- What can hurt the bottom right?
- Mechanism of pain formation
- Characteristics of pains
- Distinguishing signs of severe pain
- What is chronic pain?
- What diagnostic methods are used to identify the causes of pain in the lower abdomen?
- What should I do if I have pain in the lower abdomen on the right?
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With pains on the right side of the abdomen, doctors are most common at the bottom. This is due to the appendicular appendix located here and its inflammation. Statistics of operative interventions of the general surgical department show that appendectomy causes maximum activity.
However, right-sided pain in the lower abdomen is not limited to a single cause. In this zone, there are quite a few other organs, the pathology of which leads to a painful syndrome. To be sure of appendicitis, one must exclude the signs of all diseases with similar pains.
According to the nature of the current and the consequences, they are no less dangerous for humans. Precisely to find out why the abdominal pain hurts helps careful analysis of the patient's complaints, additional signs, confirming and refuting survey data.
What can hurt the bottom right?
Pain in the right lower abdomen can disturb both children and adults. In childhood, chronic pathology rarely develops, therefore, an acute disease or manifestation of physiological inferiority, a congenital anomaly is sought as a cause.
In adults, a lot of chronic diseases are added to the "list" of possible diseases. Some long time proceeded secretly. Hormonal imbalance severely affects the functioning of the sexual organs. In the climacteric period, inflammatory processes are activated in women and men, epithelial tissue undergoes transformation.
The lower abdomen area on the right and left is called the iliac by the name of the protruding crest of the pelvic bone. In the right side are the following anatomical structures:
- immediately under the skin tight muscular cords and aponeurosis( tendons) of large muscles forming the anterior abdominal wall;
- part of the leading right ureter;
- vertically located small intestine loop( iliac);
- ileocecal angle - connection of the beginning of the large intestine( cecum) with the terminal part of the thin, represented by the ileum;
- appendix - the process of the cecum;
- in women with the right ovary with the end of the fallopian tube.
It is true that 90% of people have the small intestine coming from the side and forming an acute angle, considering the direction of the
connection. It is completely in vain that some authors refer to the location of the bladder, prostate in men and uterus in women in this zone. These are not so huge organs to leave the central pubic part.
Even an overflowing bladder rises, but does not spread out to the sides. Another thing - the ability in hypertrophy and inflammation to give irradiative pain in the right side and lower abdomen, solder to the ligament and form a spike with the intestine.
Mechanism for the formation of the pain syndrome
Parenchymal and hollow organs may be affected in different ways. The first include dense structures filled with cells and covered with a capsule. The second - tubular formations. On the right side of the abdomen there is only one parenchymal organ - the ovary in women.
All the rest of the inside are covered with a mucous membrane, are provided with muscle fibers of circular and longitudinal direction and provide motility( the transport function of the contents).
The difference lies in the absence of pain receptors on the mucosa and the possibility of painful reaction only to a spastic contraction or a significant overstretch.
Ovaries give pain when parenchyma increases the size of the organ in swelling, inflammation, tumor growth and stretches the capsule. And, conversely, in the case of a sharp decrease in the cyst during rupture.
In addition, it is necessary to take into account additional mechanisms: sprain, adhesive process, tumor germination in the nerve ganglia, irritation of the peritoneal sheets with a casting secret, inflammatory exudate. By the nature of the pain, it can be assumed which process occurs in the body, if the lower abdomen hurts on the right.
Size of the removed ovary increased due to hemorrhage and cyst formation
Pain characteristics
Patients describe their feelings as they can, but sincerely. Therefore, the doctor should carefully consider the subjective perception of pain, try to clarify and obtain the necessary information. In addition, when examined, palpation of the abdomen, the expert makes indirect conclusions about the intensity and sensitivity of a particular person.
If the pain on the right hand bottom of the patient considers "weak"
Practice proves the need for the same approach to both intense and weak pain. Many tumor diseases begin in this way. Identify the disease until the body is able to fully restore its functions - the dream of doctors.
Non-intensive pains begin:
- inflammation of the right appendage in women, at the same time there may be a connection with "critical" days, disruption of the monthly schedule, the appearance of mild brownish discharge from the vagina;
- prostatitis and adenoma in men in the initial stage cause low pain over the pubis, in the groin, radiating to both ileum zones, sometimes it turns out when referring to the urologist andrologist about the reduction of potency or infertile marriage.
Drawing pains
Drawing pain in the right side and in the lower abdomen is considered quite tolerable. Patients do not always mention this. Typically, this character is inherent in chronic processes with slow growth of the body, the formation of adhesions and ligament tension.
As a physiological cause, a similar complaint can be made for primiparous women. They have painful syndrome caused by the growing uterus and sprain of the ligamentous apparatus. However, understanding why the right side hurts in the lower abdomen of a pregnant woman, you need maximum caution.
