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Suggest Treatment For Lower Right Abdominal Pain

Posted on Mon, 9 Nov 2015

Question: I have been having notable pain in my lower Right abdomen for about (2) weeks...have gone to the doctor and had blood tests, urine tests...they have all come back normal. Also have had an ultra-sound and CT scan plus an x-ray. Nothing whatsoever is showing up. Yet the pain persists. Any ideas what this could be? I have also had my stool tested...no blood in the stool and no inflammation markers.

Answered by Dr. Anshul Varshney (15 minutes later)

Brief Answer:
I need further details.

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
To help you and understand your problem better I need few more details:
1. Is the pain persistent or intermittent?
2. Is it severe? Grade the severity from 0-10 scale.
3. Any vomiting's?
4. Any constipation or associated motion problems?
5. Is the pain more in the night or during the day?
6. Any aggravating and relieving factors?
Revert with the asked details for a better help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (5 minutes later)

The pain is persistent...when I first get up in the morning, it does not hurt but within 30 minutes of being up and moving around, it begins to hurt. The pain has now spread to my Left side as well although it is not as severe on the Left as it has been on the Right. The pain is consistent and gnawing although not in the same league as, for example, a kidney stone stuck in a ureta. I have not had any instances of vomiting. I have had constipation although that may be attributable to the pain killers that the doctor prescribed.
I have also been experiencing a feeling of bloating in the belly area.

Answered by Dr. Anshul Varshney (36 minutes later)

Brief Answer:
Seems to be Infective.

Detailed Answer:
Hello, Rather then saying that your pain is in right lower abdomen we should say that it's in lower abdomen.
The answers you have provided with normal CT and stool examination gives two differential diagnosis:
1. Muscular pain.
2. Infection like amebiasis or giardiasis.
I do agree that your stool examination is normal but still infection can be there.
I would recommend you a week if treatment with antibiotic like Ornidazole or Tinidazole.
This should hopefully settle your pain.
Also if it is muscular then it would also get settle in a week.
If still nothing works, we would start the treatment for Irritable bowel syndrome (IBS) that should help you.
I hops it helps you.
If you have any further query, please ask me.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (1 hour later)

Thank you very much....that makes sense however could this be the case(infection) even though it has been going on relatively unchanged for 3-4 weeks? Also, the doctor here indicated to me that my white blood cell count was normal...I am certainly not a physician however my understanding is that white cell count is indicative of infection.

Answered by Dr. Anshul Varshney (10 hours later)

Brief Answer:
Yes can be

Detailed Answer:
Hello, Normal WBC count doesn't essentially rule out infection.
In fact, the amoebic or giardia infection can be there without a rise in the WBC count.
I suppose, you should discuss my opinion with your doctor and if he agrees he would prescribe you antibiotics for the same.
If no relief, as discussed, you would be treated for Irritable Bowel Syndrome.
I hope it helps.
If you have any further query, please ask me.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (2 days later)

Hi again. Sorry to bother you but I just have a couple more questions. I just took a blood test(anca/ansa) plus they made me do a Urea Breath test. The results for those tests are not back quite yet. In the meantime, I spoke to the doctor yesterday and the blood test results that did arrive back show no inflammation markers. I was worried for a while that I may have intestinal cancer however there is no blood in the stool and the CT scan did not show anything. I am being paranoid, but how likely is it that I could have, for instance, lung cancer and it is manifesting by the pain in my abdomen? (Most notably on the Right side). My white blood cell count is normal and I have not been spitting up any blood nor have I experienced any shortness of breath however when I lay down at night and everything is quiet, I noticed a very slight wheezing sound when I breath.

Answered by Dr. Anshul Varshney (16 minutes later)

Brief Answer:
Asthma is likely.

Detailed Answer:
Hi. Welcome back.
What you are imagining of intestinal cancer can't be determined based on the information provided by you.
Honestly you have no symptoms of intestinal cancer. Moreover your investigations are within normal limits so I would say you simply have Irritable bowel syndrome.
As far as wheezes are concerned they don't seem to be related. You might be having a bronchial asthma or bronchitis.
Your doctor would evaluate you for the same and if required would get a chest xray done. He would treat you with Bronchodilators like Deriphylline for a short course.
I hope it helps.
If you have any further query, please ask me.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar