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What is the cause for pain in right lower abdomen?

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Practicing since : 2008
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Pain on the right lower abdomen, what could it be? September 2012 In the begging of September 2012 I had a cold, I took some medicine for it, a few days later and already feeling better I had some Anal leakage, no color, no smell just some mucus, kind of like gel A few days later, and already cold free, I had some diarrhea, I then started having some pain on the right lower side of my abdomen when I went to the bathroom, it stopped soon after December 2012 I started having darker stools, and then they started to come with a green tint, no diarrhea, just regular stools but dark and with green liquid, soon after I started having the same pain on the right bottom side of the abdomen again and pressure under my right rib cage, like something was about to burst, It stopped soon after once again! January 2013 (first blood test) I went to the doctor, the doctor ordered an ultrasound of my liver, thinking that It could the be the root of the problem, once the ultrasound was done the doctor said I had a “Fatty liver” and that my problem could be solved with a simple diet, I started said diet, at times I completely removed meat from my diet and six months later I returned to check up on my liver, in the mean time every symptom subsided rather quickly there after. (A Week or so) XXXXXXX 2013 They checked my liver out (ultrasound) and most of the fat has been vanquished according to my ultrasound, no other issues were found with my liver I feel great, no pain, no pressure, no nothing. October 2013 I started having the abdominal pain again, my stools did not turn green this time, but they got darker, they also had this white little floating things on them, some were a bit covered in it, some were normal, the pain returned to my right bottom abdomen, I started having itching on anus, I decided to take the issue on my own hands since nothing seemed to fix it, I went and did a feces exam by myself (made the doctor sign the release), it was, to my surprise, detected :iodamoeba butschlii on my stool, actually loads of it apparently, went back to my doctor and he prescribed me Flagyl 2 pills a day for 5 days, with a 10 days waiting period and a repeat of the process once (Total of 30 days of treatment) November 2013 (Flagyl Month) During treatment, my pain went away after the second day (entirely), after the 5th day I had no issues with my abdomen, but my back and shoulder were hurting a bit, all on the right side, and the pressure under my ribs on the right hand side was back with a passion, about the 8th day after I first paused the Flagyl treatment again, the abdominal pain resumed, but it was mild in comparison, once I started taking the Flagyl again it went away on the second day like the last time, once the full treatment was completed, my abdominal pain was gone up until the 8th (28th total) day, when it started once again, in the mean time my right side is hurting on the shoulder, back and I feel pressure under my ribs, according to my ultrasound my liver is not expanded, so I honestly don't know if the shoulder pain, back pain and pressure have anything to do with this issue December 2013 Treatment stopped on the 30th of November, by the 8th of December my pain returned (8th day), and it got more intense with time, by the 11th I went to the doctor again. He basically said that I should wait it out, and see what happen... Aside from consulting another doctor next week, I'm posting here, I managed to convince him to allow me to have a colonoscopy, I'm also having a wide spectrum feces exam on Monday Shoulder, back and rib issues: The pressure is on the right hand side, just under my arm, slightly below my man breast Shoulder pain is only present on the right hand side, and it gets better when I'm lie down, and worst when I'm standing, and absolutely intolerable when I'm sitting Back pain, is also on the right hand side, at elbow high I went to an orthopedist and he gave me some anti inflammatory medicine, said medicine seem to have decreased my abdominal pain as well as my shoulder and back pain, the pressure is still there, he said I should exercise more to get right of the pain, I'll start doing that tomorrow as well My stool is currently full of white little balls, and some get stuck in the feces most of them seem to just float around, color is usual so far General observations: The internet says that iodamoeba butschlii doesn't give any pain, only diarrhea, and that it's non-pathogenic, another doctor also said that If I have this it's highly probable that I might have something else! I had diarrhea once so far According to blood tests taken throughout this whole process I never had a time where my immunological system was debilitated, aside from the cold I had when it all started (No blood test at the time), if it is iodamoeba butschlii I have no idea how it could possibly be so aggressive considering the info available on the internet My family friend has most of the symptoms I have, the white stuff, the right lower abdominal pain, the darker stool but no shoulder pain, or back pain, or pressure, whatever I have, I have a feeling she might have it as well since we live in the same town and buy food at the same place When I sleep at night the bottom right of my abdomen seem to be bloated and it's hard to sleep on my right side, it simply wasn't when I was taking Flagyl Symptoms I currently have: Even with anti inflammatory, shoulder pain, and back pain are still there, the pressure under my right rib has subsided Pain on my right lower abdomen My throat seem a bit irritated and I started coughing recently, probably not related but I'm being as thorough as possible My last blood test (few days ago) accused that my red blood cells are a bit high, My uric acid is at 7.2mg (mildly high), and my TSH is 5,94 everything else is normal, I'll do another one shortly as the TSH may be a result of using Flagyl (according to another doctor) My current course of action: to do a colonoscopy, and maybe (depending what it shows) an MRI of my liver just to check if it is in good shape and if it has something to do with back pain I spent an obscene amount of time writing this, I have no other symptoms, but I feel some inevitable questions are abound: I don't sleep on top of my right arm, never done that! I have no shortage of hunger I didn't lose much weight since it all started, and I'm dieting still I very rarely snore I dont exercice very often I did exercice before my shoulder and back pain started again, and I did push it hard I don't drink I take no other medication aside from the ones informed on this post I'm 25 Years old My worst medical condition so far has been this My bowel movements were never that good to begin with (shifting my sleep tends to clog it up a bit), but If I sleep at the same time for more than a week it still regulates to the time I wake up, once a day, it's been mostly steady throughout this whole thing, as long as I don't mess with my sleep too much it is pretty steady Feel free to ask any questions, or point out things I missed Thanks for you replies
Posted Thu, 2 Jan 2014 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 40 hours later
Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. It is a long story you have given here. First of all the fact that fatty liver does not give any symptoms at all. So this was not a reason of your symptoms. Reading your story there is still one thing that comes to my mind: partial bowels obstruction due to inflammatory bowels disease. Lower right abdomen is where Crohns disease gives first bowels changes. This condition causes intestines inflammation what leads to its narrowing. The main symptoms of it are diarrhea, lower right abdominal pain, mucus in the stool. As this condition is autoimmune, parasite presence could make it less severe as your immune system were very busy fighting the parasite. Crohns disease can give joints pain like shoulder pain as well. So this is one possibility. Other possible reason is that all symptoms you have from parasite. Shoulder pain is sometimes a symptom of liver or pleura inflammation. Iodamoeba butschlii can is rare cases be present in lungs. So as a conclusion here is what you should do: - repeat stool tests to see if you are free of the parasite - have colonoscopy - have chest X-ray - if colonoscopy will be negative, abdominal CT with oral contrast (enteroclysis) should be considered Hope this will help. Feel free to ask further questions. Regards.
