- What causes lower abdomen pain in females?
- Where is lower abdomen pain located?
- What structures can inflame in the lower abdomen in women?
- Causes of pain in the lower abdomen in women
- Ectopic reproductive disorders
- Uterous reproductive disorders
- Urological disorders
- Intestinal disorders
- Neurological disorders
- Diagnosis of the causes of lower abdominal pain in women
- Anamnesis history
- Study of the abdomen
- Examination of the organs of the urinary system
- Intestinal examination
- What to do with pain in the lower abdomen in women?
- Treatment of pain syndrome
- Antibacterial treatment
- Hormonal therapy
- Endoscopic treatments
- Why do women have pain in the lower abdomen on the left side?
- Why do women have pain in the lower abdomen on the right side?
- What are the most common causes of lower abdominal pain in women?
- Causes of pain in the lower abdomen, giving in the foot in women
- Causes of pain in the lower abdomen, giving back to women
- Why can the abdomen hurt during pregnancy?
- Disruption of the bowel
- Gynecological diseases
- Surgical diseases
- Ectopic pregnancy
- Spontaneous abortion
- Premature detachment of the placenta
- Why can there be pulling pain in the lower abdomen in women?
- Inflammatory diseases
- Pain in menstruation
Pain in the lower abdomen in women. Causes of pain in the lower abdomen in women. What to do with these pains?
In women it is a common symptom and is often a problem due to an unclear etiology of origin.
This symptom can be associated with disorders of the urogenital system, as well as with diseases of other body systems, for example, musculoskeletal, neurological or gastrointestinal systems.
What causes lower abdomen pain in females?
What does it mean when you get pain in the bottom of your stomach? The pains in the lower abdomen are most common among women of reproductive age and are observed, as a rule, at the age of twenty-five to thirty years. The manifestation of this symptom affects about one in seven women.
It should be noted that the pain in the lower abdomen may be a sign of a serious illness requiring conservative or surgical treatment. Like any other pain, the pain in the lower abdomen can lead to prolonged suffering of the patient, disability and the development of functional disability.
Where is lower abdomen pain located?
The human stomach is divided into three areas:
- epigastrium (upper floor of the abdominal cavity);
- Mesogastrium (middle floor of the abdominal cavity);
- hypogastrium (the lower floor of the abdominal cavity).
- abdominal part of the esophagus;
- the upper pole of the left and right kidneys;
- thin and large intestine;
- the lower pole of the left and right kidney;
- upper part of ureters;
- terminal ileum;
- loops of the small intestine;
- sigmoid colon;
- the lower part of the ureters;
- the fallopian tubes;
So, in the lower abdomen are the following organs:
- small and large intestine;
- uterine (fallopian) tubes;
Thin and large intestine
The small intestine is the digestive system. It is here that the process of digesting food takes place to a greater degree (chemical and mechanical processing of food).
The small intestine is divided into the following departments:
The large intestine is the final part of the digestive system. In this department, water is drawn from food, and feces are formed.
The large intestine is divided into the following departments:
- the cecum and appendix;
- colon (consists of sub-units: ascending, transverse, descending and sigmoid colon);
The bladder is the organ of the excretory system. It is located in the cavity of the small pelvis, behind the pubic symphysis.
The main functions of the bladder are the accumulation of urine, as well as its excretion through the urethra.
The bladder consists of the following parts:
- bottom part;
- the middle part is the body;
- upper part – top.
At the top of the vesicle enter the ureter, and below it passes into the urethra. At the inner opening of the urethra, the muscle bundles form a sphincter ring. It is he that allows you to hold urine in the bladder.
The uterus is the female internal sex organ, which is designed for fetal development.
This organ is located in the cavity of the small pelvis, between the rectum and the bladder.
Uterus consists of the following parts:
In the upper corners, the uterine tubes open into the uterine cavity. At the bottom, the uterus narrows into the cervical canal, which connects the organ to the vagina.
Cervix is a narrow part of the uterus, consisting of the vaginal and supravaginal parts. In the cervix, the cervical canal is located, inside of which there is a mucous plug, which prevents the entry of microbes from the vagina into the uterine cavity.
The wall of the uterus consists of the following layers:
- endometrium (mucous layer, which is partially separated during menstruation, which leads to bleeding);
- myometrium (formed by three layers of smooth muscle fibers);
- perimetry (peritoneum covering the uterus).
The length of the uterus in a woman is seven to nine centimeters. The weight of the uterus in nulliparous women varies from forty to fifty grams, in those giving birth – from eighty to ninety grams.
The fallopian tubes
Begin at the sides of the upper corners of the uterus and connect it with the abdominal cavity. The main function of the fallopian tubes is to create conditions for the promotion
sperm to the egg, and, when fertilization, ensuring its passage into the uterine cavity.
In the fallopian tube, the following parts are distinguished:
In the enlarged part of the fallopian tube (ampullar) is the fertilization of the egg. Then the formed zygote moves along the tube, thanks to its peristaltic movements and cilia, which are present on the mucous layer of the organ.
Are paired sex glands. Located on the sides of the uterus, behind the broad ligaments.
Ovaries perform the following functions:
- formation and maturation of female sex cells;
- development of sex hormones (estrogen, progesterone, androgens).
Ovaries are composed of:
- cortex, which contains the primary follicles, yellow bodies;
- Brain substance, which consists of a connective tissue containing vessels and nerves.
In the ovary, physiological processes occur monthly, which are characterized by the maturation of the follicle and the ovum. In the middle of the menstrual cycle, the follicle bursts and an egg leaves it. At the site of the ruptured follicle, a yellow body is subsequently formed.
There are two phases of the ovarian cycle:
- the first phase is follicular, characterized by the development and growth of the follicle and the production of the hormone estrogen;
- the second phase is luteal, characterized by the development of the yellow body and the production of the hormone progesterone.
The pelvis serves as a receptacle for internal organs. It consists of two pelvic bones, sacrum and coccyx. The pelvis is divided into two divisions – a large and small pelvis.
The following organs are located in the female pelvis:
- the fallopian tubes;
In women, the pelvis is the birth canal, which during childbirth the fetus is advancing. During of pregnancy with the help of a tasometer (special tool with a centimeter scale) you can measure the size of the pelvis (pelviometry).
The results of measurement of the external pelvic bones further help to predict the birth in a natural way.
The female pelvis is wider and more flat in comparison with the male one. The volume of the pelvic cavity of women is also greater.
What structures can inflame in the lower abdomen in women?
Pain in the lower abdomen can be caused by the defeat of the following organs and structures:
- internal genitalia (vagina, cervix, uterus, fallopian tubes, ovaries);
- small intestine (ileum);
- large intestine (caecum, appendix, sigmoid colon and rectum);
- muscles of the pelvis (pear-shaped muscle);
- sciatic nerve;
Causes of pain in the lower abdomen in women
The pain in the lower abdomen in women can be caused by various disorders.
The pain in the lower abdomen in women can be related to:
- ectopic reproductive disorders;
- uterine disorders;
- urological disorders;
- intestinal disorders;
- neurological disorders.
