WHAT CAN CAUSE LOWER ABDOMINAL PAIN?

Medically reviewed by Jay N. Yepuri, MD

A variety of conditions can cause lower abdominal pain, or lower belly pain. The conditions range in severity from trapped gas, which does not need urgent medical attention, to appendicitis, which does. 

The severity and location of the pain gives healthcare providers clues about the cause of the pain. In most cases, the pain and other symptoms are managed through medications, exercises, and dietary changes.  

Trapped Gas

Sometimes excess gas gets stuck in the digestive tract. Trapped gas usually occurs after meals, but it doesn't always lead to lower abdominal pain. Trapped gas becomes painful when the gas causes the gut to bloat and stretch. The gas is ultimately released when colonic gut bacteria break down undigested fibers.

To avoid trapped gas, a healthcare provider may recommend eating smaller, more frequent meals and avoiding foods that gut bacteria can use to generate gas. If there are underlying conditions leading to trapped gas, such as irritable bowel syndrome (IBS), a healthcare provider may suggest treatments tailored to those conditions.

Constipation

Constipation occurs when stool becomes hard and difficult to pass. Dehydration, a diet low in fiber, and blockages in the gut can make you constipated. Constipation can lead to pain in the lower abdomen and a feeling of fullness even if you haven't eaten any food.

Constipation is treated with over-the-counter laxatives, changes in dietary habits, probiotics, and enemas.

Appendicitis

Appendicitis is a condition that can develop when the appendix becomes blocked—such as by stool—and inflamed. The inflammation irritates the wall of the abdomen, causing significant pain. If untreated, the appendix could burst and lead to a life-threatening infection.

Appendicitis pain becomes sharper and more severe over a short period of time. The pain moves from the belly button to the lower right-hand side of the abdomen. The pain will worsen if you press on the area. The pain also intensifies when you move around, take deep breaths, cough, or sneeze. The severity feels different—often more severe—than other types of abdominal pain.

Appendicitis is treated with antibiotics and appendectomy—the surgical removal of the appendix. The surgery is considered relatively safe with few serious side effects.

Kidney Stones

Kidney stones are crystallized minerals that form obstructions inside the kidney. The pain may first be felt in your back. As the stones try to pass through the ureter, the tube that carries urine from the kidney to the bladder, they may get stuck. When this happens, you may feel the pain in your lower abdomen and groin. The pain might feel like a constant dull ache, or it might feel like a sharp pain that comes and goes in waves.

Treatment involves taking non-steroidal anti-inflammatory drugs (NSAIDs) like Aspirin (acetylsalicylic acid), Advil (ibuprofen), and Aleve (naproxen) to ease the pain. To help the stone pass, it is important to increase fluid intake. For large stones, Flowmax (tamslosin) is prescribed as it helps the stone pass through the ureter. Very large stones require surgical removal or are broken up into smaller pieces using shock waves.

Kidney Infection

A kidney infection is caused by bacterial or viral infection. The infection starts in the bladder and spreads to the kidney. The infection can cause pain in the back, side, or groin area. Other symptoms include frequent, painful urination and bloody, foul-smelling urine.

Kidney infection is treated with oral or intravenous antibiotics. In some cases, treatment will require hospitalization and rehydration via intravenous fluids.

Endometriosis

Endometriosis is a condition where the uterine lining, called the endometrium, grows outside the uterus. These growths cause localized pain based on where a person's growth is. One person may feel it on the lower right side of their abdomen while another person may feel pain in their lower back.

The pain recurs in cycles and may increase in intensity over a short period of time. There can also be pain during intercourse, urination, or defecation.

Most treatment for endometriosis focuses on managing the symptoms. There are many drugs used to manage the symptoms of endometriosis. The first-line treatments include:

  • NSAIDs: These drugs provide pain relief and reduce inflammation.
  • Progestins: Sold under brand names like Nexplanon, Mirena, and Implanon, these medications mimic the hormone progesterone, preventing ovulation and the growth of endometrial tissue.
  • Combined hormonal contraceptives: Sold under brand names like Amethyst, Aviane, and Falmina, these medications prevent the body from ovulating by mimicking the body's hormones.

Second-line treatments may be used when symptoms are hard to manage. One is a medication called Danocrine (danazol), which mimics the hormone testosterone, making it harder for endometrial tissue to grow. Another option when other treatments aren't working is removal of all the endometrial tissue.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) damages the lining of the gut, causing pain and inflammation. There are two types of IBD: Crohn's disease and ulcerative colitis. Crohn's disease can affect any part of the gastrointestinal tract while ulcerative colitis affects the large intestine or rectum.

Pain from IBD is typically felt in the lower right abdomen. Pain can occur alongside other symptoms like diarrhea (possibly with blood or mucus) and weight loss.

The treatment for IBD depends on the severity of symptoms, how much of your gastrointestinal tract has been impacted, and how severe the internal damage is. Common treatments for IBD include:

  • Mesalamine: Sold under brand names like Lialda and Canasa, this medication reduces swelling and inflammation in milder cases.
  • Corticosteroids: The anti-inflammatory drugs can treat more moderate cases.
  • Remicade (infliximab): This drug suppress the immune system in the gut, reducing symptoms for people with moderate cases of the disease.
  • Surgery: Surgical removal of damaged tissue can relieve severe symptoms.

