Intermittent Sharp Abdominal Pain on the Right Side (Female, 35)
A 35-year-old female, standing 5 feet 9 inches tall and weighing 250 pounds, presents with a chronic health history that includes well-managed conditions. She has undifferentiated connective tissue disease (UCTD), for which she takes Plaquenil and meloxicam on an as-needed basis. Additionally, she manages asthma with occasional use of albuterol, has eczema treated with Dupixent, and is hypothyroid, for which she uses Armour Thyroid. On top of these medications, she takes a daily antihistamine, some vitamins, and receives allergy shots periodically. For the past several years, she has experienced sharp, intermittent pain localized to the right side of her abdomen. Initially, the discomfort was felt higher up but now seems to have shifted lower. The pain typically occurs about three days a week but seldom persists throughout the entire day. Occasionally, she experiences accompanying nausea, though this symptom is not consistent. In 2022, she underwent an abdominal X-ray and an upper abdominal ultrasound, followed by a pelvic ultrasound last year; all results were normal. Additionally, she has been tested for celiac disease multiple times, with negative results. At times, the intensity of the pain has reached a level where she considered seeking emergency care to rule out appendicitis, particularly when the discomfort increased sharply during a heel drop test. However, these episodes often occur late at night, leading her to hesitate about going to the hospital, and by morning, the pain typically alleviates. Given that she has already consulted her primary care physician on several occasions without finding any explanation for her symptoms, she feels reluctant to revisit the issue.
Answers (1)
8/24/2025, 12:42:10 PM
OpenHealth AI
It sounds like you have been facing some frustrating abdominal pain that is not only uncomfortable but also has raised your concerns about more serious conditions. Given your detailed history, there are likely several factors at play here.
Main Points:
- Intermittent sharp abdominal pain on the right side can have various causes.
- The pain's shift lower and accompanying nausea could indicate underlying gastrointestinal issues, but the normal imaging results are reassuring.
Explanation:
Your history of sharp, localized pain that has shifted in position suggests a few possible explanations, such as gastrointestinal issues (like gallbladder problems, which might not have shown up on previous scans) or even musculoskeletal causes given your history with connective tissue disease. Notably, the pain you've felt could also relate to inflammation or irritation of the digestive tract.
The fact that the pain alleviates by morning and tends to occur at night is important to note as well—you may be experiencing something related to digestive processes occurring after meals or certain movements that are aggravated at night.
Next Steps:
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Monitor Your Symptoms: Keep a detailed record of your pain episodes. Note the time of onset, duration, intensity, any associated symptoms (like nausea), and what you've eaten or done before the pain starts. This will help identify potential triggers.
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Dietary Adjustments: Consider avoiding foods that may irritate your digestive system or cause bloating, such as spicy foods, caffeine, and fatty meals. Eating smaller, more frequent meals might help reduce discomfort.
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Self-Care for Comfort: Over-the-counter medications like antacids or simethicone (for gas) might help alleviate your symptoms if they're related to digestive issues. Warm compresses on your abdomen can also provide some relief.
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Physical Activity: Gentle physical activities, such as walking or yoga, may promote digestion and reduce discomfort.
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Regular Check-ins: If symptoms persist or worsen—especially if they begin to affect your daily life—consider discussing this ongoing issue again with your primary care physician, focusing on your symptom diary and any new patterns you've identified.
Taking these steps can help you manage your discomfort while giving you a clearer picture of your abdominal pain. It's understandable to feel hesitant about revisiting the doctor, but your health is important, and keeping a record can empower you when discussing this with them again.
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