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How Can Nausea With Lower Abdominal Pain Be Treated?
Posted on
Sat, 27 May 2017
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 27 May 2017
Answered on
Wed, 14 Jun 2017
Last reviewed on
Question : Attention Dr. XXXXXXX Burger-Durnbaugh
Hello doctor. Sorry I had to start a new thread as the old one wouldn't let me respond.
To answer, I'm seeing a gastro doctor on Tuesday at the recommendation of my primary care PA. He ran some blood and urine tests (red and white cell count, metabolic panel, etc) and it all came back normal.
The MRI (not CT; my apologies) did use contrast but that was taken due to RUQ pain at the time, that was later relieved completely with dietary and exercise changes. This new nausea and lower abdomen pain/pressure is new (since this Monday). I haven't been having a fever, sweats, or liquid stool. Just this nausea and lower quadrant pain/pressure. It's hard to not fear something deadly like the big C word when everything else seems to be getting ruled out.
Hello doctor. Sorry I had to start a new thread as the old one wouldn't let me respond.
To answer, I'm seeing a gastro doctor on Tuesday at the recommendation of my primary care PA. He ran some blood and urine tests (red and white cell count, metabolic panel, etc) and it all came back normal.
The MRI (not CT; my apologies) did use contrast but that was taken due to RUQ pain at the time, that was later relieved completely with dietary and exercise changes. This new nausea and lower abdomen pain/pressure is new (since this Monday). I haven't been having a fever, sweats, or liquid stool. Just this nausea and lower quadrant pain/pressure. It's hard to not fear something deadly like the big C word when everything else seems to be getting ruled out.
Brief Answer:
Thoughts
Detailed Answer:
Hello XXXX,
If your MRI with contrast was an abdominal MRI, the chance that there is any significant cancer looming is extremely unlikely.
I am glad you are seeing the gastro dr. on Tuesday. That is the appropriate thing at this point.
Thoughts
Detailed Answer:
Hello XXXX,
If your MRI with contrast was an abdominal MRI, the chance that there is any significant cancer looming is extremely unlikely.
I am glad you are seeing the gastro dr. on Tuesday. That is the appropriate thing at this point.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Understood. The doctor recommended a CT scan due to being unable to identify the root cause. Im having bowel movements and am passing gas so i would assume that blockage is not an issue, yes?
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Thoughts on this
Detailed Answer:
If the pain is in the lower abdomen, I am wondering if the gastroenterologist might want to do a colonoscopy as that is the most direct way to look at the large intestines.
Usually what can be seen with an MRI with contrast is as good or better than a CT with contrast, but on this one I will defer to the gastroenterologist.
If your BMs are normal, in frequency and amount, then no, it does not sound like there would be a blockage. With a blockage, usually the stool that is passed is liquid as that is all that can get around the blockage.
Thoughts on this
Detailed Answer:
If the pain is in the lower abdomen, I am wondering if the gastroenterologist might want to do a colonoscopy as that is the most direct way to look at the large intestines.
Usually what can be seen with an MRI with contrast is as good or better than a CT with contrast, but on this one I will defer to the gastroenterologist.
If your BMs are normal, in frequency and amount, then no, it does not sound like there would be a blockage. With a blockage, usually the stool that is passed is liquid as that is all that can get around the blockage.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Forgive me for asking so many questions, but what would you think there is to be on the lookout for regarding the large intestines, particularly if the pain came on rather suddenly?
Brief Answer:
Thoughts on this
Detailed Answer:
Well, although the MRI would likely have shown it (although the MRI was done for RUQ pain), a colonoscopy can show diverticulosis and inflammatory bowel problems. Usually with inflammatory bowel conditions though, you would have diarrhea and other symptoms.
I was thinking about Celiac disease (gluten intolerance) which can cause pain and nausea too, and there is bloating with gas. But usually it doesn't come on abruptly. It can be tested with a blood test (Celiac panel).
Thoughts on this
Detailed Answer:
Well, although the MRI would likely have shown it (although the MRI was done for RUQ pain), a colonoscopy can show diverticulosis and inflammatory bowel problems. Usually with inflammatory bowel conditions though, you would have diarrhea and other symptoms.
I was thinking about Celiac disease (gluten intolerance) which can cause pain and nausea too, and there is bloating with gas. But usually it doesn't come on abruptly. It can be tested with a blood test (Celiac panel).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will mention that when ive had a bowel movement, its been within 20 minutes of eating (sometimes just a few minutes) and it changes sometimes. At times, its solid nodules, and today it was light brown and soft (but not liquid diarrhea). Didnt know if mentioning stools would aid in anything .
Brief Answer:
Thoughts on this
Detailed Answer:
If this pattern is typical for you and not new, then it is unlikely to be a sign of anything pathological.
How severe is your pain on a scale of 1-10, most of the time and at it's worst. And are you having pain every day?
Be sure when you go in to have the doctor examine you for non-abdominal sources of your abdominal pain (such as testicular problems and hernia).
Thoughts on this
Detailed Answer:
If this pattern is typical for you and not new, then it is unlikely to be a sign of anything pathological.
How severe is your pain on a scale of 1-10, most of the time and at it's worst. And are you having pain every day?
Be sure when you go in to have the doctor examine you for non-abdominal sources of your abdominal pain (such as testicular problems and hernia).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
For the current pain/nausea, its about a 4-5. Not terrible, just noticeable. The right side ache and nausea have been present everyday since monday .
