Pain in the lower abdomen – Treatment, causes, symptoms. Why does it hurt in the lower abdomen?

Pains in the lower abdomen can have many sources and affect both sexes in a different way. The most common examples are lower abdominal pain in women during pregnancy or after ovulation, and lower abdominal pain in men – e.g. after intercourse. Such ailments can also result from many diseases. So let’s know the causes and methods of treating lower abdominal pain.

The abdomen is divided into epigastric, mid-abdominal and lower abdomen. The lower abdomen is the part below the transverse line at the level of the navel. It consists of three areas: the left inguinal area and the right and centrally located pubic area. Below is the genitourinary area. In the lower abdomen are the female reproductive organs, the urinary bladder, and the digestive organs – the small intestine and the large intestine. In addition, the iliac veins and arteries run in this part of the body. 

The main components of the skeletal system are the ilium, ischium, sacral and lumbar vertebrae of the spine. The lower abdomen also houses the human’s largest nerve plexus – the sacral plexus – and some of the abdominal and dorsal muscles.

As you can see, the very structure of this part of the body indicates that there may be many sources of lower abdominal pain and they may be interrelated.

Pain in the lower abdomen – causes and sources

Why does the lower abdomen hurt? To answer this question, it is best to go to the doctor or consult him during teleportation. 

The specialist may ask:

• exactly in which part of the lower abdomen the pain is located (e.g. left or right, pain below the navel),
• what is the nature of the pain (e.g. stabbing, sharp, dull), 
• does the pain radiate
• whether the pain is continuous or recurrent, how often it happens, and whether it resolves on its own.

Pain in the lower abdomen can be divided according to the systems in the human body with which the ailments are related:

• lower abdominal pain and problems with the reproductive system,
• pain in the lower abdomen and urinary system,
• lower abdominal pain and digestive system diseases,
• neuropsychological pains in the lower abdomen,
• lower abdominal pain and problems with the locomotor system.

Lower abdominal pain in problems of the reproductive system

The most common group of complaints related to lower abdominal pain concerns the menstrual cycle and gynecological problems, including pregnancy.

Premenstrual syndrome (PMS)

It occurs about a week before menstruation, and pain in the lower abdomen is one of the typical symptoms. In addition, PMS is associated with fatigue, irritability and mood swings. If your symptoms worsen, including increased pain in the lower abdomen, please consult your doctor. He or she may order treatment for pain relief, antidepressants, contraceptive pills or injections, or diuretics.

Lower abdominal pain during menstruation

Pain in the lower abdomen is a typical symptom accompanying menstruation. The symptoms are spasmodic and may radiate towards the lower back. Symptoms accompanying lower abdominal pain are: mood disorders, general feeling of tiredness and breakdown, drowsiness, nausea, diarrhea, vomiting, as well as water retention in the body. At the beginning, it is worth soothing the pains of the lower abdomen accompanying menstruation with warm compresses, drinking herbal infusions, an easily digestible diet and simply relaxing – also actively. In case of severe symptoms, NSAIDs or acetylsalicylic acid are used (attention – may increase bleeding), as well as antispasmodics with drotaverine and contraceptives. However, consultation with a doctor is necessary, as extremely painful menstruation may be symptoms of the disease.

Endometriosis

In this case, the pain in the lower abdomen is similar to that of menstruation, but it can occur regardless of the phases of the cycle. It results from the growth of the endometrium outside the uterine cavity. Lower abdominal pain occurs regularly, it also occurs around the groin and less often around the anus. Additional symptoms include heavy and prolonged periods, blood spotting, small amounts of blood in the urine and stools, pain during intercourse and during urination and bowel movements. In the event of such symptoms, consult a physician. Depending on the stage of development of the disease, pharmacological treatment (contraceptives, gestagens and drugs that suppress gonadotropin secretion), surgical and combined treatment are used.

Ovulatory pain

Lower abdominal pain may appear during ovulation, in the middle of the menstrual cycle, and may last up to several days. Its characteristic feature is stinging and radiation towards the pelvis and further to the back. Additional symptoms, apart from lower abdominal pain, are mucus with slight bloody discoloration, hypersensitivity and swelling of the breasts, a general feeling of irritation and exhaustion. Ovulatory pains in the lower abdomen can be alleviated as in the case of menstrual pains. The severity of symptoms requires medical consultation.

