Lower Abdominal Pain

Reviewed By: Pramod Kerkar, MD, FFARCSI

Pain or discomfort in the abdomen, below the level of umbilicus (belly button) is known as lower abdominal pain. Pain could be on the right lower abdomen or the left lower abdomen. Pain could also be immediately under umbilicus in the center; such pain is known as suprapubic pain.

Lower abdominal pain is quite common, particularly in the women, as they have lot of structures in that region such as uterus, ovaries and tubes as well as the organs which are also found in men.

9 Most Common Causes, Symptoms, Investigations and Treatment for Lower Abdominal Pain

9 Most Common Causes, Symptoms, Investigations and Treatment for Lower Abdominal Pain

  1. Appendicitis: Inflammation of appendix is a painful condition.

    SymptomsAppendicitis pain occurs in the lower right abdomen and can radiate to other regions of the abdomen. The pain can worsen within a span of a few hours.

    Investigations: Full Blood Count, Electrolyte and Urea, CRP, Urine dip test, Ultrasound Scan, CT-scan, and Laparoscopy.

    Treatment: Surgery is required to remove the inflamed appendix.

  2. Cystitis (Bladder Infection)

    Bacterial infection is the common cause of cystitis and it causes lower abdominal pain.

    Symptoms: Acute lower abdominal pain which persists until the infection is treated. Pressure sensation is felt in the lower abdomen, hematuria, burning micturition, and fever.

    Investigations: Urine tests, cystoscopy and imaging studies.

    Treatment: Antibiotics are given to treat the infection and pain killers or NSAIDs are given to control the pain.

  3. Pelvic Inflammatory Disease

    This is infection occurring in female reproductive organs and causes pain in the lower abdomen.

    Symptoms: Pain in the lower abdomen, pelvis; and pain in the low back, pain during intercourse, pain when urinating, vaginal discharge, weakness and fever.

    Investigations: Pelvic ultrasound, endometrial biopsy and laparoscopy.

    Treatment: Antibiotics are the main line of Treatment. Surgery is rarely needed, only in case of rupture of an abscess.

  4. Dysmenorrhea (Menstrual Pain/Cramps)

    These are cramping pain in the lower abdomen during and before a woman's monthly period.

    Symptoms: Pain present in the lower abdomen which is dull and throbbing in nature. Pain can radiate towards the lower back and thighs.

    Investigations: Ultrasound, CT scan, Magnetic Resonance Imaging (MRI), hysteroscopy and laparoscopy.

    Treatment: NSAIDs such as ibuprofen and naproxen can be given to control pain. In case of severe cramping pain, OCPs are given to prevent ovulation. Surgery is required if there are other underlying conditions such as fibroids.

  5. Miscarriage

    Spontaneous pregnancy loss before the 20th week is known as miscarriage and it causes pain in the lower abdomen.

    Symptoms: Cramping pain in the lower abdomen or low back with other symptoms like vaginal spotting/bleeding, passing of fluid or tissue from the vagina.

    Investigations: Pelvic exam, ultrasound, blood tests, and tissue tests.

    Treatment: Rest is recommended for threatened miscarriage. Otherwise medications are given to expel the pregnancy. A small surgical procedure known as suction dilation and curettage (D and C) is also done.

  6. Endometriosis

    This is a condition where the uterine tissue starts to grow outside the uterus and causes pain.

    Symptoms: Pain during periods (dysmenorrhea), cramping pain in the pelvis, pain in the lower back and abdomen, pain during intercourse (dyspareunia), pain with urination and defecation, heavy menstrual periods, and infertility.

    Investigations: Pelvic exam, ultrasound and laparoscopy.

    Treatment: Pain killers or NSAIDs are given to control pain, hormone therapy also helps in relieving endometriosis pain. Surgery is done in severe cases.

  7. Urinary Tract Infection (UTI)

    Infection in the urinary system, i.e. kidneys, bladder, ureters and urethra is termed as Urinary Tract Infection.

    Symptoms: Pain in the lower abdomen and pelvis with other Symptoms such as: Persistent urge to urinate, burning micturition, cloudy urine, hematuria and rectal pain.

    Investigations: Complete urine examination (CUE), culture and sensitivity test (C and S), CT scan, intravenous pyelogram (IVP) and cystoscopy.

    Treatment: Antibiotics are the first line of Treatment for UTI and I.V. antibiotics may be needed for severe infection.

  8. Fibroids

    These are the noncancerous growths occurring in the uterus commonly seen during childbearing age in women.

    Symptoms: Pain or pressure in the pelvis with other Symptoms such as: Heavy and prolonged menstrual bleeding, frequent urination, constipation and pain in the back and legs.

    Investigations: CBC, ultrasound, Magnetic Resonance Imaging (MRI), hysterosonography, hysterosalpingography and hysteroscopy.

    Treatment: Treatment comprises of hormonal therapy, uterine artery embolization, myolysis, laparoscopic or robotic myomectomy, hysteroscopic myomectomy, endometrial ablation and resection of submucosal fibroids, abdominal myomectomy, and hysterectomy.

  9. Polycystic Ovarian Syndrome

    PCOD is a hormonal disorder commonly seen in women of childbearing age.

    Symptoms: Pelvic pain, irregular menses, heavy periods, excessive facial and body hair.

    Investigations: Medical history and physical exam, blood tests, pelvic exam and pelvic ultrasound.

    Treatment: Low dose OCPs are given in order to regulate the cycle and surgery is also another Treatment option.

As you can see, lower abdominal pain is a symptom which indicates other underlying medical conditions. Treatment depends on that cause and condition. We have given some of the common causes for lower abdominal pain with symptoms and treatment. For correct diagnosis and treatment, you have to undergo various investigations and exams by your doctor before arriving at the right diagnosis so that appropriate Treatment can be carried out.

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Pramod Kerkar

Written, Edited or Reviewed By:


Pain Assist Inc.

Last Modified On: June 14, 2018

This article does not provide medical advice. See disclaimer

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