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What causes lower
abdominal or pelvic pain?
All women feel discomfort or pain
in the lower abdomen below the navel from time to
time, for instance, before or during menstruation.
It many
cases it can be difficult to identify the cause of
the pain, but noting certain features will help
you and your doctor come to a likely diagnosis.
The most common causes are a
urinary system disorder such as a bladder or
kidney problem, a bowel problem or a condition
involving the reproductive system - the uterus,
Fallopian tubes and ovaries.
Type of pain
arising from the urinary system
Pain from the urinary system can
indicate such conditions as cystitis (inflammation
of the bladder), inflammation of the collecting
system of one or both kidneys (pyelonephritis),
kidney stones or tumours.
Typical symptoms of all these
conditions are a burning sensation when passing
urine and a need to empty the bladder more
frequently. In addition, pain travelling from the
back and around to the front might suggest a
kidney infection or kidney stone.
The pain associated with kidney
stones may be particularly severe. The presence of
blood in the urine raises the possibilities of
infection, kidney or bladder stones or even a
bladder or kidney tumour. Both benign and
malignant tumours can first make themselves
noticed in this way. The duration of the pain will
further help you and your doctor to make the
correct diagnosis.
Type of pain
arising from conditions of the intestines
The bowel can give rise to a wide
variety of symptoms including pain. Constipation
and diarrhoea can be painful in themselves, and
the change in bowel habit usually identifies the
pain as coming from the bowel. Pain from the bowel
is often described as colicky in nature. This
means that the pain or discomfort comes in waves
with little or no discomfort in between the pain.
Bloating or swelling of the lower abdomen may be
present in many intestinal conditions including
irritable bowel syndrome. The passing of fresh
blood or altered blood (black motions) from the
back passage should be reported to your doctor as
investigation is usually necessary.
Type of pain
arising from conditions of the reproductive organs
Pain might originate from the
uterus (womb), Fallopian tubes or ovaries. It is
usually felt in the middle of the lower abdomen,
above the line of pubic hair as far up as the
navel. Occasionally, the pain is more to one side,
which is more typical of a pain coming from an
ovary.
There might be discomfort or even
pain during intercourse (called dyspareunia) felt
deep within the pelvis. Pain originating from the
uterus is usually worse at the time of a woman's
period (dysmenorrhoea). Examples of conditions of
the reproductive organs giving rise to pain
include endometriosis, pelvic inflammatory
disease, ovarian cysts, fibroids and problems
related to the early stages of pregnancy such as
miscarriage and ectopic pregnancy.
In any case of sudden, severe,
unexplained abdominal pain your doctor should be
contacted.
What will the
doctor do?
Acute and sudden pains are always
worrying but chronic pain can also have serious
implications and a doctor should be consulted. The
doctor will ask about periods, passing of urine
and bowel movements. They might also ask if there
have been episodes of nausea, vomiting, or fever.
If appropriate, they may ask questions concerning
the person's emotional life - family, friends,
work - and their sex life.
The doctor will want to examine
you. This will involve feeling your abdomen and,
in addition, an internal examination may be
necessary. Further investigations or treatment
will be based upon the description of the pain and
the findings of the doctor's examination.
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