Pregnancy pains

Lower abdominal pain in pregnancy is a common and typical problem, so it does not necessarily mean a threat to the pregnancy. The ailment can occur at different stages of pregnancy. Lower abdominal pain at the beginning of pregnancy, accompanied by vaginal bleeding or spotting, requires medical consultation. Pain is characteristic of the second trimester and is associated with the development of the fetus. A cause for concern is increased abdominal tenderness and hardness. At the end of pregnancy, the pains in the lower abdomen are associated with predictive contractions. The indications for medical consultation are regular pain in the lower abdomen, abdominal tenderness and its hardness. Lower abdominal pain may result from a miscarriage – it is then similar to menstrual pain, accompanied by uterine contractions, light brown spotting. At this stage, you should see a doctor immediately. Lower abdominal pain and heavy vaginal bleeding may mean the miscarriage is underway. Then it is also necessary to contact a doctor immediately.

Inflammation of the pelvis minor (adnexitis)

It is the result of a group of inflammatory diseases of the ovaries, fallopian tubes and pelvic peritoneum caused by bacteria. Affliction is pain in the lower abdomen which may increase with intercourse. It has the nature of sudden contractions. It is accompanied by low-grade fever or fever, sometimes also with diarrhea, nausea, vomiting. The abdominal shells can be hard, tense and painful under pressure. Drug treatment consists of taking drugs orally or vaginally, including NSAIDs and antibiotics. 

Intimate infections

They include, among others syphilis, chlamydiosis, gonorrhea, herpes virus, vulvitis, vaginitis. In addition to abdominal pain, intimate infections are accompanied by many other symptoms – vaginal discharge with an unpleasant smell, burning or itching in the intimate area, pain during voiding, sometimes low-grade fever or fever. If you have these symptoms, see your doctor urgently. In the treatment of intimate infections, both oral and vaginal preparations are used – antibacterial (including antibiotics, metronidazole) and antifungal agents.

Torsion of the ovary (appendages)

It can have many causes (cysts, tumors, excessively elongated fallopian tube, ovary) and is characterized by lower abdominal pain, most often located on the right side. The pain is sudden, sharp, radiating to the back, as well as to the pelvis and thigh. It’s easy to confuse it with other conditions such as pancreatitis or renal colic. Lower abdominal pain may be associated with nausea, vomiting and diarrhea. Ovarian torsions are treated surgically.

Ovarian cysts

There is pain in the lower abdomen, the feeling of pressure on the bladder, and additionally disturbances in the menstrual cycle, intermenstrual bleeding. With ovarian cysts, hormone therapies and surgery are used.

Ovarian cancer and endometrial cancer

It manifests itself with pains in the lower abdomen and sacrum, irregular and strong purulent discharge, bleeding. Depending on the advancement of the disease, surgical treatment, radiotherapy, brachytherapy, chemotherapy and hormone therapy are used.

Degeneration of the uterus (polyps and fibroids)

Pain in the lower abdomen is not a common problem, but uterine bleeding, a feeling of pressure, pressure on the bladder or rectum are characteristic. Surgical treatment is the most effective. Hormone therapy, radiological treatment, and embolization or coagulation of the uterine arteries are also used.

Pain after intercourse and sexual position

Lower abdominal pain may result from the rupture of the hymen during the first intercourse, and may also accompany the rapprochement, e.g. due to an inappropriate sexual position.

Postoperative adhesions

Lower abdominal pain can occur during intercourse in women who have undergone abdominal surgery. The ailment is the result of abnormal tissue growth. They can be removed surgically, but there is a risk of pain recurrence.

Pain in the lower abdomen and urinary system

Lower abdominal pain caused by problems in the urinary system is most often associated with difficult micturition. Additional symptoms and differentiated pain characteristics help to diagnose the source of the ailment. The specialist who deals with these types of conditions is a nephrologist or urologist.

Inflammation of the bladder

It is manifested by pain in the lower abdomen – a feeling of pressure on the bladder and burning during micturition. The urine may be stained with blood and have an unpleasant odor. There is also an increased frequency of urination. In the case of cystitis, pharmacotherapy with furagine as well as analgesic and diastolic drugs is used.