Ectopic reproductive disorders
Ectopic reproductive disorders include diseases and pathological conditions of such genital organs as the vagina, fallopian tubes and ovaries.
The main clinical manifestations of gynecological diseases are:
- pains in the lower abdomen (intensified before menstruation);
- violation of the menstrual cycle;
- leucorrhea (often mucopurulent);
- itching in the perineum (in the inflammatory process);
- general fatigue and weakness;
- frequent urination.
Ectopic reproductive disorders include:
- adhesive disease;
- ovarian cyst;
- ectopic pregnancy;
- salpingitis and salpingo-oophoritis (adnexitis);
- residual ovarian syndrome;
- ovulatory syndrome;
Disease characterized by pathological proliferation of endometrial cells beyond the mucous layer of the uterus. They can grow in the genitals, for example, fallopian tubes or ovaries (genital endometriosis) or in other organs, for example, the intestine (extragenital endometriosis).
Since these endometrial cells are susceptible to hormones, they undergo identical changes every month, as in the endometrium of the uterus, which is manifested by bleeding. Regular bleeding leads to the fact that the inflammatory process develops in the nearest tissues. In most cases, endometriosis is seen in women of reproductive age. Initially, a woman has periodic pain in the abdomen before the onset of menstruation.
Subsequently, the pain begins to be permanent. Also, pain can appear during intercourse, with urination and defecation (in the late stages of the disease). A woman has a disorder of the menstrual cycle and a change in the character of the menstrual flow, which may be manifested by their scarcity or, on the contrary, abundance. It should also be noted that in women with endometriosis, infertility is observed.
With poor hygiene or sexually transmitted diseases, a bacterial infection can enter the internal sexual organs.
Penetrating bacteria germinate in a warm, moist environment of the vagina, inflammation, pain, and discharge. If a bacterial infection in the vagina is not treated in a timely manner, it can spread to neighboring organs. Thus, for example, bacteria enter the cavity of the uterus through the cervix, fallopian tubes, ovaries and other organs (bladder, intestine, pelvic wall).
In the fallopian tubes and ovaries, the inflammatory process contributes to the formation of adhesions. Spikes, in turn, can completely cover the lumen of the fallopian tubes, so that the egg can not enter the uterine tube.
As a result, infertility develops when the sperm does not reach the oocyte. If the egg enters the tube, there is a risk of developing an ectopic pregnancy, when the embryo begins to grow in the fallopian tube and the woman needs emergency medical care. Endometriosis and surgical interventions (eg, abortion, scraping) can also contribute to the formation of adhesions in the fallopian tubes and ovaries.
In the presence of adhesions, a woman may have the following symptoms:
- irregular pain in the lower abdomen of the aching nature.
It should be noted that the adhesions can be asymptomatic. Violation of menstrual function in women is not observed, and the main complaint when referring to a doctor is infertility. That is why, as a rule, this disease is detected accidentally with ultrasound (ultrasound).
A cyst is a cavity formation filled with fluid or blood. Ovarian cyst is divided into functional and non-functional. The functional cyst (follicular cyst, yellow body cyst) resolves itself or under the influence of hormonal drugs. The non-functional cyst (for example, parovarial, dermoid cyst) is removed only through surgical intervention. T
he cause of cyst development in most cases is a hormonal imbalance in the body of a woman. A woman can complain about:
- Stretching pains in the lower abdomen (usually on one side);
- violation of the menstrual cycle (frequent or rare menstruation);
- change in the nature and quantity of bloody discharge during menstruation (may be meager or abundant).
With such complications as torsion or suppuration, cysts of pain become pronounced, body temperature rises, nausea and vomiting occur.
In ectopic pregnancy, the implantation and development of the embryo is observed outside the uterine cavity, for example, in the fallopian tube (most often), the ovary, the abdominal cavity.
The causes of the development of ectopic pregnancy can be diseases of internal genital organs (for example, with the development of adhesions in the fallopian tubes), abortion, underdevelopment of the fallopian tubes. Pipe pregnancy terminates in the period from two to three to ten to twelve weeks.
Interruption of pregnancy can be carried out by the type of tubal abortion or rupture of the tube. Initially, the symptoms of an ectopic pregnancy are no different from a normal pregnancy (for example, nausea, changes in appetite, sensitivity and enlargement of the mammary glands).
When the fallopian tube ruptures, the woman experiences sharp pains in the lower abdomen (can give in the anus, hypochondrium, right shoulder or shoulder blade), weakness, dizziness, spotting, lowering of blood pressure, increased pulse and pale skin.
Salpingitis and salpingo-oophoritis (adnexitis)
Salpingitis is an infectious and inflammatory disease of the fallopian tubes.
Very often, in this disease, the ovaries (salpingo-oophoritis) are additionally involved in the pathological process.
The causes of development of salpingitis and salpingo-oophoritis are:
- penetration into the fallopian tubes of pathogenic microflora (ascending or hematogenous pathway);
- intrauterine interventions (eg, scraping, abortion, hysteroscopy, establishment or removal of the intrauterine device).
The acute form of salpingitis and salpingo-oophoritis is manifested by the following symptoms:
- absence of menstruation;
- pain in the lower abdomen (can give in the rectum and sacrum);
- increased body temperature;
- seborrheic-purulent discharge;
- painful sensations during intercourse;
- frequent and painful urination.
With the chronic form of the disease, the general condition of the patient improves, but the pain in the lower abdomen persists.
Residual ovarian syndrome is observed in the case of incomplete removal of ovarian tissue during bilateral or unilateral oophorectomy (removal of the ovary). The main complaint with residual ovarian syndrome is the lower abdominal pain on one or both sides.
Characterized by the manifestation of symptoms during the period of ovulation, that is, the release of the oocyte from the follicle. This syndrome is not observed in all women. The exact cause of ovulatory syndrome is not revealed.
It is believed that its appearance may be due to the fact that when the body breaks the follicle, the blood enters the small pelvis and irritates the peritoneum. It is also believed that the syndrome can trigger the presence of a woman’s adhesions in the fallopian tubes and ovaries.
The main symptom in women with ovulatory syndrome is lower abdominal pain localized on one side (depending on where ovulation has occurred). In addition, there may be weakness, nausea, spotting in a small amount, as well as pain during sexual intercourse.
It is characterized by inflammation of the mucous layer of the vagina.
The reasons for the development of vaginitis are:
- Sexually transmitted diseases (eg, gonorrhea, chlamydia);
- hormonal disorders (eg, menopause, obesity);
- violation of the integrity of the mucous layer of the vagina due to gynecological manipulations (for example, taking a smear, performing douching);
- allergic reactions (for example, to hygiene products, condom material);
- violation of hygiene.
With vaginitis, the woman may experience the following symptoms:
- discharge with an unpleasant odor and in an increased quantity;
- itching and pain in the vagina;
- aching pain in the lower abdomen;
- edema and redness of the vaginal mucosa and external genitalia;
- discomfort during sexual intercourse;
- burning during urination.
Uterous reproductive disorders
Uterine reproductive disorders include:
- adenomyosis (genital endometriosis);
- uterine myoma;
- polyps of the uterus;
- stenosis of the cervical canal;
- genital prolapse;
- incorrectly selected intrauterine device.
