[40F] Experiencing abdominal and pelvic pain with low back discomfort

Patient Description

A 40-year-old female presents with a 24-hour history of intermittent, sharp, stabbing pain around the belly button and right side, which worsens upon palpation near the right hip bone. The pain is rated at a 6/10 in severity and is somewhat alleviated by laying down with knees up, and by taking Tylenol and ibuprofen. Additionally, the patient reports sharp, achy pelvic pain with a sensation of pressure, also rated at a 6/10 in severity. Low back pain described as a burning sensation is exacerbated by walking and standing. The patient has experienced some nausea and changes in urine, which has become cloudy. No fever, chills, or blood in stool or urine were reported. The patient has a history of ovarian cysts diagnosed 18 years ago, is not currently on any medications, and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Appendicitis: This condition is characterized by sharp pain in the lower right abdomen, often starting around the belly button. It can cause nausea and changes in bowel movements. Appendicitis is a medical emergency and requires immediate attention.

    • Treatment usually involves surgery to remove the appendix.
  • Ovarian Cysts: Given your history of ovarian cysts, it's possible that a cyst could be causing your symptoms. Cysts can cause abdominal and pelvic pain, especially if they rupture or twist.

    • Treatment can range from watchful waiting to surgery, depending on the size and type of the cyst.
  • Kidney Stones: These can cause severe pain in the back, side, abdomen, and groin, along with changes in urine and nausea.

    • Treatment can involve pain management, drinking lots of fluids, and in some cases, medical procedures.
  • Urinary Tract Infection (UTI): This can cause lower abdominal pain and changes in urine. However, it usually also causes a burning sensation during urination, which you did not report.

    • Treatment typically involves antibiotics.

What you can do

You should seek immediate medical attention given the severity and sudden onset of your symptoms. While waiting for medical attention:

  1. Try to stay comfortable. Lying on your side and drawing your knees up to your chest may help to relieve some of the pain.
  2. Stay hydrated. Drink plenty of water unless advised otherwise by a healthcare professional.
  3. Avoid eating or drinking anything until you've been evaluated by a healthcare professional, especially if appendicitis is a possibility.

What you should look out for

Seek immediate medical attention if you experience:

  • Increased severity or frequency of pain
  • Fever or chills
  • Vomiting
  • Blood in your urine or stool

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of appendicitis?

Common symptoms of appendicitis include sharp pain in the lower right abdomen, nausea, vomiting, loss of appetite, and sometimes fever. The pain often starts around the belly button and then moves to the lower right side.


How can ovarian cysts cause abdominal pain?

Ovarian cysts can cause abdominal pain if they grow large, rupture, or twist (a condition known as ovarian torsion). This can lead to sharp, sudden pain in the lower abdomen or pelvis, sometimes accompanied by bloating or pressure.


What are the signs of a kidney stone?

Signs of a kidney stone include severe pain in the back, side, abdomen, or groin, nausea, vomiting, and changes in urine such as blood or cloudiness. The pain often comes in waves and can be very intense.


What changes in urine might indicate a urinary tract infection?

Changes in urine that might indicate a urinary tract infection include cloudiness, a strong odor, and sometimes blood. UTIs often cause a burning sensation during urination and a frequent urge to urinate.


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