Why i am having lower abdominal pain? - #11730
Sir/ma’am Merko around 1.5 month Pehle constipation ka issue hua tha and i was having blood in my stool. Mene piles ki medicines ki and mera constipation and piles ka issue dhire dhire theek ho gaya but then uske baad merko black stool aane laga apne aap I didn’t take iron supplements or anything like that. Dhire dhire vo bhi thik ho gaya apne aap and i was passing normal stool. Pichle 5-6 dino se Merko suddenly right lower abdomen me pain hone laga and jaha 2020 me appendix ki surgery hui thi right side me uss same jagah bhi pain hone laga. I thought ki maybe gastric issue hoga ya kuch khane pine ki wajah se ya jo pehle constipation or piles hua tha uski wajah se kuch ho rha hoga so i took medicine for gas( pantosec-D) and painkillers( Powergesic MR for two days and Zerodol SP for two days) but their was no relief. Then suddenly parso merko constipation hua and in afternoon merko firse stool me blood aaya that was pure red. Uske baad even when i was going for urination the blood was still coming. So tomorrow I went to the hospital and consulted a doctor and he suggested me for USG whole abdomen. The reports was ok everything was normal, just a dominant follicle cyst measuring 1-1.5 cm and doctor said that its normal. Kuch din pehle i also had blood test for regular checkup which included CBC, lipid profile, thyroid, fasting blood sugar, LFT, KFT, urine test and it was also normal just mild anemia, nothing serious. I am not getting if all my reports are normal then why i am having sharp pain? What should i Do ? Is it really only gastric pain ? And if so then why so sharp pain ? Any suggestions please?
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Doctors’ responses
Hello dear See after careful analysis of your history it seems either combination of disease or hormonal alterations Since you have done majority of the tests please get below tests done for confirmation Serum ferritin Serum prolactin Serum progesterone HbA1c if not done Crp Esr Sigmoidoscopy Anoscopy Kindly share the results with gastroenterologist or laproscopic in person for better clarification In the meantime time you can take below medications for improvement Ferrous sulphate once a day for 1 month Vit d sachets once a week for 2 months Zincovit multivitamin therapy once a day for 1 month Febres plus medications for gastric relief These medications can be taken but I request you to please share results of test for confirmation and then take any other medications for improvement Hopefully you recover soon Regards
Hi Ekta,
Since ultrasound was normal, but the pain is sharp and persistent, and localized to an area with surgical history, a CT scan can give more detail.
Please do a CT scan abdomen + pelvis. It can detect: Adhesions Stump appendicitis Small abscesses or bowel wall thickening IBD features
Also do Colonoscopy, since there is recurrent blood in stool, even if due to piles, it’s best to confirm the source by a colonoscopy
Please don’t ignore this pain or try to manage it just with over-the-counter medication, especially if it’s not improving. Since you already took a good step by getting ultrasound and blood work done, the next logical step is CT abdomen and possibly a colonoscopy
Feel free to talk Thank you dear
1. Your reports are mostly normal, which is reassuring, but pain and bleeding cannot be ignored.
2. Black stool in the past suggests old bleeding from the stomach or intestine, while fresh red blood usually comes from piles or fissure.
3. Since you had constipation and piles earlier, they are the most likely reason for the red blood now.
4. Pain near your old appendix surgery site could be due to gas, muscle spasm, or adhesions from the old surgery.
5. Mild anemia shows that repeated bleeding has affected your blood count, so this needs correction.
6. To prevent further issues, keep stools soft with high fiber diet, plenty of water, and avoid straining.
7. If bleeding continues or pain worsens, you must see a gastroenterologist for colonoscopy to rule out any deeper cause.
Hello Ekta, I understand your concern and I know that this must be disturbing. The problems that you are facing might be due to any of these reasons - Gastric/Intestinal issues, recurrence of piles/fissure, post surgical adhesions or Gynecological issue. To find out the exact reason, you need further evaluation. So here is my advise for management of your condition and further evaluation -
1. Diet & Lifestyle - High-fibre diet (green vegetables, fruits, salads). 2–3 litres water daily. Avoid spicy/oily foods, excess tea/coffee. Regular exercise / brisk walking.
