Lower Abdominal Pain: Symptoms, Causes, and Treatment

Lower abdominal pain, located below the belly button, is a frequent symptom with various possible causes, often linked to the gastrointestinal, urinary, or reproductive systems. The pain can range from mild to severe, sometimes requiring prompt diagnosis and intervention to address underlying conditions. This guide examines the symptoms, common causes, and treatment options associated with lower abdominal pain.

Common Symptoms of Lower Abdominal Pain

Lower abdominal pain can present differently depending on its cause and severity. Common symptoms include:

Sharp or Cramping Pain: The pain may feel dull, sharp, or cramping and can spread to areas such as the back, sides, or groin.

Bloating and Distension: A sensation of fullness or visible swelling, often linked to gastrointestinal issues, may accompany the pain.

Changes in Bowel Habits: Diarrhoea, constipation, or sudden stool changes may indicate digestive problems.

Urinary Symptoms: Painful urination, frequent urges, or discoloured urine are often signs of urinary tract infections (UTIs) or kidney stones.

Nausea and Vomiting: These symptoms may arise due to infections, obstructions, or inflammation in the abdominal region.

Fever: A high temperature can indicate inflammation or infection, such as in appendicitis or diverticulitis.

Potential Causes of Lower Abdominal Pain

Lower abdominal pain may stem from a variety of conditions affecting the gastrointestinal, urinary, or reproductive systems. Common causes include:

Appendicitis: Inflammation of the appendix due to blockage or infection, often causing acute lower right abdominal pain. This condition typically requires emergency surgery.

Gastroenteritis: Viral or bacterial infections leading to stomach and intestinal inflammation can cause cramping pain, diarrhoea, nausea, and vomiting.

Urinary Tract Infections (UTIs): UTIs often present with abdominal pain, painful urination, and frequent urges, commonly triggered by bacteria.

Kidney Stones: Sharp pain in the lower abdomen may occur as stones pass through the urinary tract, often linked to insufficient hydration or high dietary sodium.

Ovarian Cysts: In women, ovarian cysts can cause sudden pain if they rupture or grow large, often linked to hormonal imbalances.

Testicular Torsion: In men, this involves twisting of the spermatic cord, cutting off blood flow and causing severe pain in the lower abdomen and groin.

Conditions Linked to Lower Abdominal Pain

Conditions affecting the colon or rectum are frequent sources of lower abdominal pain, particularly when inflammation, obstruction, or other disruptions occur.

Colorectal Cancer

Early-stage colorectal tumours may be asymptomatic, but as they enlarge, they can cause persistent lower abdominal pain and changes in bowel habits that worsen over time. 

Inflammatory Bowel Disease (IBD)

IBD can cause significant inflammation throughout the digestive tract, leading to severe abdominal pain, chronic diarrhoea, and malabsorption issues that affect overall nutrition. 

Irritable Bowel Syndrome (IBS)

IBS symptoms typically follow a pattern of recurring abdominal pain associated with changes in bowel movements, with many patients reporting worse symptoms during periods of stress or after consuming certain trigger foods.

Diverticular Disease

This includes both diverticulitis and diverticulosis. Diverticulitis causes acute pain when small pouches in the colon wall become infected or inflamed. Chronic diverticulosis can lead to ongoing digestive issues and complications such as bleeding, perforation, or fistula formation if left untreated.

Diagnostic Methods

The evaluation of lower abdominal pain typically involves a combination of clinical assessment, imaging, and laboratory tests to determine the underlying cause.

Physical Examination

During a physical exam, doctors check the abdomen by pressing different areas to locate pain points and identify any unusual masses or swelling. They perform specialised tests like checking for rebound tenderness (pain that worsens when pressure is suddenly released) and assess the abdomen’s appearance for signs like distension or asymmetry.

Laboratory Tests

Blood tests measure white blood cell counts to detect infection, haemoglobin levels to check for anaemia, and inflammatory markers that may suggest conditions like IBD or diverticulitis. Urine analysis helps identify kidney stones, UTIs, or other urinary tract problems through examination of factors like bacteria presence.

Imaging Studies

Ultrasound generates real-time images using sound waves and is especially useful for examining organs such as the appendix, ovaries, and gallbladder. CT scanning provides detailed cross-sectional views of the entire abdomen and pelvis, allowing doctors to diagnose conditions such as bowel obstruction, inflammation, and abscesses.

Endoscopic Procedures

A colonoscopy enables direct visualisation of the entire colon using a flexible scope with a camera, allowing doctors to spot abnormalities like polyps, tumours, or inflammatory changes. Sigmoidoscopy examines the lower portion of the colon and rectum, with both procedures offering the ability to collect tissue samples during examination for accurate diagnosis.

Treatment Options

Management of lower abdominal pain depends on the specific cause and may involve non-surgical or surgical approaches.

Non-Surgical Treatment

Lifestyle Modifications
Dietary adjustments, such as incorporating more fibre, can improve bowel function and reduce the frequency of symptoms in conditions like IBS or diverticular disease. Adequate hydration prevents issues like constipation and kidney stones, while regular exercise supports overall digestive and urinary health. Avoiding known trigger foods, such as spicy or fatty meals, may also help prevent symptom flare-ups.

Medications
Antibiotics are prescribed to eliminate bacterial infections like UTIs or diverticulitis and often provide quick symptom relief. For chronic conditions like IBD, anti-inflammatory medications or immunosuppressants may be used to control inflammation and prevent flare-ups. Pain relievers and antispasmodic drugs are commonly given to manage discomfort and reduce cramping in functional gastrointestinal disorders like IBS.

Surgical Treatment

Appendectomy
An appendectomy is performed to remove an inflamed appendix, a common emergency surgery to prevent rupture or infection. Laparoscopic methods are widely used, involving small incisions that result in less scarring and faster recovery. Early intervention is key, as delaying surgery can lead to complications like peritonitis or abscess formation.

Polypectomy
This minimally invasive procedure removes polyps during a colonoscopy, helping to prevent the development of colorectal cancer. It is typically quick and performed on an outpatient basis, with patients resuming normal activities soon after. If the polyps are found to be precancerous, timely removal reduces the risk of further progression.

Bowel Resection
A bowel resection involves surgically removing a diseased portion of the bowel, which is then reconnected to restore normal function. This procedure is often necessary for conditions like advanced diverticulitis, colorectal cancer, or severe IBD that do not respond to other treatments. 

Colostomy or Ileostomy
In cases where the bowel cannot be reconnected, a colostomy or ileostomy is performed, diverting waste to an external bag through an abdominal opening. This procedure is often temporary, but in some cases, it may be permanent depending on the severity of the condition. 

Prevention of Colorectal Disorders

Prevention of colorectal disorders focuses on lifestyle choices and regular screening. A diet high in fibre and low in processed meats, combined with regular exercise and proper hydration, helps maintain digestive health. Regular colonoscopy screenings starting at age 45, avoiding smoking, and limiting alcohol are also key preventive measures, with earlier screenings recommended for those with a family history of colorectal issues.

Conclusion

Lower abdominal pain can result from various conditions, ranging from minor to serious. Accurate diagnosis and appropriate treatment are necessary for managing symptoms and addressing underlying causes. Preventative measures, particularly for colorectal-related issues, can help maintain long-term digestive health.

If you are experiencing persistent lower abdominal pain or severe symptoms, schedule a consultation today to ensure a proper evaluation and diagnosis.