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Follow-up: What is the cause for pain in right lower abdomen? 12 hours later
I recently realized that other symptoms I have had may be be linked to this and may aid in detecting what I have, I didn't mention these earlier as they lasted for 4 days and vanished soon after, except they just got back! So by the end of October my finger nails (hand and feet) were slight blue under the base of the finger nail and I had some blood spots and some bruise marks (black marks like bruises on the skin), they didn't stay for long because and as soon as I started taking Flagyl they literally vanished, more notably the blue under the fingernails changed back to normal after just 2 days, and on Flagyl they stayed normal up until 2 days ago. 3 days ago I started getting blood spots and my fingernails started getting a bit blue as well, yesterday I had a black mark (bruise like) on my leg, and today I have 5 bruise like marks on my body (didn't do anything that warrant this)... they're not very dark, they're quite Grey-ish like a bruise usually gets when it's almost cured I'm going to the doctor tomorrow to get prepped for my first colonoscopy and to talk about all of this, a Gastroenterologist, I'll present all of the info from you, thank you very much, I added this information hoping you could help me narrow it down, and because it's easier to type this, as a normal doctor appointment is usually short and doesn't allow me to think about everything and put together that much detail, so once again thanks
Answered by Dr. Grzegorz Stanko 34 minutes later
Brief Answer: . Detailed Answer: Its hard to tell not seeing it. But skin lesions in autoimmune diseases are well known. So this may be a part of your main problem. As I have mentioned before, parasites can mess up with immune system as well, vascular inflammation or low platelets level (both can give such strange black and blue marks). But its hard to give more precise answer. Gastroenterologist is a good choice. Hope he will help you. Regards.
Above answer was peer-reviewed by
Follow-up: What is the cause for pain in right lower abdomen? 10 hours later
So I started taking probiotics like I was instructed to, the first day I took it my feces were yellow, very light yellow, and today (second day) I had a huge scare, my feces were partially white (but normally colored otherwise), as in liver failure white, I panicked a bit, but I had to collect feces because I have to do a lot of consecutive exams to figure out what the hell I have, and once I did so I was a bit releaved to realize that the white on my feces is just a thin veil over the normal feces, then I realized that I had no floating white dots on my stool, so 2 + 2 = 4 I'm guessing the white veil is made of the little white dots that usually floats around, I'm getting it tested today for candidiasis, could it be something else? Why did it react like this to probiotics? In my mind this strikes me as a good sign Now another thing that probiotics seems to have done is to enhance the consistency of my stool (yes in 2 days) they were mushy (would break apart and dissolve easily on the bow's water) and with white dots floating around, now they're more like they used to be, smoother and defined, in both cases they're easy to pass On a bright note, no new black bruise like blemishes or red blood spots appeared, my fingernails are still a tad blue as they were before tho My pain has also decreased in the last few days, it just hurts occasionally, and today it seems to be gone all together... It did that last time and it vanished for several months... Anyway I'm again thankful you for your help, and for your patience with my overzealous explanatory rampages, thanks you!
Answered by Dr. Grzegorz Stanko 12 hours later
Brief Answer: . Detailed Answer: Well, probiotic might be very beneficent for intestines after anitbacterial and antiparasites treatment. In normal condition, large intestine is covered with good intestinal bacteria. This bacteria digest bile so it change the color to brown, produce some vitamins and most important protect intestines from other bacteria. So for sure it might help to get back normal consistency of stools as well as can help with the pain. But as your intestines have quite rich history of parasites presence and possible other issues, you should have mentioned before tests (especially colonoscopy) to rule bad things out. Inflammatory bowels disease usually have flare ups after witch symptoms can go away for some time. White stuff in your stool is most likely a mucus. Mucus is constantly produced by intestine cells. And there can be much more mucus in the stool in case of any inflammation. Candida is also possible. But I have no idea why the mucus has appeared after probiotic usage. Regards.
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