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Reasons for Pulling Sensation in Lower Abdomen

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Reasons for Pulling Sensation in Lower Abdomen

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A pulling sensation in the belly is normal but sometimes could be due to some underlying conditions. This article explores the reasons; read on to find them.

Medically reviewed by

Dr. Ghulam Fareed

Published At February 13, 2023
Reviewed AtApril 3, 2024

Introduction

A pulling sensation in the lower abdomen can be for several reasons. Often these sensations are completely normal, but sometimes these unusual movements may occur due to some conditions like - indigestion or diverticulitis, etc.

What Causes Pulling Sensation in the Lower Abdomen?

The following are some reasons for the pulling sensation in our lower abdomen -

  • Digestion - Digestion is carried out by the process called peristalsis. It is a reflex triggered by a gut wall, consisting of a circular muscle contraction in a wave motion, pushing food into the small intestine. Due to that, a person can feel a pulling sensation in the abdomen, which is completely normal.

  • Indigestion - Indigestion affects 30% of the general population, leading to discomforts like heartburn and acid reflux. It is often provoked by bending with a pulling sensation in the lower abdomen. It is generally caused due to accumulation of gastric acid in the abdomen.

  • Diverticulitis - Diverticula most commonly occur in middle-aged people in the sigmoid and descending colon. The condition is rare in populations with high dietary fiber intake, such as in Asia, where it affects the right side of the colon. Diverticula consists of protrusion of mucosa covered by the peritoneum. There is hypertrophy (enlargement) of the circular muscle coat. Repeated inflammation leads to bowel wall thickening and eventual obstruction.

Symptoms of Diverticulitis Are:

  • Pain in the abdomen.

  • Diarrhea.

  • Spasm.

  • Constipation.

  • Rectal bleeding.

  • Fever.

Diarrhea - Diarrhea is the passage of more than 200 grams of stool daily, and measuring stool volume helps confirm this. Diarrhea is the most common complaint, ranging from mild to severe. Fortunately, diarrhea is a short-term acute disease lasting for a few days. It is an illness in which the body's solid waste is eliminated in liquid form.

Symptoms of Diarrhea Include -

  • Fever.

  • Thirsty.

  • Hypotension.

  • Headache.

  • Watery stool.

  • Irritable bowel syndrome.

  • Lethargy.

  • Abdominal cramps.

  • Mucus in the stool.

Irritable Bowel Syndrome - Irritable bowel syndrome is characterized by recurrent abdominal pain associated with abnormal defecation. About 10% to 15% of the population are affected at some time, but only 10% consult their doctor because of symptoms. Young women are affected two to three times more often than men.

Symptoms of Irritable Bowel Syndrome Are:

  • The most common presentation is that of recurrent abdominal discomfort associated with two or more of the following -

    • Improvement with defecation.

    • Onset associated with a change in the frequency of the stool.

    • Onset is associated with the change in the form of stool.

  • Usually, a colicky or cramping pain is felt in the lower abdomen and relieved by defecation.

  • Abdominal bloating worsened throughout the day. The cause is unknown but not attributed to excessive intestinal gas.

  • The bowel habit is variable.

  • Passage of mucus is common, but rectal bleeding does not occur.

  • Patients do not lose weight and are constitutionally well.

  • Physical examination is generally unremarkable, except for variable tenderness to palpation.

  • Small changes in diet can manage irritable bowel syndrome.

Dietary Management of Irritable Bowel Syndrome -

  • Eat regularly and avoid missing meals.

  • Take time to eat.

  • Ensure adequate hydration and avoid carbonated and caffeinated drinks.

  • Reduce alcohol intake.

  • Reduce intake of resistant starch and insoluble fiber.

  • Avoid food with artificial sweeteners.

  • Consider a wheat-free diet.

  • Exclude lactose from the diet.

Dietary Management of Irritable Bowel Syndrome

Inflammatory Bowel Disease - The inflammatory bowel disease incidence varies widely between populations. Ulcerative colitis and Crohn's disease are chronic inflammatory bowel diseases that pursue a protracted relapsing and remitting course, usually extending over the years. The diseases have many similarities, and it is sometimes impossible to differentiate between them. One crucial distinction is that ulcerative colitis involves only the colon, while Crohn's disease can involve any part of the gastrointestinal tract from mouth to anus.