2. Medicines (short-term relief) - Syp. Lactulose 15–20 mL at night if constipated. For piles/fissure: sitz bath (warm water sitting) Tab. Drota + Mf , whenever the pain is severe.
3. Further Evaluation - Since USG and blood tests are normal, if symptoms continue, get done a Colonoscopy / Proctoscopy, also get done this blood test - PT-INR. Then, CECT abdomen if pain persists unexplained.
4. When to Re-consult Urgently-Persistent or worsening sharp pain. Recurrent heavy bleeding in stool. Fever, vomiting, severe bloating. Weight loss, loss of appetite.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
Hello dear
As u said you operated for appendicitis then this is not issue
It’ can be infective colitis.
Cbc rule out anemia
Investigation
Sigmodoscopy or colonoscopy
It’s likely inflammation of sigmoid colon
That why you have frequent constipation
Drink plenty of water
Consult to gastroenterologist
Don’t take medication like without sigmoidoscopy
Thanks
Hello Ekta,
I understand your concern — let’s go step by step:
1. Constipation, blood in stool, piles
Your earlier constipation and piles can explain red blood per rectum.
Bright red blood usually means the source is lower intestine / anal region (like hemorrhoids, fissure).
2. Black stool
You had black stool for a period — that usually suggests upper GI bleeding (stomach/duodenum), though it resolved on its own.
3. Current right lower abdominal pain
Pain at the site of previous appendectomy could be due to:
Adhesions / scar-related pain (common after abdominal surgery).
Colitis / constipation-related spasm.
Urinary / gynecological causes (though your USG was normal except for a small follicular cyst, which is benign).
Severe, persistent pain despite antacids + painkillers means it’s not simple gastric acidity.
4. Investigations so far
USG normal, blood tests okay except mild anemia.
Anemia + history of black stools + blood per rectum → you should rule out GI causes (ulcer, polyp, IBD, hemorrhoids).
5. What you should do
Do not ignore persistent pain + bleeding.
Please see a gastroenterologist for further evaluation. They may suggest:
Colonoscopy / proctoscopy (to directly see piles, fissures, colon lining).
Upper GI endoscopy (since you had black stools earlier). Meanwhile:Keep stools soft (fiber, fluids, stool softener if needed). Avoid heavy painkillers like NSAIDs (Zerodol, Powergesic), as they can worsen GI bleeding. Track frequency and severity of pain + bleeding
Experiencing sharp pain in the right lower abdomen, especially after a previous appendectomy, indeed calls for careful attention. It’s understandable to be concerned, especially when your various tests appear normal but symptoms persist. The pain could stem from several issues, which might not have been picked up in your initial tests. One potential cause is adhensions from your past appendix surgery. These are bands of scar tissue that might be compressing portions of your intestine, leading to pain, intermittent obstruction, or even changes in bowel habits—this might explain the constipation and blood in stool. Although ultrasound can rule out many issues, sometimes detailed imaging like a CT scan might be more revealing if adhesions are suspected.
Another consideration might be Irritable Bowel Syndrome (IBS), particularly with a history of constipation, which often presents with abdominal pain relieved by defecation. The presence of blood in the stool complicates this picture a bit; conditions like hemorrhoids or anal fissures can cause fresh, red bleeding, especially with constipation, but this blood shouldn’t be present during urination.
If your doctors think bleeding could be more serious or originating from higher in the gastrointestinal tract, they might suggest an endoscopy to observe the inside of your digestive tract directly.
Given your medical history, recent symptoms, and the complexity of your case, I would strongly suggest following up again with your healthcare provider. A thorough evaluation by a gastroenterologist could be beneficial. This would clarify whether it’s a recurrent issue with your bowels or something related to your surgical history. They may recommend additional tests or a different approach to treatment. Do remember that serious, rapid changes in symptoms like continuous bleeding or severe pain should prompt immediate medical attention. Avoid over-the-counter pain relief without professional approval as they can potentially mask important symptoms or worsen gastrointestinal bleeding. Focus on a diet aiming to soften stools to prevent straining, including enough fiber and fluids, until you get further evaluation.
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