Pyelonephritis

It is the result of an untreated infection (bacterial, viral, fungal) of the bladder or urethra. The main symptoms are lower abdominal pain, sudden and sharp pain in the sacrum area radiating to the groin, nausea and vomiting, painful micturition, pollakiuria and haematuria.

Urolithiasis and renal colic

Urolithiasis is a chronic disease involving the gradual build-up of deposits in the kidneys. Pain in its course – the so-called renal colic – occurs due to the movement of deposits through the ureter to the bladder. The pain is sharp and intense, and there may be nausea and vomiting. Often the pain is localized in the lumbar region of the back. There is pollakiuria, blood-red urine, fever. Treatment of kidney stones consists in drinking plenty of fluids, strong painkillers (including opioids), and antispasmodics. Surgical treatment is less and less necessary, and it gives way to methods such as smashing the urinary stones with shock waves, percutaneous nephrolithotripsy, and ureterorenoscopy.

Inflammation of the prostate gland / chronic prostatitis syndrome

Typical symptoms are pain in the lower abdomen, around the anus, in the crotch, at the base of the penis and in the lower parts of the spine. Additionally, there is fever, chills, general malaise and muscle pain. Prostatitis is treated with antibiotics. Hot compresses also bring relief.

Lower abdominal pain and digestive system diseases

Pain in the lower abdomen associated with diseases of the digestive system most often coexists with problems with defecation – constipation, diarrhea, as well as characteristic changes in the stool.

Appendicitis

It is manifested by pains in the lower abdomen and abdomen that arise suddenly. As they intensify, they may migrate to the right – towards the iliac fossa. Additionally, there is vomiting, nausea and fever. Surgical treatment is applied, and in the event of a periappendicular infiltration, antibiotic therapy and NSAIDs are also used.

Irritable bowel syndrome

Lower abdominal pain is located in the left part, there are problems with defecation – constipation and diarrhea, including alternating, mixed forms. Additionally, there may be nausea, gas, vomiting, a feeling of fullness and mucus in the stools. Pharmacological treatment is used – antispasmodics and, depending on the symptoms, drugs against constipation or against diarrhea, as well as antibiotics. 

Diverticulitis

There are: lower abdominal pain on the left side, flatulence, problems with bowel movements – alternating diarrhea and constipation. In the treatment of diverticulitis, a bran diet and pharmacotherapy – drotaverine and oxyphenonium bromide are used.

Constipation

Lower abdominal pain accompanies problems with defecation. A diet rich in gut stimulating ingredients – prunes, figs, raisins, flax seeds or sunflower seeds – plays a key role in constipation. Laxatives, including suppositories, are also available.

Irritable bowel syndrome

Lower abdominal pain results from accompanying disorders related to the dysfunction of the kidneys, liver, stomach and ovaries. There is diarrhea, small pellet-shaped stools, sometimes fluid and mucilaginous.

Neuropsychological pains in the lower abdomen

The lower abdomen is a highly innervated part of the body that is also influenced by psychological factors. One of the main diseases manifested by lower abdominal pain is neuralgia – neuralgia. They can be due to nerve damage or stress. Additional symptoms are diarrhea, indigestion, gas. The above-mentioned irritable bowel syndrome is also a neuropsychological disease.

Lower abdominal pain and problems with the locomotor system. Osteoarticular and muscular system

Lower abdominal pain may be related to the sustained injury or muscular and osteoarticular problems.

Pubic symphysis stretch

It occurs during pregnancy as a result of the loosening between the pubic cartilage and the connection with the sacroiliac joints. Symptoms include lower abdominal pain around the symphysis pubis, radiating to the thighs and sacrum, and is aggravated by walking. Treatment consists of limiting physical activity and stress, as well as rehabilitation exercises. As part of pharmacotherapy, drugs with an analgesic and anti-inflammatory effect are administered.

Pathologies of the lower spine

Pain in the sacral spine can also radiate to the lower abdomen. The source of pain is most often located in the intervertebral disc. Back pain is sometimes confused with ailments of other systems – urinary, reproductive and digestive systems, the common symptom of which is often pain in the lower abdomen. Lower spine pathologies are treated with physical therapy and rehabilitation, as well as surgery.