What causes pain in the lower right abdomen?

Question

Hello doctor,

Five days ago, I had sudden pain in my lower right abdomen, along with nausea, vomiting, and fever. The pain subsided to a dull ache, which I still have now, the pressure is bad at the moment. I have been to the doctors twice, and I have had a urine test, which came back positive for a UTI. I am on Trimethoprim for three days, and the pain has not gone. As well as this, I am finding it very difficult to pass gas and stools. I am not convinced this is just a UTI. Any advice? Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your post. You have pain in right lower abdomen along with the history of vomiting. The differential diagnosis are many, but I will mention two important diagnoses:

Appendicitis is the first diagnosis. It begins with pain around the umbilicus, which then proceeds to right lower abdomen associated with fever and vomiting.
Pyelonephritis and renal stone. However renal stone does not cause fever unless it is associated with infection of the kidney, which will not respond to Trimethoprim. It is just a urinary antiseptic and not really an antibiotic.

Lower UTI (urinary tract infection) rarely causes fever. I would suggest an ultrasonogram abdomen and pelvis and CBC (complete blood count), to rule out appendicitis.

Regards.