. Suggests prolonged inflammation in the intestinal area, found in 20% of appendectomy operations. The reasons are similar to the last one. If Crohn's disease is suspected, additional tests will be ordered.

• Tumors in the intestines. Nagging pain in the lower abdomen can indicate benign or malignant formations in the large or small intestine.

  Pain often occurs after pressing on nearby tissues. In addition, right-sided tumors in the intestine often provoke bleeding, which is why chronic anemia is possible.

  Malignant tumors have other characteristic symptoms, such as loss of appetite, exhaustion, and weakness. In this case, a detailed examination in a hospital setting with further removal of the tumor is important.

• Acute mesadenitis. This is an inflammation of the lymphatic vessels of the intestine, in which discomfort occurs in the very lower part of the abdomen. The intensity may vary. Often this condition manifests itself against the background of tuberculosis.

There are a number of characteristic symptoms - high fever, exhaustion, weakness, instability of the emotional background. Treatment should be aimed at combating the underlying disease against which inflammation has developed.

• Diseases of the urinary system. Usually they make themselves felt by stabbing pain attacks. We may be talking about renal colic, which requires examination and therapy in a hospital setting.

• Pregnancy. Dull and nagging pain often occurs in pregnant women due to certain physiological characteristics. They can be caused by an enlarged uterus.

It is especially important to consult a doctor as soon as possible if you experience cramping sensations that may indicate a particular pathology. In late pregnancy, it can be difficult to recognize pathologies as internal organs become displaced.

When to take action yourself

Any pain is a symptom that something is wrong in the body. Therefore, medical intervention is necessary in most cases.

But there are also situations when everything is not so serious, and you can take appropriate measures yourself. For example, if the cause is intestinal colic, and you know about it.

Then it may be enough to drink No-shpa and soothe the gastrointestinal tract with a herbal decoction, for example, mint.

Pain in the lower abdomen on the right often occurs in women before or during menstruation. Although they should normally be painless, few women can boast of this.

This discomfort is physiological, and usually goes away on its own, but you shouldn’t tolerate it. You can take a painkiller, which should always be in your first aid kit just in case.

Sometimes a warm heating pad applied to the painful area helps. Try to lie down, rest and relax - this will calm the pain syndrome.

In what cases should you go to the doctor?

If the pain is intense, does not stop for several hours and, in principle, interferes with normal activities, you need to consult a specialist. First of all, you should visit a gynecologist and gastroenterologist. If necessary, they will refer you to other doctors, such as an infectious disease specialist or even an oncologist.

Since diagnosis with such a vague symptom is quite difficult, It is recommended to carry out a number of tests:

• General blood analysis;
• Urinalysis, including culture and antibiotic susceptibility testing;
• Diagnosis of pregnancy;
• Ultrasound of the pelvic organs to identify neoplasms;
• If inflammation is suspected, a church mucus test is performed;
• Culdocentesis, which determines the presence of fluid in the area of ​​the uterus and rectum;
• X-ray of the peritoneum;
• Laparoscopy of the pelvis.

Based on the results of these tests, the cause will be determined and appropriate measures will be prescribed. You should definitely follow the advice of a specialist.

Please note that If acute pain occurs in the lower abdomen, you should not perform the following actions:

• Try not to take antispasmodic and painkillers. They can complicate the diagnostic process.
• Do not apply heat to the painful area, otherwise the infection may spread through the blood.
• Do not rinse the intestines. If the cause is intestinal obstruction, water will only worsen the situation.
• Don't take laxatives. They can only worsen your condition.

Elena Malysheva will tell you why the lower right abdomen hurts in women in the following video:

Severe pain in the lower abdomen on the right in women - already reason to see a doctor. Since there can be many reasons for this condition, the main preventative measure is regular visits to a gynecologist and, if possible, periodic undergoing a comprehensive examination of the body. A healthy lifestyle and proper nutrition are also important.