[28F] With acute lower right abdominal pain

Patient Description

A 28-year-old female presents with acute sharp and dull pain in the lower right abdomen, persisting since the previous day. The pain intensifies with movement or when attempting to sleep, rated as 8-9 out of 10, and decreases to 5-6 when sitting. Temporary relief is noted with the application of heat. The patient reports no changes in bowel movements, nausea, vomiting, fever, or chills. There have been no recent dietary changes or travel history. The patient is on the Depo-Provera shot and has not had a menstrual period in several years, with no new symptoms since starting the shot. There is no history of surgeries, but there is a family history of appendicitis in the patient's father and brother. The patient has no pre-existing conditions but is allergic to gabapentin and penicillin. Current medications include Sertraline and Tylenol as needed.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Appendicitis: This is an inflammation of the appendix and is a common cause of sudden, severe abdominal pain, particularly in the lower right side. The pain often starts near the belly button and then moves to the lower right abdomen. It can worsen with movement and may be accompanied by other symptoms like nausea or fever, which you haven't experienced yet. Given your family history, this is a possibility to consider.

    • Treatment typically involves surgical removal of the appendix. It's important to seek medical attention promptly if appendicitis is suspected.
  • Ovarian Cyst: These are fluid-filled sacs that can develop on the ovaries and may cause sharp or dull abdominal pain. While you are on Depo-Provera, which often suppresses ovulation, cysts can still occasionally form.

    • Treatment may vary from watchful waiting to surgical intervention, depending on the size and symptoms caused by the cyst.
  • Muscle Strain or Injury: Sometimes, abdominal pain can be due to a strain or injury to the muscles in the area, especially if there has been recent physical activity or strain.

    • Treatment typically involves rest, heat application, and over-the-counter pain relief.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

  1. Monitor Your Symptoms: Keep track of any changes in your pain or the development of new symptoms. Using MDandMe to journal your symptoms can help you track progress and share detailed notes with your healthcare provider.

  2. Apply Heat: Continue using a heating pad on the affected area, as it provides temporary relief.

  3. Rest: Avoid activities that may exacerbate the pain, and try to rest as much as possible.

  4. Pain Management: Continue taking Tylenol as needed for pain relief, but avoid taking more than the recommended dose.

What you should look out for

Seek medical attention promptly if you experience any of the following:

  • Increased Pain: If the pain becomes more severe or spreads to other areas.
  • Fever or Chills: Development of a fever could indicate an infection.
  • Nausea or Vomiting: These symptoms, along with abdominal pain, could suggest appendicitis or another serious condition.
  • Changes in Bowel Movements: Any new changes in your stool, such as blood or significant changes in frequency or consistency.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a proper diagnosis and treatment plan.

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1 mo ago

People Also Ask


What are the common symptoms of appendicitis?

Common symptoms of appendicitis include sudden, severe abdominal pain that often starts near the belly button and moves to the lower right abdomen, pain that worsens with movement, nausea, vomiting, fever, and loss of appetite. It's important to seek medical attention if you suspect appendicitis.


Can ovarian cysts cause abdominal pain even if I'm on birth control like Depo-Provera?

Yes, while Depo-Provera often suppresses ovulation, ovarian cysts can still occasionally form and cause abdominal pain. The pain can be sharp or dull and may vary in intensity. It's important to consult a healthcare provider for an accurate diagnosis.


How can I differentiate between muscle strain and more serious abdominal conditions?

Muscle strain typically results from recent physical activity or strain and may improve with rest and heat application. In contrast, more serious conditions like appendicitis or ovarian cysts may present with persistent or worsening pain, and additional symptoms like fever or nausea. Consulting a healthcare provider is crucial for proper evaluation.


What should I do if my abdominal pain worsens or new symptoms develop?

If your abdominal pain worsens or you develop new symptoms such as fever, chills, nausea, vomiting, or changes in bowel movements, it's important to seek medical attention promptly. These could indicate a more serious condition that requires immediate care.


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