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Please Explain The Issue Severe Pain In Lower Abdomen For More Than 8 Years
Posted on
Mon, 12 Sep 2022
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 12 Sep 2022
Answered on
Fri, 27 Sep 2024
Last reviewed on
Question : Good Evening Sir,
Iam male 39 years has a history of severe pain in lower abdomen for more than 8 years. The pain went away with medication. No of times taken USG but everything was normal.
Similar pain encountered more than one month back and 2 days back. Upon the advice of Doctor Sir, undergone USG.
The report came back normal except for:
Right Iliac fossa: Evidence of well defined oval hyper echogenic focus measuring 5×2mm located in appendix proximal part. Appendix calibre 5.0mm normal limits. No evidence of probe tenderness noted at the time of scan. Surrounding messengers appears normal.
IMPRESSION: APPENDICOLITH (Incidental finding)
Sir, please explain the issue. Any thing to worry.
Thank You.
Iam male 39 years has a history of severe pain in lower abdomen for more than 8 years. The pain went away with medication. No of times taken USG but everything was normal.
Similar pain encountered more than one month back and 2 days back. Upon the advice of Doctor Sir, undergone USG.
The report came back normal except for:
Right Iliac fossa: Evidence of well defined oval hyper echogenic focus measuring 5×2mm located in appendix proximal part. Appendix calibre 5.0mm normal limits. No evidence of probe tenderness noted at the time of scan. Surrounding messengers appears normal.
IMPRESSION: APPENDICOLITH (Incidental finding)
Sir, please explain the issue. Any thing to worry.
Thank You.
Brief Answer:
Appendicolith can be cause of recurrent pain in lower abdomen on right
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns well.
The issue with explanation:
Appendicolith means hardened lump/stone (lith) of feces(stool) in the lumen of appendix. As you may know appendix is a blind tubular structure that opens in large intestine. If the fecolith can not pass through the opening in to the large intestine and gets stuck at the opening then the mucus secreted by appendix enlarges appendix and can cause pain. Since mucus is very viscid it may find a way to the large intestine reducing the pressure and pain thus caused.
Hence this can be one of the causes of pain in lower abdomen on right side.
If the mucus or secretions can not pass through, then the pressure can cause inflammation, infection, rupture (attack of appendicitis).
Hence you should get the Ultrasound, preferably CT scan of abdomen with focus on this area when you are in pain. This will hep to decide whether removal of appendix will help for relief of pain or not.
I hope this answers your specific query.
Please give feedback, and ask for further relevant queries if you feel that there is a gap of communication.
Dr T Chandrakant.
General Surgeon.
Appendicolith can be cause of recurrent pain in lower abdomen on right
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and understood the concerns well.
The issue with explanation:
Appendicolith means hardened lump/stone (lith) of feces(stool) in the lumen of appendix. As you may know appendix is a blind tubular structure that opens in large intestine. If the fecolith can not pass through the opening in to the large intestine and gets stuck at the opening then the mucus secreted by appendix enlarges appendix and can cause pain. Since mucus is very viscid it may find a way to the large intestine reducing the pressure and pain thus caused.
Hence this can be one of the causes of pain in lower abdomen on right side.
If the mucus or secretions can not pass through, then the pressure can cause inflammation, infection, rupture (attack of appendicitis).
Hence you should get the Ultrasound, preferably CT scan of abdomen with focus on this area when you are in pain. This will hep to decide whether removal of appendix will help for relief of pain or not.
I hope this answers your specific query.
Please give feedback, and ask for further relevant queries if you feel that there is a gap of communication.
Dr T Chandrakant.
General Surgeon.
Above answer was peer-reviewed by :
Dr. Kampana
Good Evening Sir,
Thank you for the response,
I APOLOGIZE FOR MY LONG FOLLOW UP QUESTION
I would like to add some thing to my previous question,
1. Sir, the lower abdominal pain was exactly 1 inch below belly button,
2. Only twice I was given injection for pain. First time (in 2014) I was given a pain killer injection for Relieving pain, that too after 1week of suffering. And second time was last months episode, but by then most of pain was subsided. Later never given any pain killers. Generally used Mefthal spas or colospa along with some antibiotics. ANTIBIOTICS are always used only with Doctor's prescription, but Mefthal spas was used OTC.
