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What causes lower right abdominal pain?

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General Surgeon
Practicing since : 2008
Answered : 5372 Questions
Present complaint : lower right abdominal discomfort for last 2 months not improving. Is there when I wake up in morning and some days really uncomfortable. Made worse by driving or walking. Have had FBC and U&E's no problems both normal. An abdominal ultrasound to look for hernia showed nothing.
Posted Sun, 2 Mar 2014 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 28 minutes later
Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. Lower right abdominal discomfort/pain can be caused by ovaries cyst, ovaries inflammation, large intestines issues (like polyp or other lump). If the pain radiates to the leg through buttock, spine disc herniation is possible. Even if the urine analysis is negative, urinary tract infection or stones are still possible. Such pain usually radiates to the back or leg through groin. As regular tests are negative, I suggest you to have urine culture test and consult gynecologist (transvaginal ultrasound should be done). If this will be also negative, please consult orthopedist for spine problems. As a last step, colonoscopy should be considered. Hope this will help. Feel free to ask further questions. Regards.
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Follow-up: What causes lower right abdominal pain? 2 hours later
Thank you for your prompt reply. I don't know if I stated but I am male so the female problems don't apply. I Previously had an undiagnosed Urinary tract infection that lasted for some time as the doctor never asked for a urine culture which resulted in a urethral stricture. I was told this was due to scar tissue from the infection. For this I had several urethral dilatations. The present discomfort is very low down on the lower right side and is just there mainly as an ache. The groin area on the right feels a bit tender although the lymph nodes don't feel significantly enlarged and the discomfort does radiate into the upper thigh at times. I wondered if it was my colon as it has been a bit hyperactive since the pain started and I often have a lot of wind and stools are a bit loose but no blood or mucus. My Doctor keeps telling me its a hernia that's developing despite a negative ultrasound and no sign of a lump and that he will give me some pain relief to dull the nerves. I will take your advice and ask for a urine culture as the doctor only used urinalysis strips. What other advice can you give when I next visit him so that I don't just walk out with a prescription for pain killers
Answered by Dr. Grzegorz Stanko 16 hours later
Brief Answer: . Detailed Answer: From your description it seems that you are dealing more with the groin pain than abdominal pain. Hernia is one possibility. Sometimes it is very hard to rule it out. Ultrasound sometimes can give negative answer and hernia can be still present. I just hope your ultrasound were done while you have been standing (not lying down) and coughing (during coughing hernia can appear). If not, you should have one. Hernia should give symptoms mainly when lifting heavy objects, coughing or even pushing on stool. Please try to put your hand in the pain area and cough few times (you should stand up when doing it). If the pain aggravates during this activity and some lump knocks to your finger, hernia is possible. Urinary tract infection can give lower right abdominal pain. But it usually causes lower both sides pain, one side back pain and one side groin pain. Please try to push your abdomen in the lowest place, just above the bone located in the pubis area. This is where bladder should be painful. Groin one side pain can sometimes imitate hernia pain and be caused by inflammation of the adductor of the thigh. This condition is mostly caused by some physical activity (like jogging, bike riding, stretching). The pain appears when walking or stretching. To diagnose it, soft tissues ultrasound (or better MRI) should be done. Your stool problems can be related to the left lower abdominal pain, but not groin pain. Colon hyperactivity may be caused by some antibiotics course (for UTIs for example), stress, bad diet or some tumor. But all of that does not cause groin pain. Here is what I suggest you to do: - urine culture and regular urine analysis (not a strip test) - consult good surgeon who will be able to perform physical activity for possible hernia, if there will be any doubts, MRI is the best way to finally rule hernia out - consult orthopedist if you find adductor muscle inflammation possible - have stool test, stool culture test; in case of blood in the stool colonoscopy is necessary, in case of infection, probiotic and Rifaximine treatment should be beneficial Hope this will help. Regards.
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