Disease characterized by proliferation of the endometrium in the muscular layer of the uterus (myometrium).
There are four stages of adenomyosis:
- at the first stage of the endometrium penetrates into the intermediate tissues;
- at the second stage of the endometrium penetrates into the muscle layer less than half;
- the third stage of the endometrium penetrates more than half;
- at the fourth stage permeates the entire muscle layer and enters the abdominal cavity.
The reasons for the development of adenomyosis can be hormonal disorders, curettage of the uterine cavity, hereditary predisposition, and the use of an intrauterine device. In adenomyosis, a woman is disturbed by regular pains in the lower abdomen, as a rule, they are observed before and during menstruation, and also during intercourse. In addition, a characteristic feature of this disease are abundant menstrual bleeding and bloody intermenstrual secretions.
A woman has a menstrual cycle and infertility. The shape of the uterus changes, acquiring a round or spherical appearance.
This disease is characterized by inflammation of the endometrium, that is, the mucous layer of the uterus. The endometrium plays an important role in the uterus. During each menstrual cycle, this layer is formed anew, its thickness increases.
Thickening of the layer is due to the fact that the endometrium is preparing to take a fertilized egg. If fertilization does not occur, the endometrium is separated and in the process of menstruation is released in the form of bloody discharge. In the case when infectious agents enter the uterus through the genital tract or through the hematogenous pathway (through the blood), an inflammatory process develops.
These changes in the endometrium lead to a violation of menstrual and reproductive function. Predisposing factors for the development of endometritis can be avitaminosis, the establishment of an intrauterine device, scraping, as well as impaired personal hygiene. Endometritis can be acute and chronic. In acute disease, a woman experiences fever, abdominal pain, bleeding, or inadequate discharge (turbid with an unpleasant odor).
When palpating, the uterus becomes compacted, as well as its soreness. If the acute form is not appropriate treatment, the disease becomes chronic. At this period, the symptoms subsided, and a woman usually has irregularities in the menstrual cycle, minor discharge and painful sensations of a noisy character in the lumbar region.
Myoma of the uterus
The wall of the uterus has three layers, the inner – the endometrium, the middle – the muscular and the outer – the serous. The development of a benign tumor from the muscular tissue of the uterus is called the myoma of the uterus. The main cause of this disease is hormonal imbalance (predominance of estrogens). By the number of nodes formed, the myoma can be single or multiple.
Depending on the layers, the myoma can develop in the following areas:
- close to the mucous layer of the uterus – submucous myoma;
- in the muscle layer – interstitial or intramural myoma;
- under the outer layer – subserous myoma.
Depending on the layers, the myoma can develop in the following areas:
- close to the mucous layer of the uterus – submucous myoma;
- in the muscle layer – interstitial or intramural myoma;
- under the outer layer – subserous myoma.
The manifestation of symptoms of uterine fibroids largely depends on the location of the myomatous node. With submucosal myoma, painful sensations in the lower abdomen and menstrual bleeding are predominant.
With the progression of the disease, bleeding becomes more abundant, which can subsequently lead to the development of anemia in a woman. With intramural or subserous myoma, the pain syndrome predominates.
Pain of a cramping character, observed in the lower abdomen and strengthened during menstruation. It should be noted that over time, the growth of fibroid leads to the development of infertility, as well as to compression of neighboring organs (rectum and bladder), which leads to disruption of their work.
This disease is characterized by a lesion of the vaginal part of the cervix.
The cervix is an obstruction to the protective uterus and its appendages from the infectious agents entering them. However, with the development of the inflammatory process in this section of the uterus, the protective function is reduced, which can subsequently lead to the spread of infection to the overlying organs.
Cervicitis is divided into exocervicitis (lesions of the vaginal part of the cervix) and endocervicitis (damage to the mucous layer of the cervical canal).
This disease can lead to the development of complications such as an increase in the size (hypertrophy) of the cervix, erosion of the cervix, the spread of infection to the upper genitalia (uterus, appendages of the uterus). In the initial stage, the disease can often occur asymptomatically. The early sign of cervicitis is a change in the nature and amount of secretions. With the progression of the disease, a woman may experience menstrual bleeding, abdominal pain, burning during urination, and painful sensations and spotting during or after intercourse.
Polyps of the uterus
This is a benign process that manifests itself in the growth of the basal layer of the endometrium.
That is, in the uterus cavity outgrowths are formed from the mucous layer, which can be from a few millimeters to several centimeters in size.
By their structure, polyps can be:
- fusiform (formed from glandular tissue);
- fibrotic (formed from connective tissue);
- glandular fibrous (mixed);
- adenomatous (formed from glandular tissue with a high risk of cancer).
The reason for the development of polyps is most often a change in the hormonal background in a woman (an excess of estrogens and a deficit of progesterones). In addition, the causes may be surgical interventions, scraping the uterine cavity, infectious and inflammatory processes in the internal genital organs.
Among the symptoms, menstrual irregularity comes first. So, for example, a woman may have intermenstrual bloody discharge, bloody discharge after sexual intercourse, heavy bleeding during menstruation.
Regular blood loss eventually leads to the development of anemia in a woman, which will manifest pallor of the skin and weakness. In addition, uterine polyps are characterized by pain in the lower abdomen of the pulling character, regardless of the menstrual cycle. It should also be noted that this disease can lead to infertility or to violations of pregnancy (for example, miscarriage, premature birth).
Dysmenorrhea is a painful menstruation. Allocate primary and secondary dysmenorrhea. Primary occurs in girls after one to three years from the beginning of menstruation.
The main cause of the development of dysmenorrhea has not yet been identified. It is believed that a certain role in its occurrence is played by underdevelopment of the genital organs, as well as the production of prostaglandins, which cause painful spastic contractions of the uterus.
Secondary dysmenorrhea appears in women of reproductive age, and its development is associated with diseases of internal genital organs (for example, inflammatory diseases, endometriosis, uterine myoma).
Characterized by the appearance of pain of a different nature (pulling, sharp, cutting), which appear one to two days before the start of menstruation or directly on the day of menstruation. Pain can be given in the rectum, perineum or lower back. Intense pain can be accompanied by dizziness, nausea, vomiting, loss or loss of appetite.
Stenosis of the cervical canal
The cervical canal is the cervical canal that connects the vagina to the uterine cavity. Stenosis of the canal is characterized by its pathological constriction. Can be congenital and acquired. Acquired stenosis can develop due to the infectious process of the cervix, surgical interventions (for example, scraping the uterus, abortion), cervical cancer.
A woman may have amenorrhea (absence of menstruation), dysmenorrhea, bleeding during menstruation, and infertility. In women in menopause (period after the termination of menstruation), as a rule, there is an asymptomatic course.
The ligamentous apparatus (muscles, fasciae and ligaments) normally provides the correct position of the uterus, fallopian tubes and ovaries in the small pelvis. In cases of disorders in the ligamentous apparatus, the female experiences the omission of the internal genital organs before the entry of the vagina or their fall out of the vagina. The most common genital prolapse occurs in older women.
