lower abdominal pain in ibs and other causes such as appendix pain

Lower abdominal pain in ibs is a common symptom .

The pain is often described as a spasm or ‘discomfort’, which can be associated with bloating and trapped wind. It is usually worse in the morning, but can occur at any time of the day, although night time or nocturnal symptoms are unusual.



Sometimes, the pain can be so severe that it can be mistaken for acute abdominal pain of other cause such as appendix pain. It is important to understand the cause for your pain in view of this.

The pain is usually accompanied by a change in bowel habit which is usually diarrhea or constipation, or a combination of the two. The history is usually recurring and needs to be taken in the context of the Rome criteria for IBS .

Other causes of pain should be considered and it is important to seek guidance from your doctor in this situation. I will highlight some of the other causes of abdominal pain here:

Bowel

Acute inflammatory bowel disease (Crohn’s disease, Ulcerative Colitis)

Appendicitis - appendix abdominal pain can start in the left side of the abdomen or midline, localising to the right lower abdomen as symptoms progress. There maybe associated symptoms of nausea, vomiting and fever also associated , but it can be very difficult determine for certain appendix pain so it is important to seek early help from a medical practitioner if you display any of these symptoms.

Cholecystisis (Inflammed gallbladder)- pain in the right upper abdomen radiating through to the back and sometimes the shoulder. Often associated with nausea, vomiting, sometimes change in bowel habit and fever.

Pancreatitis (Inflammed Pancreas) a potentially serious cause of upper abdominal pain, fever, nausea and vomiting. Early advice from a medical practitioner is important here as you need to be examined and treated appropriately.

Ischaemic Colitis (Usually in the elderly)- often diarrhea which can be bloody and associated with abdominal pain, nausea, vomiting and fever. A potentially life threatening condition requiring early medical intervention.

Tumours – Bowel cancer, rare tumours such as carcinoid.

Urinary Tract

Kidney or renal stones

Hydronephrosis (Dilated ureter or urine tube due to various causes)

Tumours

Gynaecological

Mittelschmertz syndrome (Mid-cycle bleeding into the fallopian tube)

Fibroids

Ectopic pregnancy

Endometritis (Inflamm/ed womb lining)

Endometriosis

Vascular

Acute bowel ischaemia (lack of blood flow to the bowel usually due to blood clot)

Portal/Hepatic vein thrombosis

Retroperitoneal bleeding of various cause

Bone/Nerve

Neuropathic pain

Radiation of Hip pain

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The above list is not there to frighten, but to highlight that there are other causes for lower abdominal pain and these should always be considered. Further investigations maybe required. However, IBS symptoms are usually fairly obvious and might not require investigation, but your doctor will be able to advise you in this matter. There are various treatments available for IBS and the symptoms of lower abdominal pain. These may include antispasm drugs such as Mebeverine , Mintec or Colpermin , analgesics and the tricyclic antidepressant drug, Amitriptyline . You might like explore the IBS store which could help in the management of your lower abdominal pain .

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