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Q. Can you explain the conditions which cause right lower abdominal pain?

Answered by
Dr. Muhammad M. Hanif Md.
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 04, 2015 and last reviewed on: Oct 09, 2018

Hi doctor,

I am having mild pain in my mid and right lower abdomen region. When I press, I can feel some gas moving inside. I poked it continuously. I am also burping and passing gas. My doubts are, is the pain due to gas? Or did my constant poking worsen it? Or is it something serious like appendicitis? I have attached my blood reports with this. Please guide.

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

I want to assure you do not worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case history and reports (attachment removed to protect patient identity) and can well understand your genuine health concerns.


The Probable causes:

1. The normal CBC (complete blood count) and no raise in white blood cell count says that it is not an appendix pain. So, relax and do not worry much.
2. Pain in this area can be due to the urinary tract infection and that is very common in this age group.
3. Other reasons may be stomach or small intestine ulcers and increased acidity in the stomach but it does not seem to in consistent with your history. Also liver or gallbladder involvement can cause such pain.

Investigations to be done:

Complete abdominal ultrasound including kidney, ureter and bladder.

Treatment plan:

1. You can take tablet Phenazopyridine for pain. I usually prescribe it for only two days.
2. You just keep taking Nitrofurantoin as prescribed.
3. Add cranberry juice which will help you a lot.
4. You should not poke the area and feel relaxed.
5. Take plenty of water and take more of vegetables, salads and fruits in diet.

Regarding follow up:

Revert back with the investigation report to an general medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/general-medicine-physician


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Hi doctor,

The blood test was done before few days of severe pain. I had my ultrasound done before a week when cystitis along with left kidney stone was suspected. Please tell me your opinion regarding this.

Dr. Muhammad M. Hanif Md.

Cardiology Critical Care Physician General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.


The Probable causes:

Appendicitis is very less likely at my diagnosis list. But, limited data is available, so I will prefer repeat blood test.
I suspected bladder infection (cystitis) that is why I suggested tablet Phenazopyridine for pain relief. It acts directly on the mucosal lining, inner wall of the bladder to soothe and relieve the pain.

Investigations to be done:

CBC with ESR (erythrocyte sedimentation rate) and differentials.
Once you get the report let me know by uploading the reports. It is very important to rule out earlier on, otherwise appendicitis may get complicated. For example, rupture of the appendix.

Treatment plan:

1. Kidney stone when moves a bit from its place, causes pain. Pain management is the key in this issue. Along with Phenazopyridine, you need to add the following.
2. Oxycodone plus Acetaminophen for example Tylox.
3. Take plenty of water and cranberry juice for prompt relief of the symptoms.

Preventive measures:

1. You should not take excess salt and carbohydrates.
2. Please avoid tap water and use bottled water.

Regarding follow up:

Revert back with the investigation report to an general medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/general-medicine-physician


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