Genital prolapse can develop due to the following reasons:
- numerous genera;
- postpartum trauma (eg, perineal rupture);
- increased intra-abdominal pressure;
- defeat of the pelvic floor due to injuries;
- violation of the production of sex hormones (estrogen deficiency).
The main symptoms of genital prolapse are the sensation in the vagina of a foreign body and the pain of a pulling character in the lower abdomen and in the lower back. It should be noted that with prolapse there is a disruption of the work of nearby organs (bladder, rectum).
So, for example, a woman has urinary disorders (acute retention or urinary incontinence) and defecation (constipation).
These disorders are subsequently a predisposing factor for the development of infectious inflammatory processes in the affected organs.
Incorrectly selected intrauterine spiral
The intrauterine device is an intrauterine contraceptive. This tool is a plastic device with copper, silver or hormones. The establishment and selection of a spiral is made individually, by a doctor-gynecologist.
Symptoms such as abdominal pain, menstrual bleeding or amenorrhea can be observed due to adaptation of the body to a foreign body, either because of improper installation or incorrect selection of an appropriate spiral size.
Pain in the abdomen with pathologies of the urinary system can be associated with the defeat of organs such as the kidneys, ureters, bladder, and urethra.
Urological disorders include such pathologies as:
- urolithiasis disease;
- a tumor of the bladder.
Disease, which is manifested by the formation of stones (different in structure and composition) in the organs of the urinary system. As a rule, stones form in the kidneys, but they can also be found in other urinary organs, for example, in the ureters and bladder. In some cases, stones can be formed in an isolated manner in the bladder. As a rule, this is due to the presence of an obstruction to the outflow of urine.
Risk factors for urolithiasis are:
- insufficient fluid intake;
- metabolic diseases (eg obesity);
- deficiency or excess of calcium in the body;
- excessive consumption of salt and meat;
- insufficient intake of fruits and vegetables;
- low-active lifestyle.
The main manifestation of urolithiasis is renal colic. This condition is associated with a violation of the outflow of urine due to obstruction (obstruction) of the urinary tract by concrement (stone). This leads to an increase in pressure in the urogenital system and overgrowth of the capsule of the kidney, which causes a pronounced pain syndrome in the lower back. Pain can spread to the lower abdomen due to a stiffening of the calculus in the ureter or, on the contrary, because of its progress.
The duration of pain is varied – from several minutes to several days. With renal colic, the patient may also experience a rise in body temperature, nausea, vomiting, the appearance of blood in the urine.
This disease is characterized by inflammation of the bladder due to the infiltration of an infectious agent (eg, E. coli, staphylococcus). Pathogenic microorganisms, hitting the organ, affect its inner layer, causing the patient to develop a false urge to urinate and a burning sensation.
Cystitis can be primary and secondary. When primary cystitis is directly affected by the bladder pathogenic microorganisms.
Secondary cystitis develops due to existing diseases of the bladder (for example, urolithiasis) or other genitourinary organs (for example, kidneys, urethra). With cystitis, the following symptoms can occur in a woman:
- frequency of urination (up to twenty times a day);
- pain at the end of urination (can give to the area of the rectum);
- pain in the lower abdomen of the aching nature;
- blurred urine;
- increased body temperature;
- weakness and malaise.
Tumors of the bladder
Tumors of the bladder are divided into benign and malignant. Benign, in turn, includes epithelial (eg, polyps) and non-epithelial (eg, fibromas, hemangiomas, leiomyomas) tumors.
Malignant tumors include cancer and sarcoma.
The causes of the bladder cancer have not been established to date.
It is known that the factors that increase the risk of its development are hereditary predisposition, the effect on the body of carcinogens, inflammatory diseases of the bladder (for example, cystitis), as well as diseases that disrupt the outflow of urine (for example, urolithiasis).
In the early stages of a tumor, the bladder can be asymptomatic. Later, women begin to appear signs such as the presence of blood in the urine (hematuria), painful urination, and suprapubic pain.
If the tumor grows close to the ureters or urethra, it can disrupt the outflow of urine from the urinary tract. As a result, these changes can lead to the development of pyelonephritis, as well as chronic renal failure.
Pain in the lower abdomen can occur when the following sections of the small and large intestine are affected:
- ileum (lower part of small intestine);
- the cecum (the initial section of the large intestine);
- appendix (appendix);
- sigmoid colon (subcollectomy of the colon);
- rectum (end section of large intestine).
Intestinal disorders include:
- nonspecific ulcerative colitis;
- Crohn’s disease;
- intestinal obstruction;
- chronic constipation;
- irritable bowel syndrome;
- diverticulosis of the large intestine;
- polyps of large intestine;
- cancer of the large intestine.
Nonspecific ulcerative colitis
Chronic disease characterized by inflammation of the large intestine followed by ulcerative lesions of its mucous layer. The disease almost always begins with a lesion of the rectum and then spreads to other parts of the colon.
The exact cause provoking the development of this disease has not been revealed to date. However, it is known that its appearance is influenced by negative factors of the environment, as well as infectious, genetic and immunological factors. As a rule, the manifestation of the disease begins gradually. Periodically, exacerbations alternate with asymptomatic periods. The initial signs of ulcerative colitis can be bleeding from the rectum.
The patient may have a formed or loose stool with an admixture of mucus and blood. Also, abdominal pain is noted more often in the left ileal region (lower abdomen on the left), fever, loss of appetite and body weight.
A disease manifested by an inflammatory lesion of the gastrointestinal tract in any of its departments. In the affected area, formation of infiltrates of inflammatory nature and ulcers that can bleed and lead to perforation of the intestinal wall is observed.
With an acute onset, the clinical picture of the disease may resemble a picture of acute appendicitis. The patient has a general malaise, fever, severe abdominal pain (the localization of pain depends on the area of the lesion).
Intestinal obstruction Syndrome, manifested by a violation of the passage of intestinal contents through the gastrointestinal tract. Intestinal obstruction can be congenital due to the absence of the small and large intestine or acquired.
Acquired intestinal obstruction develops against the background of:
- inflammatory diseases of the abdominal cavity (for example, appendicitis, cholecystitis, pancreatitis);
- injuries and surgical interventions on the organs of the abdominal cavity;
- an attack of renal colic;
- thrombosis of intestinal vessels;
- consumption of abundant food;
- helminthic invasions;
- scars formed after the healing of ulcers;
- infringement of intestinal loops.
Characterized by the sudden appearance of cramping pain in the abdomen. As a rule, pain is not localized in one area, but is diffuse (the umbilical region and the lower abdomen). In this period, patients are restless, take a forced position in bed (bent in the embryo posture) to reduce the severity of pain or rush. Painful sensations can be accompanied by vomiting and bloating. In most cases, with intestinal obstruction, patients experience stool and gas retention. However, in the case of incomplete occlusion of the lumen of the gut, a small amount of fecal matter can be observed.
Constipation is called stool retention for more than forty-eight hours. In this case, the patient has a violation of intestinal peristalsis.
