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- Fri Feb 10, 2006 8:41 am
I woke up tuesday feeling hot, no fever, later my stomach was just moving and making all sorts of noise, this lasted all day, on tuesday night I had alot of pressure in rectal area and wednesday morning I woke up with diarrhea, very watery. That lasted a few hours, the rest of the day my stomach was just making noise and movement, thursday I woke up with stomach pain, i figured gas it last all day and night, by thursday night i was able to figure out that pain was coming from my right side just above my pelvis, if i touch the area it hurts, today is friday and the only pain I have is on the right side, should i be concerend or could it be a gass bubble trapped?
| Dr. Tamer Fouad
- Fri Feb 10, 2006 3:21 pm
As I mentioned in another post, when investigating abdominal pain, it is important for the physician to first exclude any serious causes. Those at high risk include, patients above the age of 50 years, those with dysphagia, anorexia with weight loss or persistent vomiting; in addition to those with a palpable mass or those with evidence of GIT hemorrhage (melena, anemia or hypotension) and those presenting with a board-like abdomen. For those cases immediate surgery (laparotomy) or endoscopy may be needed.
Location of abdominal pain is most easily categorized on the basis of embryologic origin. Pain between the umbilicus and the symphysis pubis emanates from hindgut organs (eg, distal one third of the transverse colon, descending colon, rectosigmoid region).
Pain may be diffuse, as in early appendicitis, or crampy and nonradiating, as in ectopic pregnancy. Colon obstruction secondary to colon cancer, diverticulitis, and ureterolithiasis are common causes of pain in this area. Yersinia enterocolitica and Campylobacter sp., may mimic appendicitis and cause right lower quadrant pain, anorexia, low grade fever, and vomiting preceding the onset of diarrhea leading to a syndrome of mesenteric adenitis (lymph node enlargement) and terminal ileitis. The classic presentation of Crohn's disease is that of colicky right lower quadrant pain and diarrhea. Low-grade fever and weight loss are frequently present as well. High fever indicates a possible infectious complication (ie, abscess). Hematochezia occurs in a minority of patients, most often in those with colonic involvement.
In women right lower quadrant pain could be a manifestation of pelvic inflammatory disease, acute salpingitis, ectopic pregnancy, ovarian cysts, abscesses and tumors in addition to the causes listed above. Cancer of the cecum, ileal carcinoid, lymphosarcoma, systemic vasculitis, radiation enteritis, ileocecal TB, and ameboma should be excluded.
The fact that you have other GIT symptoms does raise the probability that your condition is of GIT origin, possibly gastroenteritis. However the fact that you are feeling tenderness in that area warrants a visit to the doctors just to rule out anything serious.