There was a dramatic increase in the incidence of both ulcerative colitis and Crohn's disease in Western countries starting in the second half of the last century and coinciding with the introduction of a more 'hygienic' environment with the advent of domestic refrigeration and widespread use of antibiotics. The developing world has seen similar patterns as the country is increasingly adopting a westernized lifestyle.

Irritable Bowel Syndrome Symptoms Are

The primary symptoms are abdominal pain, diarrhea, and weight loss.

Crohn's disease may cause subacute or even acute intestinal obstruction.

The pain is often associated with diarrhea, which is usually watery and does not contain blood or mucus.

Almost all patients lose weight because they avoid food since eating provokes pain.

Weight loss may also be due to malabsorption, and some patients present with fat, protein, and vitamin deficiencies.

Pregnancy - Pregnancy is a common phenomenon in which a mother can feel sensations or pain in the lower abdomen, but it is quite normal. Baby's movement or kicks, stretches, or turning could cause a pulling sensation.

Menstrual Cycle - Some women feel pain (menstrual cramps) in the lower abdomen during their menstrual cycle. It generally starts a day before the cycle or after the onset of the period. Though it is quite normal due to uterine contraction, some women find it handicapping as the cramps may interfere with their day-to-day work.

How Can Pulling Sensation Be Diagnosed?

A pulling sensation in the lower abdomen can be due to various reasons. Following are the diagnostic ways that will help to rule out the cause, such as:

  • Stool Test - Stool cultures are essential in investigating acute or bloody diarrhea to identify pathogenic organisms.

  • Routine Blood Test - Blood tests may identify alternative sites of infection, particularly if the clinical features suggest a syndrome other than gastroenteritis. Blood tests are essential to assess the full blood count, erythrocyte sedimentation rate (ESR), and measurement of C-reactive protein (CRP), folate, vitamin B12, iron status, albumin, calcium, and phosphate. Blood tests will detect pregnancy.

  • Serology - It is the blood test that detects antibodies. Detection of antibodies plays a limited role in the diagnosis of gastrointestinal infection caused by organisms such as Helicobacter pylori, salmonella species, and Entamoeba histolytica.

  • Breath Test - Non-invasive breath test is performed for suspecting small intestine bacterial overgrowth like helicobacter pylori.

  • Fecal Calprotectin Test - Fecal calprotectin is a protein secreted non-specifically by neutrophils into the colon in response to inflammation or neoplasia. The fecal calprotectin test is a useful screening test for gastrointestinal inflammation and monitoring patients with ulcerative colitis.

  • Endoscopy - Endoscopy is undertaken to obtain mucosal biopsies.

  • Microscopy - It is done for leucocytes and examines ova, cysts, and parasites if the history indicates residence or travel to areas where these infections are prevalent.

When to See a Doctor?

If the symptoms worsen, a physician should be consulted, such as -

High fever for three to four days.

  • Severe diarrhea.

  • Vaginal bleeding.

  • Blurred vision.

  • Feeling difficulty in urination.

  • Swelling in hands or feet.

  • Lethargy.

What Is the Treatment for the Pulling Sensation?

It is suggested that a person should take drugs after the recommendation of a doctor. The following are treatment modalities for the pulling sensation in the lower abdomen:

  • Oral Rehydration Solution(ORS) - ORS can be just as effective as an intravenous replacement fluid, even in managing cholera, as it contains sugars, water, and electrolyte. Adults should be encouraged to drink fluid in mild to moderate gastroenteritis and, if possible, continue regular dietary intake.

  • Antibiotics - Antibiotics are effective in Crohn's disease.

  • Surgical Treatment - Up to 60% of patients with extensive ulcerative colitis eventually require surgery. Surgery involves the removal of the entire colon and rectum and cures the patient.

Conclusion

The pulling sensation or movement in your lower abdomen is normal during digestion, the menstrual cycle, or pregnancy. Mild in-intensity pain can be treated at home. However, consult the doctor immediately if the symptoms get worse.

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Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

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