The reasons for the development of constipation can be:
- nutritional factor (eg, inadequate intake of fiber and liquid);
- irritable bowel syndrome;
- presence in the intestines of adhesions, tumors, polyps (mechanical obstruction);
- diseases of the abdominal cavity (for example, cholecystitis, peptic ulcer, appendicitis);
- sedentary lifestyle (including patients with bed rest);
- neurological disorders (eg, neuritis);
- inflammatory bowel disease (eg, ulcerative colitis);
- endocrine diseases (eg, hypothyroidism, myxedema);
- pregnancy and menopause.
The signs of constipation are:
- complete absence of stool;
- regular emptying of the intestine in a small amount (the so-called fragmentary stool);
- regular stools that do not bring relief and sensation to the emptied bowel;
- the release of gases, mucus, blood without feces.
Stool retention provokes the development of a person feeling a bursting of the abdomen, a pain in the abdomen of a blunt character (in the navel and lower abdomen), false urges to defecate. With constipation, there may be a small amount of hard stool that does not relieve the patient.
Irritable Bowel Syndrome
This is a chronic disruption of the operation of the large intestine, characterized by a violation of its peristalsis. Normally, the muscular wall of the large intestine is rhythmically contracted, which allows the contents of the intestine to move toward the rectum. At this time, the large intestine absorbs water and nutrients from the partially ingested food.
Unnecessary material, called a stool, accumulates in the rectum until it is expelled during an act of defecation. With irritable bowel syndrome rhythmic contractions of the intestinal wall are violated. The reasons leading to abnormal bowel reduction, for today it is not revealed.
However, it is known that with this syndrome the intestine can be especially sensitive to such factors as stress, lack of sleep and inadequate nutrition.
The main symptoms in this syndrome are the alternation of constipation in the patient and a loose stool. As it was already said earlier, with irritable bowel syndrome its peristalsis is broken. In some cases, when the bowel movements move the food lump too quickly, the water does not have time to suck in the intestine. This disorder leads to the appearance of a patient’s watery stool (diarrhea). In other cases, bowel movements move food too slowly. As a result, too much water is absorbed from the food, which eventually leads to the formation of a tight stool and constipation in a person.
Also, the patient with irritable bowel syndrome, there are pains and a feeling of discomfort in the abdomen, swelling, secretion of gases, and spasms.
Diverticulosis of the large intestine
Disease characterized by the formation in the wall of the intestine of saccular protrusions, that is, the diverticulum. As a rule, diverticulosis develops in the descending colon and sigmoid colon.
The causes of this disease are chronic constipation, obesity, flatulence, as well as uncontrolled intake of laxatives. These factors provoke an increase in pressure in the intestines, which eventually leads to a decrease in the elasticity of the intestinal wall and the subsequent protrusion of its areas. In the initial stages, diverticulosis can be asymptomatic.
However, with the progression of the disease, the patient has abdominal pains that are localized most often in his left side. There is also a disturbance of the stool (constipation or diarrhea) and flatulence.
It should be noted that in case of accumulation of fecal masses in the diverticulum, an inflammatory process (diverticulitis) may develop. The patient will then have an increase in body temperature, severe abdominal pain, flatulence, and the presence of mucus and blood in the stool.
Polyps of the large intestine
The growths that are formed from the glandular epithelium of the large intestine. Are precancerous condition. In most cases, their growth is observed in the colon and rectum. Polyps can be on a thin and thick stalk, single and multiple (polyposis).
Their sizes can vary from a few millimeters to several centimeters. The exact cause leading to the development of polyps in the large intestine has not been revealed to date. Initially, polyps of the large intestine do not manifest themselves in any way and are found by chance during examination. With the progression of the disease (increase in growth and the number of polyps), feces begin to injure the polyps, and the patient has intestinal bleeding.
Also, the patient may have pain in the formation of polyps, stool (diarrhea and constipation) and the development of anemia.
The exit of the internal organs covered by the peritoneum through the weak points of the aponeurosis (tendon plate) is called a hernia. Hernias can go out through the natural (for example, umbilical or inguinal ring) or pathological (false-formed) openings.
The most common hernia is located on the anterior abdominal wall, as well as in the inguinal and femoral rings. They can be congenital (malformations) and acquired. The cause of development of the acquired hernia is an increase in intra-abdominal pressure. This can contribute to such factors as, for example, lifting weights, regular constipation, coughing with lung diseases, obesity, pregnancy and ascites (accumulation of fluid in the abdominal cavity).
The development of a hernia occurs gradually. Initially, a person with increased physical exertion, running, lifting the severity in the area of hernia formation experiences painful sensations of tingling character. Then, with progression, the hernia begins to bulge with physical exertion and disappear when the person is at rest. It should be noted that with refractory hernia pain is of a periodic nature, and in case of unrecoverable – permanent.
A disease characterized by an inflammation of the appendix. Appendicitis can be acute and chronic. Acute, in turn, is catarrhal (simple), destructive (for example, phlegmonous) and complicated (for example, peritonitis, sepsis).
Appendicitis can develop due to stagnant phenomena in the caecum, helminthic invasion, chronic inflammatory diseases. The patient has acute pains that are localized initially in the epigastric region, and after a few hours are concentrated in the right ileal region (the lower abdomen on the right). Painful sensations can be given to the right inguinal region and the right leg.
The patient also has nausea, vomiting, fever, stool and gas retention.
Cancer of the large intestine
Malignant colon tumor, the source of which are the cells of the mucous membrane lining the large intestine. The tumor can sprout into the wall of the intestine or protrude into its lumen (exogenous and endogenous).
The tumor, as a rule, is localized in the following sections of the large intestine:
- sigmoid colon;
There are the following predisposing factors contributing to the development of colon cancer:
- hereditary predisposition;
- intestinal diseases (eg, polyps, colitis);
- chronic constipation.
In the early stages of the disease, as a rule, is asymptomatic. Later, the patient has intestinal bleeding, a violation of the stool (constipation alternates with diarrhea), pain in the lower abdomen on the left (if the tumor is localized in the sigmoid or rectum) of a dull and aching character.
Also, with cancer of the colon, the patient has blood in the feces, impurities of pus and mucus are possible. There is meteorism and tenesmus (false urge to defecate). With the progression of the disease, the patient begins to lose body weight, there is weakness and pallor of the skin.
To neurological disorders that can lead to the development of pain in the lower abdomen, you can refer:
- pear-shaped muscle syndrome;
- lesions of the lumbar plexus and its branches.
Pear-shaped muscle syndrome
Pear-shaped muscle is a deep pelvic muscle that is located under the gluteus maximus muscle. It begins from the inside of the sacrum and moves to the large trochanter of the femur. In cases of spasm of this muscle, infringement and irritation of the sciatic nerve (under the pear-shaped muscle) occurs.
The sciatic nerve, in turn, is the longest nerve in the human body. With spasm of the muscle, the nerve is clamped, which leads to the development of severe pain in the buttock and thigh in a person. Painful sensations at the same time give into the inguinal region and the back surface of the leg. The pain is aggravated by the movements of the foot, as they contribute to the tension of the affected nerve.
