Persistent Pain in the Right Lower Abdomen for Six Months
For the past half-year, I have been enduring nearly constant discomfort in my right lower abdomen. Interestingly, I do not notice any pain in the mornings; however, as the day progresses, the discomfort begins to surface. At times, the pain can last for about 20 minutes, but there are instances when it stretches on for several hours. My bowel habits are consistent, occurring once or twice daily, and I’ve found that the pain persists even after using the restroom. Occasionally, I observe that my stool floats, yet I can't seem to identify any link between my dietary choices and the discomfort I feel. In the evenings, I also experience stomach aches accompanied by a feeling of bloating. Curiously, during my vacation, I did not notice any of these symptoms. Thus far, I've undergone two calprotectin tests, both yielding results under 20, alongside two negative FIT tests. Furthermore, tests for CEA and CA-125 were normal, and an abdominal ultrasound did not show any abnormalities. I also had an MRI scan of my abdomen and pelvis. While the initial report noted only a fatty liver, the follow-up scan showed normal results. However, I sought a second opinion from a different facility where they identified a 1.4 cm hemorrhagic cyst on my right ovary and some mildly enlarged lymph nodes in the ileocecal area. After visiting a gynecologist last week, I was informed that everything appeared normal, and one gastroenterologist reassured me that my health status was satisfactory. Additionally, I sometimes feel a sensation of tightness around my right hip and pelvic region when I stretch. I’m unsure if it is relevant, but these pains began about a week following the cessation of my hypothyroidism medication, as advised by my physician, as well as a reduction in my Lexapro antidepressant dosage. This change occurred shortly after I completed physical therapy for a fractured left foot. Has anyone encountered similar issues? I'm starting to feel increasingly anxious about my situation.
Answers (1)
3/25/2025, 4:10:52 PM
OpenHealth AI
You're experiencing persistent right lower abdominal pain that has lasted six months, which can understandably cause anxiety, especially given the complex diagnostic history you've shared. Your symptoms, including the pain that worsens over the day, the occasional bloating, and the floating stool, warrant attention, especially considering the medical evaluations you've undergone have yielded mixed results.
Explanation
The pain in your right lower abdomen could arise from a variety of factors. Since your tests for inflammatory markers (calprotectin and FIT tests) and imaging (ultrasound, MRI) have come back mostly normal, some potential causes to consider may include functional gastrointestinal disorders (like Irritable Bowel Syndrome or IBS), referred pain from the musculoskeletal system (especially following your prior foot injury), or even some temporary effects from the changes in your thyroid medication and antidepressants.
The floating stool may suggest malabsorption of fats, but considering your stool habits are consistent, it might not be a primary concern unless you have other symptoms indicating malabsorption, like weight loss or nutritional deficiencies.
Next Steps
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Monitor Symptoms: Keep a detailed journal of your symptoms, noting the timing, nature, and any activities or foods that may trigger or alleviate the discomfort. This can help identify potential patterns or triggers.
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Consider Dietary Changes: Although you mentioned no direct link between meals and discomfort, it's worth trying an elimination diet. Focus on low FODMAP foods, which can benefit those with bloating and IBS symptoms. A trial period of a few weeks could provide insight into whether diet significantly influences your pain.
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Manage Stress and Anxiety: Given the recent reduction in your Lexapro dosage and subsequent anxiety regarding your symptoms, incorporating stress-relief techniques such as mindfulness, yoga, or gentle stretching may help alleviate discomfort around your pelvis and hip.
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Follow-Up and Evaluation: Consider returning to your healthcare provider for ongoing evaluation if symptoms persist or worsen, particularly to explore options for further imaging or new tests. It could also be beneficial to discuss the connection between medication changes and your symptoms.
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Physical Activity: Engage in light physical activity as tolerated to improve overall well-being and potentially alleviate pain symptoms. Consulting with a physical therapist about strengthening and stretching exercises for your abdomen and pelvic area may also be beneficial.
Feeling uneasy about ongoing pain is completely natural, especially with so much uncertainty. By focusing on tangible steps and effective symptom management, you can work towards finding relief and peace of mind. Let me know if you have more questions or need additional support!
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