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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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