Lesions of the lumbar plexus and its branches
Pain in the lower abdomen can be caused by the defeat of the following nerves of the lumbar plexus:
- ilio-hypogastric nerve (provides innervation of the lower parts of the rectus abdominis);
- ilio-inguinal nerve (provides innervation of the transverse and internal oblique muscles of the abdomen);
- femoral-genital nerve (provides innervation of the skin of the upper thigh, in women innervates the skin of the labia majora, as well as the round ligament of the uterus).
These nerves can be affected during operations on the pelvic organs, as well as during hernia repair. With the defeat of these nerves, the woman has pronounced painful sensations.
The localization of pain will depend on which nerve is affected. So, for example, if the iliac-hypogastric nerve is damaged, the woman will have pain in the lower abdomen. When the ileo-inguinal nerve is damaged, painful sensations appear in the lower back, the groin area and the inner surface of the thigh. With lesion of the femoral-genital nerve, pain is observed in the lower abdomen, in the groin area, and also on the inner surface of the thigh.
Diagnosis of the causes of lower abdominal pain in women
To identify the diseases that provoked the development of pain in the lower abdomen, the following diagnostic methods are used:
- anamnesis collection;
- examination of the abdomen;
- a study of blood.
Depending on the location of the pathological process, the following studies can be assigned to a woman:
Because of the complex etiology of pain in the lower abdomen, the doctor needs to make a general approach to the patient and carefully collect the anamnesis. The collected information will subsequently allow further assessment of existing complaints and appoint appropriate consultations as necessary.
The doctor needs to ask the patient specific questions, allowing a detailed review of reproductive, musculoskeletal, urological, and neuropsychiatric systems.
It is necessary to find out whether the woman has treated the pain in the abdomen for medical help before, and if so, whether the studies were assigned and what results were obtained. This information can help to avoid re-appointment of aggressive and expensive procedures.
With pains in the lower abdomen, the woman needs to specify:
- when and how pain began;
- with what the patient connects them;
- how they developed (gradually or suddenly);
- whether any treatment was carried out and how effectively.
During the interview, the doctor should pay attention to the following key aspects of pain:
- The location of pain
The location of the pain is an important information that needs to be clarified during the collection of an anamnesis. For clarification, you can ask the patient to mark its location in the picture with the image of the human body (anteroposterior and lateral view of the person in the picture).
- Provoking factors
Questions should be asked about factors that provoke or intensify the pain in the lower abdomen. This can help to identify the alleged causes of pain and related disorders. So, for example, with endometriosis, the pains in the lower abdomen usually appear during or after sexual intercourse.
- Weakening factors
Here, it is necessary to find out whether there are factors contributing to the easing of pain. For example, rest can reduce the pain of locomotor or sexual origin.
- The nature of pain
Various terms can be used to describe the nature of pain in a patient. The definition of pain can include pulsating, shooting, pricking, stitching, cutting, drawing, burning, clammy and dull pain.
- The spread of pain
In the study of the causes of pain in the abdomen, it is important to find out whether the woman has a spread of painful sensations (for example, the entire abdomen), as well as their irradiation (for example, in the lumbar region, thighs, inguinal region). This information is of particular importance in assessing neuropathic pain.
- Intensity of pain
It is recommended to use rating systems to determine the severity of pain. The most informative and reliable way to assess the severity of pain are numerical scales. So, for example, a doctor can ask a patient to estimate the pain intensity on a scale of one to ten, where ten is a very severe pain, and one is a very weak, aching pain.
Further it is necessary to obtain information about the various systems of the body and the available possible disorders.
- type of menstruation (duration, periodicity, intensity, presence of pain);
- whether there are profuse bleeding during menstruation (you can assume uterine myoma or adenomyosis);
- secretory function (amount of secretions, color, admixture of blood, odor);
- Whether operations on bodies of a small basin were carried out (it is possible to offer intra-abdominal or pelvic adhesions);
- patients with cervical stenosis, as a rule, have chronic cervical infection in the history or treatment with cryodestruction, laser surgery;
- presence of several sexual partners (is a risk factor for the development of pelvic inflammatory disease).
- whether the raised frequency of an emiction is observed (it is possible to assume a cystitis);
- whether there are painful sensations during or after urination;
- whether there were episodes of urinary incontinence.
- regularity of stool;
- character of the chair (liquid, tight);
- Whether the bloating worries;
- whether there is a discharge of blood with feces (it is possible to assume such diseases as polyps, ulcerative colitis, colon cancer);
- whether there is a nausea, vomiting.
- whether there is a constant burning pain (occurs in patients with neuralgia);
- Whether the sharp pain at movement by a leg, in position sitting or during walking worries.
Study of the abdomen
It allows to reveal a number of pathological processes in the organs of the small pelvis and the abdominal cavity, and also to carry out differential diagnostics between diseases of the sexual and adjacent organs of the small pelvis.
First of all, the doctor examines the patient’s stomach, how symmetrical it is, whether hernial protrusions are present. Then palpation is performed sequentially along the topographic areas of the abdomen. The painful part of the abdomen is palpated in the last place.
When palpating the abdomen, the doctor assesses the degree of tension in the muscles of the anterior abdominal wall, as well as its soreness.
In the study of blood, a woman can be assigned a general and biochemical blood test.
A general blood test allows you to examine blood cells (erythrocytes, platelets, leukocytes), their parameters, hemoglobin level, leukogram and erythrocyte sedimentation rate (ESR). In inflammatory diseases causing pain in the lower abdomen, the results of this analysis reveal leukocytosis (increase of leukocytes) and accelerated ESR.
Biochemical blood test helps to determine the quality of work of various organs (for example, liver, kidneys) and systems (for example, digestive, urinary). Identification of such signs of inflammation as C-reactive protein, seromucoid (+++), hyperfibrinogenemia in the results of the study indicate the presence of an inflammatory process in the body.
These tests must be taken in the morning, on an empty stomach. Blood for research is taken from the ulnar vein (a general blood test can also be taken from an anonymous finger).
Among the methods of research of gynecological patients, the following are distinguished:
- examination of the external genitalia;
- examination of the vagina in the mirrors;
- two-handed study.
Examination of external genital organs
In this study, a gynecologist examines the external opening of the urethra, the vestibule, and the height of the perineum.
Examination of the external genitalia makes it possible to determine:
- degree of hairiness;
- the presence and nature of vaginal discharge;
- presence of formations, ulcers and other lesions on the skin and mucous membranes;
- omission of the walls of the vagina and uterus.
Inspection of the vagina in the mirrors
In this study, disposable vaginal mirrors of different sizes are used. Mirror is necessary for widening the walls of the vagina and denuding the cervix.
Inspection of the vagina in the mirrors allows you to consider:
- Vaginal walls (pathological changes, color, presence of ulcers or ruptures);
- vaginal discharge and discharge from the cervical canal (their presence and nature);
- shape (conical, cylindrical), size and condition of the cervix (hypertrophy, hypoplasia);
- violation of the integrity of the mucous cervix (tears, eversion, ulceration);
- presence of papillomas;
- shape of the external throat (hole of the uterus);
- omission of the uterus.
When examining the vagina in the mirrors, the material is sampled for the following examinations:
- Urogenital smear
This study allows you to determine the purity of the vaginal flora. Detachable is taken from three points – cervix, vagina and urethra, then applied to a slide and examined under a microscope.
