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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Reason For Pain In Right Lower Abdomen With Tenderness And Bloating

Hello, I am experiencing pain in my right lower abdomen. The pain is very tender, dull, aching, and I am also experiencing bloating. It has been going on for 48 hours, and I m wondering if these are ER worthy symptoms. I have a history of reflux and IBS as well, however, I usually experience pain on my left side -- so the right side is a very new symptom. When I usually get pain on the left side, it is usually a sign of gas. I have very little gas associated with this pain that I m feeling now in the lower right abdominal pain. I have had diarreha today as well. Thanks for your guidance.
Mon, 11 Aug 2014
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  User's Response
Hi, thanks for posting your concern in the HCM.
If you have IBS, pain can actually occur at any point of abdomen. So, it is not uncommon to have pain in right lower abdomen.
But, there are possibilities of enteritis or enterocolitis too. Even giardia infection should also be ruled out.
My understanding is you should have the following tests done-
1. Blood for complete blood count, CRP, fasting TSH, HbA1c, fasting LFT
2. Stool for routine examination and OBT
After sending the sample, you may start on
1. Tab Rifaximin 400 twice daily for 14 days
2. Cap Enterogermina twice daily for one month
You should also consult a local gastroenterologust at the earliest for further evaluation.
Continue having good oral hydration ( home available fluid and ORS) and fat restricted non spicy high fiber diet frequently in small amount.
Hospitalisation may be required in case of fever, dehydration, electrolyte imbalance etc.
Colonoscopy may also be required to rule out IBD or any significant colonic pathology.
For any further questions, please write back.
Regards,
Dr. Kaushik
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Reason For Pain In Right Lower Abdomen With Tenderness And Bloating

Hi, thanks for posting your concern in the HCM. If you have IBS, pain can actually occur at any point of abdomen. So, it is not uncommon to have pain in right lower abdomen. But, there are possibilities of enteritis or enterocolitis too. Even giardia infection should also be ruled out. My understanding is you should have the following tests done- 1. Blood for complete blood count, CRP, fasting TSH, HbA1c, fasting LFT 2. Stool for routine examination and OBT After sending the sample, you may start on 1. Tab Rifaximin 400 twice daily for 14 days 2. Cap Enterogermina twice daily for one month You should also consult a local gastroenterologust at the earliest for further evaluation. Continue having good oral hydration ( home available fluid and ORS) and fat restricted non spicy high fiber diet frequently in small amount. Hospitalisation may be required in case of fever, dehydration, electrolyte imbalance etc. Colonoscopy may also be required to rule out IBD or any significant colonic pathology. For any further questions, please write back. Regards, Dr. Kaushik