Chronic inflammation of the right appendage( adnexitis), appendicular infiltration, with an independent cessation of an attack and transition to a chronic course is most often manifested.
Of particular importance is the transition from the pulling character of pain to pulsation. This indicates a festering within a confined focus, joining a more powerful infection.
Acute infection accompanied by high temperature
Aching pain
When patients are concerned about aching pain in the right side in the lower abdomen, it leaves an imprint on the appearance: the person is really exhausted by incessant thoughts about the disease, malaise, lack of sleep, inability to work peacefully.
This perception concerns emotionally unstable, easy-to-get people. So, they assess their condition of the woman in the last month before giving birth. The lack of permanent localization and spread throughout the stomach is typical of irritable bowel syndrome. In order not to bring a person to a nervous breakdown, it is necessary to conduct a full-fledged survey and convince him to apply the minimum funds, to engage in the regime, nutrition.
Blunt pain
Probable cause of blunt pain in the right ileal region may be in women a moderate increase in the ovary with increased blood filling, chronic inflammation. If the pain is of a cyclic nature and appears regularly, this can mean a tissue reaction to the maturation of the follicle.
In the absence of communication with the monthly, chronic adnexitis, cyst on the right, should be excluded. People who are thin with an asthenic physique tend to omit the right kidney. Sometimes it comes from below to the small pelvis, has increased mobility, therefore, it constantly stretches the ligaments.
In such a situation, favorable conditions are created for infection and development of right-sided pyelonephritis. The patient's history of pain passes through pulling, blunt and intense with exacerbation, with fever, chills, irradiation into the right side and lower back.
How to assess the pulsating nature of pain?
Pulsating pain in the lower abdomen on the right is described by patients as "pulling", "stirring", "rhythmic contraction" of the viscera. A symptom occurs when a suppuration occurs next to the nerve endings. Usually it should be regarded as a dangerous signal of the transition of ordinary inflammation to gangrene with appendicitis, adnexitis.
It is very dangerous sensation of pulsating pain in the right side in the postoperative period against the background of a rise in temperature, changes in the blood formula. This is a complication that can quickly move from a weak patient to a septic state.
Similar manifestations occur in women with complicated abortion, congestion and suppuration of blood in the uterine cavity after severe childbirth. Irradiation of such pains is different: in the right thigh, in the hypochondrium, in the side and the center of the abdomen.
Additional symptoms are:
- repeated chills;
- nausea;
- intense sweating;
- thirst;
- dizziness;
- heartbeat;
- drop in blood pressure;
- bloating;
- growing weakness.
For an induced abortion, a woman should be sent to a specialized department where the first 3 days of observation are performed.
Distinguishing signs of severe pain
With severe pain, a person adds emotional color to suffering, which can not help in diagnosis. Strong constant pains cause malignant neoplasms of the intestine, ovary.
Initially, they are local, worried only in the right ileal zone, supported by a metastatic increase in regional lymph nodes.
Then metastases are given and the primary focus is not possible on the symptoms. Pain syndrome is accompanied by signs of cancer intoxication: weight loss, loss of appetite, nausea, weakness.
If the pain is described as a "sharp"
Usually patients mean a sudden, acute appearance against a background of well-being. For the most part, when clarifying the details, it is possible to identify the signs of previous unstable blunt abdominal pain, manifestations of dyspepsia.
Severe pain always requires special attention, as it causes suspicion of sudden pathology and provides a limited time for diagnosis. The patient needs urgent medical help. When the pains are localized in the abdomen, differential diagnostics between different diseases is carried out on the right and below.
Attack of acute appendicitis - in the classical version begins with pain in the stomach, nausea, vomiting, then the pain descends into the right iliac zone. At pregnant women passes in the right hypochondrium, as the inflamed process is displaced by the increased uterus upward. The disease can be caused by:
- by any chronic inflammation of the abdominal cavity, scarring with the appendage;
- with prolonged constipation;
- infections( typhoid, tuberculosis);
- abdominal trauma;
- plugging the outlet with coarse food( husks of sunflower seeds, nuts).
Inspection and palpation indicate local muscle tension in the area of pain in the right lower abdomen, strengthening the sign when the patient turns to the left side. Surgeons use the definition of a group of symptoms that have the name of the authors.
Increasing the gestation period pushes the appendix right and up
Torso of the right ovarian cyst leg - may be accompanied by a pain shock with loss of consciousness. Pain sensations are greatly enhanced with body movements. A woman has fever, a cold sweat, a decrease in pressure, a constant pulse, a possible delay in urination and constipation.