- Bacterial sowing
When an infectious inflammatory process is detected in a woman, it is necessary to produce a bacterial culture of the separated. This study allows you to identify the infectious agent, as well as determine its sensitivity to the antibiotic for the subsequent appointment of an adequate treatment.
- Pap smear (cytological smear)
A study to detect the presence of cancer and precancerous cells. The cells are taken at the level of the cervical canal with a special tool (brush) and a container.
Used to assess the condition of the internal genitalia. This study is done with two hands. The index and middle finger of one hand is inserted into the vagina, and the other hand is placed on the anterior abdominal wall.
Two-hand study allows you to determine:
- capacity of the vagina;
- condition of the walls of the vagina;
- abnormalities of the vagina;
- the state of the vaginal part of the cervix (size, shape, tenderness, possible deformities);
- body of the uterus (position, mobility, size, shape, tenderness, consistency);
- uterine tubes and ovaries (normally not palpable);
- ligamentous apparatus.
Among the instrumental methods of diagnosis, a woman can be assigned:
The method of diagnosis, characterized by the study of the walls of the vagina and cervix with a special device colposcope (optical and lighting device).
There are simple and advanced colposcopies. Extended is characterized by applying on the mucous membrane of the cervix of 3 percent acetic acid (narrows the healthy vessels) or Lugol’s solution (Schiller’s test).
- assess the condition of the walls of the vagina and the vaginal part of the cervix;
- identify pathological changes, ulceration;
- distinguish benign tumors from malignant;
- take a piece of material on a biopsy.
Endoscopic diagnostic method, which allows to study the uterine cavity with the help of a special tool of a hysteroscope.
Hysteroscopy can be carried out with both diagnostic and therapeutic purposes.
Indications for diagnostic hysteroscopy are:
- pain in the abdomen of an unclear etiology;menstrual bleeding;
- spotting in the postmenopausal period;
- suspicion of the remains of the fetal egg;
With the help of hysteroscopy, the doctor can identify and if necessary eliminate intrauterine pathologies, remove the intrauterine device, and take a piece of tissue for a biopsy.
Laparoscopy is characterized by examination of the abdominal organs with the help of a special endoscopic instrument of the laparoscope. In contrast to the traditional method of surgical intervention (through an incision) this examination is performed through small holes in the anterior abdominal wall.
The laparoscope is equipped with lenses that provide high definition of the organ under examination, and a video camera that transmits the image to the monitor.
Laparoscopy is used as a diagnostic (with pain in the abdomen of an unclear etiology), and with a therapeutic purpose.
Laparoscopy helps to detect:
- adhesions of the small pelvis;
- chronic pelvic inflammatory disease;
- ovarian cysts;
- the remainder of the ovary (if it is not completely removed);
- myoma of the uterus;
- ectopic pregnancy;
- ruptured ovary.
It should be noted that diagnostic laparoscopy can, if necessary, go into the treatment.
X-ray method of diagnosis, allowing to examine the uterine cavity, as well as patency of the fallopian tubes.
During the study, a gynecologist enters a contrast agent into the uterine cavity with a special syringe.
- anatomical pathologies of the uterus (eg, intrauterine septum);
- adhesions in the uterine cavity and fallopian tubes;
- polyps and myoma of the uterus;
Highly informative research method, which uses high-frequency sound waves. Ultrasound can be performed through the anterior abdominal wall or vaginally.
The study is as follows. The woman lies down on the couch exposing a part of the body where the sensor will be installed. If the study is done intravaginally, then a condom is put on the sensor for protection. During the procedure, the sensor sends ultrasonic waves, which, reflected from the tissues, give an image to the monitor.
This method of diagnosis allows you to assess the status of the following organs:
- the uterus;
- Fallopian tubes;
Ultrasound can be prescribed if a woman has symptoms such as lower abdominal pain, menstrual irregularities, and heavy menstrual bleeding.
Ultrasound allows you to determine:
- anomalies in the structure of the uterus;
- condition of the mucous and muscular layers of the uterus;
- scar formation on the uterus;
- benign (for example, polyp, myoma) and malignant uterine and ovarian formations.
Examination of the organs of the urinary system
To study the organs of the urinary system, the following studies can be assigned:
- Analysis of urine;
A laboratory diagnostic method that allows you to examine the physico-chemical properties of urine, and also microscopically assess the sediment.
This study can identify the following diseases and pathological conditions:
- urolithiasis disease;
- inflammatory diseases of the kidneys and bladder (for example, cystitis, pyelonephritis, nephritis);
- hematuria (blood in the urine).
Endoscopic method of the study of the urinary bladder. Diagnosis is performed using a cystoscope – a metal tube that is inserted through the urethra into the bladder under local or general anesthesia.
Indications for cystoscopy are the presence of blood in urine, urination disorders (soreness, in small numbers, rarely or often), tumors detected in other studies to clarify and take a biopsy, and frequent exacerbations of cystitis. In carrying out this study, you can find stones, polyps, diverticula, tumors and inflammatory process of the bladder.
X-ray method of the study of the bladder, carried out by the introduction of a contrast agent in it. Cystography can be ascending when the substance is injected through the urethra (through the catheter) and downward when the substance comes from the kidneys (the substance is administered intravenously).
Cystography allows you to determine:
- anatomical features of the organ and its location;
- malformations of the bladder;
- presence of stones, diverticulum and tumors;
- vesicoureteral reflux (return of urine from the bladder to the ureters);
- fistulas of the bladder.
In this case, the study helps to assess the condition of the kidneys and bladder.
Indications for ultrasound can serve as lower abdominal pains, frequent and painful urination, the presence of blood and erythrocytes in the urine, as well as the suspicion of the presence of neoplasms.
Ultrasound research helps to detect:
- kidney and bladder stones;
- benign (eg, polyp) and malignant bladder formation;
- diverticula of the wall of the bladder;
- inflammatory diseases (eg, cystitis).
It should be noted that during the procedure, the bladder should be complete. This is necessary in order to spread the walls of the organ and get a good image. For this it is necessary to drink half a liter of water for one – one and half hours before the study.
For the study of the intestine, a woman can be assigned to:
- analysis of feces for occult blood;
- anorectal and colonic manometry;
Fecal occult blood test
This study can reveal hidden intestinal bleeding.
A week before the test, stop taking laxatives and iron preparations. Three days before the study, the patient is recommended to exclude the consumption of products containing iron (for example, apples, meat, liver). On the eve of the analysis, it is not allowed to do enemas and undergo an x-ray examination of the gastrointestinal tract.
The patient on the day of the test must empty the intestine and collect the feces from three different points in a special container and deliver as soon as possible to the laboratory.
Analysis of feces for latent blood can reveal ulcerative processes in the intestine, as well as benign (for example, polyps) and malignant tumors.
Anorectal and colonic manometry
Functional studies of the anorectal zone and colon, allowing to assess the tone of sphincters, motor activity and coordination of the work of all parts of the colon.
The study is performed using a special catheter, which has a multitude of channels. Each catheter channel is connected to a pressure sensor and a water pump.
