[28F] With dull lower right abdominal pain radiating to back

What might be happening

Based on the symptoms you’ve described—dull, on-and-off pain in the lower right abdomen above the hip for 3-4 weeks, radiating to your back, worsening after eating, and occasionally accompanied by a loss of appetite—here are some possible explanations:

1. Irritable Bowel Syndrome (IBS):

   • IBS is a common condition that can cause abdominal pain, often triggered by eating. The pain may radiate to the back and is sometimes relieved by lying down. While IBS often comes with changes in bowel habits (diarrhea or constipation), it can also present with pain alone. Stress, diet, or certain foods can exacerbate symptoms.
   • Treatment typically involves dietary changes, stress management, and sometimes medications to manage symptoms.

2. Chronic or Subacute Appendicitis:

   • While appendicitis is usually an acute condition with severe pain, there is a less common form called chronic or subacute appendicitis. This can cause dull, intermittent pain in the lower right abdomen that worsens after eating. The absence of fever, nausea, or vomiting makes this less likely, but it’s worth considering if the pain worsens or becomes constant.
   • Treatment would involve imaging (like an ultrasound or CT scan) to confirm the diagnosis, and surgery may be required if appendicitis is confirmed.

3. Gallbladder Issues:

   • Pain after eating, especially if it radiates to the back, can sometimes indicate gallbladder problems, such as gallstones or inflammation. However, this is more common in the upper right abdomen, not the lower right.
   • Diagnosis typically involves an ultrasound, and treatment may include dietary changes or surgery if gallstones are present.

4. Muscle Strain or Rib Pain:

   • The dull ache behind your back rib could be related to lifting or a mild muscle strain. This may not be connected to your abdominal pain but could explain the back discomfort.
   • Rest, heat therapy, and avoiding heavy lifting can help alleviate this.

5. Ovarian or Gynecological Issues:

   • While you haven’t noticed menstrual irregularities, ovarian cysts or other gynecological conditions can sometimes cause lower abdominal pain. This is less likely given your description but should be ruled out if symptoms persist.
   • Diagnosis may involve a pelvic ultrasound, and treatment depends on the underlying cause.

What you can do

Here are some steps you can take to manage your symptoms and gather useful information for your healthcare provider:

1. Adjust Your Diet:

   • Eat smaller, more frequent meals to reduce strain on your digestive system.
   • Avoid greasy, spicy, or highly processed foods, as these can irritate the digestive system.
   • Stay hydrated by drinking plenty of water.

2. Use Heat Therapy:

   • Apply a warm compress or heating pad to your lower right abdomen or back to help relax muscles and reduce pain.

3. Rest and Avoid Strain:

   • Since lying down helps, make sure to rest when the pain flares up.
   • Avoid heavy lifting or strenuous activities that could worsen the pain.

4. Over-the-Counter Pain Relief:

   • If the pain becomes bothersome, you can try acetaminophen (Tylenol) for mild pain relief. Avoid NSAIDs like ibuprofen (Advil) or aspirin, as they can irritate the stomach lining.

5. Track Your Symptoms:

   • Use MDandMe to journal your symptoms, noting when the pain occurs, its severity, and any potential triggers (e.g., specific foods, activities, or stress). This can help identify patterns and will be useful for your doctor.

6. Consider Gentle Movement:

   • Light stretching or gentle yoga poses (like child’s pose or cat-cow) may help relieve tension in your back and abdomen.

What you should look out for

While your symptoms don’t currently suggest an emergency, here are some red flag symptoms to monitor. If you experience any of these, seek urgent medical attention:

1. Severe or Worsening Pain:

   • If your abdominal pain suddenly becomes sharp, severe, or constant, it could indicate a serious condition like appendicitis or a ruptured ovarian cyst.

2. Fever or Chills:

   • A fever (temperature above 100.4°F or 38°C) along with abdominal pain could signal an infection, such as appendicitis or another abdominal infection.

3. Nausea, Vomiting, or Inability to Keep Food Down:

   • Persistent nausea or vomiting, especially if you can’t keep food or fluids down, could indicate a blockage, infection, or other serious condition.

4. Changes in Bowel Movements or Urination:

   • Watch for blood in your stool, black/tarry stools, or difficulty urinating. These could point to gastrointestinal or urinary tract issues.

5. Dizziness, Fainting, or Rapid Heartbeat:

   • These symptoms could indicate internal bleeding, dehydration, or another serious condition, especially if they occur alongside worsening abdominal pain.

If your symptoms persist or worsen, it’s important to consult a healthcare provider for further evaluation. They may recommend imaging (like an ultrasound or CT scan) or blood tests to investigate further. Let me know if you’d like help preparing for a doctor’s visit or creating a summary of your symptoms!