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Detailed Answer:
"Right side ache and nausea" - I was under the impression that the pain was now diffusely throughout the lower abdomen.
Right sided ache (and not right below the liver/rib cage) could be a kidney stone or a kidney infection. If the PA checked your urine and it did not show signs of UTI, then possibly a stone. An X-ray or ultrasound can show this.
And if low down it can be appendicitis, hernia, testicular problems. Also diverticulitis but you are on the young end for that.
Thoughts on this
Detailed Answer:
"Right side ache and nausea" - I was under the impression that the pain was now diffusely throughout the lower abdomen.
Right sided ache (and not right below the liver/rib cage) could be a kidney stone or a kidney infection. If the PA checked your urine and it did not show signs of UTI, then possibly a stone. An X-ray or ultrasound can show this.
And if low down it can be appendicitis, hernia, testicular problems. Also diverticulitis but you are on the young end for that.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
They did rule out a kidney stone. My RUQ pain has returned as well but at my own fault due to poor diet as of late. The blood work showed normal for red and white cell counts and the urine didnt show anything either. Being thats its not necessarily getting worse, would a hernia or teste problems cause this constant overall nausea and right sided ache?
Keep in mind i had an inguinal hernia two years ago and it was repaired but that pain was strictly in the testicles .
Keep in mind i had an inguinal hernia two years ago and it was repaired but that pain was strictly in the testicles .
Brief Answer:
More thoughts
Detailed Answer:
Inguinal hernia pain is typically as you described. In some cases the pain can be referred to the abdomen.
Testicular torsion would cause more pain usually. It would not necessarily progress unless there is impending herniation. Prostatitis can sometimes cause abdominal pain but doing so is not that common or typical.
I wish I could see the location, and whether, on exam, you have any abdominal guarding, because right lower abdomen can be appendicitis. Some people have what is called "grumbling appendicitis" where it hurts and can go on for a long time without progressing (typical appendicitis progresses with increasing pain). But appendicitis does cause pain in the lower right, and nausea. It usually hurts more when walking or with jarring motions.
I noticed on the MRI that the radiologist stated that interpretation was somewhat limited by respiratory movements during the test. He didn't write in great detail, which may just be his style. It appears he was able to see the results with a fair amount of detail though based on that he was able to record some measurements, etc. Generally, I've learned as a primary care doctor it's best to either go look at the results with the radiologist (which can be done at any time, usually when doing rounds at the hospital in the morning) at which point he/she can provide more details about what they were thinking, or give the radiologist a call and discuss just how "limited" the study really was and what they were thinking. Of course you will be seeing the GI dr. on Tuesday, and he can look at the actual MRI and interpret it himself.
More thoughts
Detailed Answer:
Inguinal hernia pain is typically as you described. In some cases the pain can be referred to the abdomen.
Testicular torsion would cause more pain usually. It would not necessarily progress unless there is impending herniation. Prostatitis can sometimes cause abdominal pain but doing so is not that common or typical.
I wish I could see the location, and whether, on exam, you have any abdominal guarding, because right lower abdomen can be appendicitis. Some people have what is called "grumbling appendicitis" where it hurts and can go on for a long time without progressing (typical appendicitis progresses with increasing pain). But appendicitis does cause pain in the lower right, and nausea. It usually hurts more when walking or with jarring motions.
I noticed on the MRI that the radiologist stated that interpretation was somewhat limited by respiratory movements during the test. He didn't write in great detail, which may just be his style. It appears he was able to see the results with a fair amount of detail though based on that he was able to record some measurements, etc. Generally, I've learned as a primary care doctor it's best to either go look at the results with the radiologist (which can be done at any time, usually when doing rounds at the hospital in the morning) at which point he/she can provide more details about what they were thinking, or give the radiologist a call and discuss just how "limited" the study really was and what they were thinking. Of course you will be seeing the GI dr. on Tuesday, and he can look at the actual MRI and interpret it himself.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So i went to the ER because of this morning, it wasnt much worse but its not getting better. They ran a CT, both with and without contrast, blood tests, and urine and everything came back totally normal. So now i dont really know what to think. Maybe a long lasting virus? H. Pylori? IBS?
Brief Answer:
Information
Detailed Answer:
Well, at least we know without a doubt that nothing serious is going on. It is possible that it is IBS, but usually there is diarrhea or constipation or both with that, and usually the pain is less after having a BM.
H. Pylori will usually give upper GI symptoms, such as pain when the stomach is empty or when it is full.
I am not sure what is going on. Make sure to sign releases if necessary so that the gastroenterologist you will see on Tuesday will be able to review both the CT and MRI. Generally when there is nothing wrong identified, it is chalked up to IBS, but let's see what the GI doctor thinks when he or she sees you.
Information
Detailed Answer:
Well, at least we know without a doubt that nothing serious is going on. It is possible that it is IBS, but usually there is diarrhea or constipation or both with that, and usually the pain is less after having a BM.
H. Pylori will usually give upper GI symptoms, such as pain when the stomach is empty or when it is full.
I am not sure what is going on. Make sure to sign releases if necessary so that the gastroenterologist you will see on Tuesday will be able to review both the CT and MRI. Generally when there is nothing wrong identified, it is chalked up to IBS, but let's see what the GI doctor thinks when he or she sees you.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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