Female abdominal pain

by Ian
(UK)

My wife has severe abdominal pain 2" below and 2" to the right side of the navel (appendix area, but hers was removed). The pain is deep inside the abdomen. This pain has been present for a few months now. She went to the hospital last week for a check, but all that was carried out was external examination of the abdomen. Urine tests at the doctor have all been clear and a blood test for cancer has been clear so far, though a new sample has been taken for rechecking. After the check at the hospital, the pain has become more severe, probably due to the irritation of the abdomen.

Bladder control can be weak at times, and when passing stools the abdomen is very sore. She feels that her stomach is bloated, but I don't really notice that, but the right side is slightly larger than the left. She has to go back to the hospital for a scan, but this could take several weeks. Any ideas?

Female, severe abdominal pain

Right iliac fossa pain (pain in the lower, right abdomen)has many causes and you can find more information at lower abdominal pain. You dont mention your wifes age as this may influence the sort of diagnosis her doctors are considering. The main causes of pain in this area for a woman can be classified into:

Gynaecological reasons include ovarian cyst, ovarian torsion, ectopic pregnancy, Mittelschmerz syndrome (mid cycle ovulation bleeding causing pain), fibroids, endometriosis, pelvic inflammatory disease, tumours

Renal causes are less likely as urine negative, although not excluded. Consider renal stones, infection, ureteric cysts, hydronephrosis, ureteric and bladder tumours.

Bowel causes include Crohns disease, UC, ischaemic bowel (lack of blood flow to the bowel), tumours (bowel cancer, Carcinoid tumours, rarer tumours), intestinal intersusseption, ibs or irritable bowel syndrome

Vascular causes include Aortic aneurysm leak and infarction

Referred pain can include Back problems causing pain in the abdomen, chest problems, heart disease

Gallbladder, gallstones, liver diseases

Pancreas causes include pancreatitis, tumours

Sorry for the long list, but unless more detail is given as advised i.e. age, past medical history (including operations), drug history and family history it is difficult to narrow down possible diagnoses. The fact that the abdomen is sore when opening her bowels and the weak bladder control maybe significant, although not diagnostic. The scan will be very helpful to either diagnose the problem or at least exclude some of the above causes.