A rupture of the right-sided ovarian cyst is accompanied by acute pain in the right side and ileum. The condition differs little from the previous female pathology.secret, released into the abdominal cavity, causes irritation of the abdominal sheets.
Ectopic tube pregnancy on the right - characterized by sharp one-sided pain at rupture. Until that moment, the woman felt moderate bursting pains in her stomach and did not attach importance to them. Gynecologists determine the accumulation of blood in the posterior and lateral vault of the vagina.
The complication of Crohn's disease is one of the initial parts of the lesion - the ileum( ileitis), so a break in this place is accompanied by sudden severe pains. Although before this, patients can suffer long lasting from spasmodic pains, diarrhea.
Pain cramping
Pain is inherent in hollow structures. Patients feel spastic contractions in the lower abdomen on the right, different in intensity, unstable, sometimes disappearing on their own. They are provoked by physical activity, shaking, hypothermia.
It is impossible to judge accurately about the affected organ. Characteristic: for initial signs of ectopic pregnancy, renal colic. Possible for cholelithiasis and appendicitis. Typical for irritable bowel syndrome.
Stitching pain
A feeling of tingling in the abdomen is noted by people with intestinal diverticula. They arise as a congenital anomaly of the structure or a consequence of inflammation and thinning of the intestinal wall. They can be single or multiple, localized in both the thick and the small intestine.
Are sacked protrusions from a thin wall, which has lost its elasticity. About what hurts in the right side in the lower abdomen of speech does not go, while sterility remains. With stagnation and ingress of infected contents, diverticulitis( inflammation) develops with the formation of abscesses, the threat of rupture and peritonitis. The pain thus changes to pulsating, bursting.
Sometimes stops spontaneously when the stone leaves the urethra, more often this happens in women, because their urethra is wider and shorter
Cutting pain
Cutting type of pain is most typical for passage through a narrow channel of rocky stone. Sometimes it is described as "burning".The mucosa is injured, the muscular layer is reduced in response. Characterized by pronounced irradiation.
Pain is localized in the right ileal zone, since it gives away the movement of the stone along the right ureter, the bile duct. The attack comes almost suddenly. Patients may have nausea and vomiting, urinary retention in kidney stones. Men suffer renal colic severely and require medical intervention.
What is chronic pain?
A familiar phrase means not pain in chronic diseases, but a stable sensation for at least six months without diagnostic confirmation of any changes in the internal organs, even with laparoscopic examination.
The relationship of chronic pain in the lower abdomen in women with the experience of sexual violence has been proven. It is believed that the most likely mechanism of education is the disturbed psyche. Specialists in psychology and psychiatry conduct treatment for such symptoms.
What diagnostic methods are used to identify the causes of pain in the lower abdomen?
The doctor's reception provides clarification of the characteristics of the pain syndrome with the help of finding out:
- how long pains occur, do they have a frequency, how many last;
- does the patient consider them sudden or the gain has progressed gradually;
- to what type belong( blunt, bursting, cramping and others);
- that strengthens and weakens the pain;
- where the most painful place is located and where pain gives away;
- which features are followed.
Examination and palpation of the abdomen help to objectively evaluate some of the answers. To exclude the pathology of the digestive organs are important:
- blood tests, feces, urine;
- review radiograph;
- ultrasound;
- colonoscopy;
- endoscopic examination with fence material for biopsy.
Diagnosis of diseases of the genitourinary system needs:
- in blood tests, including hormonal composition;
- special urine studies on Nechiporenko, Amburzh;
- bacteriological culture of excreta;
- contrast X-ray techniques;
- ultrasound;
- magnetic resonance and computed tomography.
What should I do if I have pain in the lower abdomen on the right?
First, let's warn about what not to do:
- to apply a heating pad to the stomach, it is better to fill it with cold water or ice, this method will not allow the inflammation to spread on the peritoneum, restricts internal bleeding;
- take analgesics such as Analgin, strong sedatives, drugs have a general effect regardless of localization and greatly alter the symptoms;
- give any medicines to pregnant women;
- to seek out popular ways and spend it for this time;
- delay the call of the "First Aid" and hope that "it will pass by itself".
Women with cyclical menstrual pains are often helped by rectal suppositories with
Acute pain requires the fastest delivery of the patient to the surgery. If gynecological care is needed against the background of pregnancy, the discharge from the uterus begins, the question of directed hospitalization is decided by the ambulance doctor.
If the pain is weak, aching, bursting, you should consult your therapist on your own. Having conducted an initial examination, the doctor will decide whether it is advisable to consult a urologist or gastroenterologist, an oncologist.
Symptoms of pain in the right ileal region are useless to treat independently. They are difficult even for experienced doctors. When you can not refuse medical help. The examination helps identify the cause and choose the treatment.