Irritable Bowel Syndrome

IBS can cause abdominal pain or discomfort. IBS also changes your bowel habits. Some people have constipation, some have diarrhea, and some people have a mix of both. Healthcare providers diagnose someone with IBS if they have these symptoms and there is no other condition causing them.

IBS treatment differs based on symptoms. Someone with constipation might increase the amount of fiber in their diet and start using laxatives while someone else might be prescribed physical activity to help regulate gut motility.

Diverticular Disease

Some people develop small pouches on the lining of their colon. These pouches are known as diverticula and usually don't cause any problems. Inflamed diverticula lead to diverticulitis. When diverticulitis causes complications, it's known as diverticular disease.

Diverticular disease can cause sudden, dull lower abdominal pain. Other symptoms include diarrhea, constipation, and bloating.

To rest the colon, you may be advised to follow a clear liquid diet for a day or two. To treat pain, a healthcare provider may recommend medications like acetaminophen. Antibiotics would be prescribed on a case-by-case basis.

In severe cases, surgery is necessary to remove the pouches. This prevents a life-threatening abdominal infection called peritonitis.

Adhesions

Adhesions are scar tissue that forms inside the abdomen. The adhesions form between two organs or between an organ and the abdominal wall. These adhesions most often form following abdominal surgery. They can also form due to conditions like Crohn's disease or endometriosis.

Adhesions don't usually cause symptoms. When they do, it's because the adhesions has twisted or is pulling the lining of the abdomen and other organs. In addition to cramp-like pain, this can also cause bloating, constipation, and vomiting.

Adhesions are only treated if they cause abdominal pain and other symptoms. It is treated either through surgery or intravenous fluids that flush out obstructions.

Pelvic Floor Dysfunction

Pelvic floor dysfunction is the abnormal activity of the pelvis muscles. When the muscles aren't working well or are overactive or underactive, you can experience pain in the lower abdomen and pelvic region. You may also have difficulties with defecation control, bladder control, and sexual function.

There are many options for treating pelvic floor dysfunction, including:

  • Dietary changes: Avoiding alcohol, caffeine, acidic foods, and spicy foods can help manage bladder-related symptoms.
  • Pelvic floor (Kegel) and core exercises: These help strengthen the muscles, reducing pain and other symptoms.
  • Medications: Topical estrogen treats vaginal and bladder symptoms. Drugs like Toviaz (fesoterodine) are used to treat overactive bladder.
  • Biofeedback and physical therapy: These methods help improve pelvic floor function.

Uterine Fibroids

Uterine fibroids are non-cancerous growths that form on or outside the uterus. In many cases, the fibroids don't cause symptoms. When they do, the fibroids can cause pelvic and back pain, uterine bleeding, and bowel and bladder problems.

When the fibroids cause symptoms, management involves reducing pain and addressing other symptoms. Treatment involves hormonal contraceptives, NSAIDs, and hormones that act directly on the brain's pituitary gland. In more severe cases, treatment may involve surgery to remove the fibroids. Sometimes a hysterectomy, which involves the removal of the entire uterus, is needed.

Interstitial Cystitis

This condition causes pain above the pubic region, near the bladder. Some people might also feel pain in their lower back. Interstitial cystitis may be caused by chronic inflammation of the bladder or the misfiring of nerves. Since the condition is not well understood, it often takes time to receive this diagnosis.

Most of the pain and symptoms of interstitial cystitis are localized to the bladder. The pain is accompanied with a frequent urge to urinate as well as pain or discomfort during urination or intercourse.

There isn't a known cure for interstitial cystitis. Treatment focuses on managing symptoms through the use of multiple methods, such as:

  • Pelvic floor exercises to relive pain or tenderness
  • Bladder re-training to reduce leakage and frequency of urination
  • A focus on stress reduction to minimize the flare-up of symptoms
  • Dietary changes to exclude any foods that might lead to flare-ups
  • Electrical nerve stimulation of the bladder to manage symptoms

In more severe cases, drugs or surgical procedures may be needed to relieve pain and restore bladder control.

When to See a Healthcare Provider

In most cases, lower abdominal pain is not an emergency. Consider seeking non-emergency medical care if you have lower abdominal pain and experience:

  • Pain or discomfort that lasts longer than one week
  • Pain that doesn't improve within 48 hours or worsening pain
  • Nausea and vomiting
  • Bloating for more than two days
  • Burning pain during urination
  • Diarrhea lasting five or more days
  • Fever
  • Low appetite or unexplained weight loss
  • Prolonger vaginal bleeding

Get emergency care if you are experiencing lower abdominal pain and you:

  • Are being treated for cancer
  • Can't pass stool
  • Have blood in your vomit or stool
  • Have chest, neck, or shoulder pain
  • Have lower abdominal pain that is sudden and sharp
  • Have tenderness in your belly or your belly becomes rigid and hard to the touch
  • Are or may be pregnant
  • Had recent abdominal injury
  • Have difficulty breathing

A Quick Review

Lower abdominal pain can be experienced in many different ways. It can be described as sharp, dull, or cramp-like. it can come on suddenly or develop over time. It can also range in severity, from mild to severe. Many conditions can cause lower abdominal pain, including gas, constipation, IBD, IBS, and appendicitis. For some conditions, the pain is localized to a specific side of the body. In other conditions, the pain can be felt in places besides the lower abdomen, usually the back. Figuring out the cause of your lower abdominal pain is the first step toward managing and treating it, alongside other symptoms.

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Read the original article on Health.

2023-06-05T14:31:23Z dg43tfdfdgfd