Some times the pain relieved itself in 2 days WITHOUT MEDICATION.
ALMOST 10 EPISODES WERE ENCOUNTERED FROM 2014 TO TILL DATE.
Every episode of pain was having correlation with my FOOD a day or 2 days before or having huge tea in previous 2-3 days, and I could feel that I'm about to get the pain atleast a half day before.
BUT IN ALL THE CASES, THERE WAS TENDERNESS IN THE AREA OF PAIN FOR 3-5DAYS EVEN AFTER RELIEVING FROM PAIN.
From last months episode to till today, I feel like uncomfortable in the abdomen area (NOT PAIN BUT Some thing like anxious feel) 3-4 times a day.
Sir, should I need to wait for another episode of pain before going further,
OR can I take any medication to prevent such pain in future.
Thank You Sir.
Thank you for the response,
I APOLOGIZE FOR MY LONG FOLLOW UP QUESTION
I would like to add some thing to my previous question,
1. Sir, the lower abdominal pain was exactly 1 inch below belly button,
2. Only twice I was given injection for pain. First time (in 2014) I was given a pain killer injection for Relieving pain, that too after 1week of suffering. And second time was last months episode, but by then most of pain was subsided. Later never given any pain killers. Generally used Mefthal spas or colospa along with some antibiotics. ANTIBIOTICS are always used only with Doctor's prescription, but Mefthal spas was used OTC.
Some times the pain relieved itself in 2 days WITHOUT MEDICATION.
ALMOST 10 EPISODES WERE ENCOUNTERED FROM 2014 TO TILL DATE.
Every episode of pain was having correlation with my FOOD a day or 2 days before or having huge tea in previous 2-3 days, and I could feel that I'm about to get the pain atleast a half day before.
BUT IN ALL THE CASES, THERE WAS TENDERNESS IN THE AREA OF PAIN FOR 3-5DAYS EVEN AFTER RELIEVING FROM PAIN.
From last months episode to till today, I feel like uncomfortable in the abdomen area (NOT PAIN BUT Some thing like anxious feel) 3-4 times a day.
Sir, should I need to wait for another episode of pain before going further,
OR can I take any medication to prevent such pain in future.
Thank You Sir.
Brief Answer:
As detailed.
Detailed Answer:
Nice to get a detailed history as it helps a lot. You can add anything related to pain in abdomen.
If there is no pain now you can wait and watch/
In the next episode go for the following investigations:
- Stool tests for three consecutive days.
Contrast enhanced CT scan of abdomen with CT Enteroclysis (study of whole intestines including appendicitis and provide them the previous Ultrasound reports of Apendicoliths). Request then to study the abdomeinal wall also and to put a marker at the point of pain/ tenderness (pain on pressure).
Tests of blood like: CBC, ESR, Liver and kidney functions, Electrolytes, stools tests, urine tests, and any other tests that your Surgeon would suggest.
Unless we know the proper diagnosis, specific medical/surgical treatment can not be done. So no medications if no pain now.
Certainly you have to avoid/say no to the foods and beverages that instigate or enhance your problems.
I hope there are no urinary symptoms.
I hope this answer helps you further.
Dr T Chandrakant.
13/9/2022
As detailed.
Detailed Answer:
Nice to get a detailed history as it helps a lot. You can add anything related to pain in abdomen.
If there is no pain now you can wait and watch/
In the next episode go for the following investigations:
- Stool tests for three consecutive days.
Contrast enhanced CT scan of abdomen with CT Enteroclysis (study of whole intestines including appendicitis and provide them the previous Ultrasound reports of Apendicoliths). Request then to study the abdomeinal wall also and to put a marker at the point of pain/ tenderness (pain on pressure).
Tests of blood like: CBC, ESR, Liver and kidney functions, Electrolytes, stools tests, urine tests, and any other tests that your Surgeon would suggest.
Unless we know the proper diagnosis, specific medical/surgical treatment can not be done. So no medications if no pain now.
Certainly you have to avoid/say no to the foods and beverages that instigate or enhance your problems.
I hope there are no urinary symptoms.
I hope this answer helps you further.
Dr T Chandrakant.
13/9/2022
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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