With the help of a water pump, water flows through the channels at a rate of half a million liters per minute. At this time, the sensors detect the change in pressure in a particular section of the gut and transmit information to the device recording the result in the form of a graphic image.
Indications for anorectal and colonic manometry are:
- painful sensations in the lower abdomen;
- chronic constipation (if the treatment methods used do not bring the proper result);
- fecal incontinence;
- diverticulosis of the large intestine;anomalies in
- he development of the colon (eg, Hirschsprung’s disease, megacolon);
- irritable bowel syndrome;
- need to evaluate the work of anal sphincters;
- the need to determine whether there is resistance to medications that are used in the treatment of bowel diseases;
- need to evaluate the effectiveness of the treatment;
- the need to assess the work of the intestine before and after the surgical intervention.
It is an endoscopic method for diagnosis of the colon. The study is carried out using a flexible probe – a colonoscope. This unit has a built-in video camera that transfers the image to the monitor. A colonoscopy is usually performed under general anesthesia.
Indications for colonoscopy are:
- frequent abdominal pain of unclear etiology;
- presence of polyps or suspicion of their presence;
- gastrointestinal bleeding;
- suspicion of nonspecific ulcerative colitis;
- suspicion of Crohn’s disease;
- suspected malignancies;
- chronic constipation;
- unreasonable loss of body weight.
During the colonoscopy, the doctor can take a piece of tissue on a biopsy, in addition to examining the intestine, and also perform therapeutic manipulations, for example, stop intestinal bleeding, remove polyps and coagulate
Diagnostic method, which allows to examine the straight line and part of the sigmoid colon with the help of a special instrument of the sigmoidoscope. This device is a metal tube containing a lighting system and a device that supplies air.
The patient is placed on the left side during the procedure with knees bent at the knees and brought to the abdomen. The doctor neatly enters the sigmoidoscope, then the air is sent to the rectum to spread its walls. Subsequently, this device is separated and the eyepiece is placed to examine the cavity of the organ.
Radiographic method of diagnosis of the large intestine. Produced by the introduction of enema contrast medium.
Irrigoscopy is used to detect:
- the degree of intestinal damage in diseases such as Crohn’s disease, ulcerative colitis;
- tumors, polyps, diverticulum, fistulas of the large intestine;
- developmental anomalies.
What to do with pain in the lower abdomen in women?
Treatment of pathology that caused the development of pain in the lower abdomen should be aimed at restoring the normal function of the affected organ (to minimize disability), improving the quality of life of the patient, as well as the prevention of relapse (repeated exacerbation) of chronic diseases.
If you have symptoms of inflammation of the pelvic organs, you should contact your doctor as soon as possible. Early detection can prevent an undesirable outcome of the disease. Such a symptom as the pain in the lower abdomen can be a manifestation of not only some gynecological problem, but also a surgical pathology (for example, appendicitis).
With acute pain in the abdomen is unacceptable:
- take painkillers and antispasmodics (their use can hide the picture of the disease and complicate the process of diagnosis);
- apply heat (promotes the expansion of blood vessels and the spread of the infection through the blood);
- wash the intestines (if the pain is caused by intestinal obstruction, the influx of water can aggravate the situation);
- take laxatives (with intestinal obstruction, taking laxatives will worsen the patient’s condition).
Appearance of pain in the lower abdomen such symptoms as nausea, vomiting, fever, deterioration of general condition, uterine bleeding, as well as the increase in pain is an indication for urgent medical treatment.
With pains in the lower abdomen, the woman can be prescribed the following treatment methods:
- diet therapy;
- treatment of pain syndrome;
- antibacterial treatment;
- hormonal therapy;
- endoscopic methods of treatment;
With diseases of the intestine, a woman may be assigned a third or fourth table.
A woman must comply with the diet, that is, eat regularly, at the same time. Foods consumed daily must be varied and freshly prepared.
Dietary nutrition for bowel diseases helps:
- stabilize the motor activity of the intestine;
- prevent the development of exacerbations of diseases;
- normalize the stool;
- eliminate unwanted symptoms (eg, flatulence, abdominal pain) associated with impaired intestinal function;
- prevent the development of food allergies;
- increase the intake of essential nutrients in the body;
- normalize the intestinal microflora.
Table number 3
This table is assigned with atonic locks.
The woman shows the consumption of the following foods:
- products rich in vegetable fiber (for example, vegetables and fruits in raw or cooked form);
- fruit compotes and juices;
- dried fruits (for example, prunes, figs, dried apricots);
- dark bread;
- sour-milk products (for example, milk, curdled milk);
- porridge (buckwheat, pearl barley, oats);
- meat and fish;
- abundant drinking of ordinary and sparkling mineral water.
With spastic constipation caused by increased motor activity of the intestine, a woman needs to limit the consumption of foods rich in vegetable fiber.
With constipation, it is recommended to exclude the consumption of strong tea, coffee, soups of mucous consistency and kissels.
Table number 4
This table is prescribed for intestinal diseases in the acute stage, accompanied by diarrhea.
The woman shows the consumption of the following foods:
- white bread crumbs;
- cottage cheese;
- Boiled soft-boiled egg (one per day);
- soups of mucous consistency;
- porridge (rice and semolina);
- meat and fish in boiled form;
- kefir is low-fat;
- strong tea, coffee, cocoa, jelly.
Treatment of pain syndrome
Drug treatment in this case consists of symptomatic therapy and is aimed at eliminating or reducing the manifestation of pain in the low abdomen.
Treatment (name of the drug, dosage and duration of treatment) is always appointed individually and is carried out according to the principles of a three-step scale.
The three-step scale includes the following groups of drugs:
- non-steroidal anti-inflammatory drugs (eg, ibuprofen, diclofenac, dexalgin);
- potent analgesics (for example, tramadol, tramal);
- narcotic analgesics (for example, morphine).
Initially, a woman is prescribed the administration of simpler analgesics, such as paracetamol, ibuprofen,
aspirin. If the results of treatment are unsatisfactory, the doctor may in time prescribe the use of stronger drugs from the group of potent or narcotic analgesics (for example, with cancer of the uterus or large intestine).
Nonsteroidal anti-inflammatory drugs in addition to analgesic effect also have anti-edematous and anti-inflammatory effect. Initially, the drugs are prescribed twice a day, but if necessary, their multiplicity can be increased to three to four times. In the future, increase the dose is not recommended, since it does not provide the necessary analgesic effect, but only increases the risk of side effects.
Taking non-steroidal anti-inflammatory drugs can lead to the development of the following side effects:
- nausea and vomiting;
- ulcers of the mucosa of the gastrointestinal tract;
- gastrointestinal bleeding (due to ulceration);
- negative impact on the red marrow;
- stool (diarrhea);
- toxic effects on the liver and kidneys.
Preparations from this group should be taken strictly after meals. In parallel with the use of non-steroidal anti-inflammatory drugs, enveloping agents are prescribed, for example,
almagel, maalox, phosphalugel.
Also, to eliminate the pain syndrome, a spasmolytic drug (eg, drotaverin, no-shpa, platifillin) may be prescribed to a woman. This group of medicines reduces the tone of the smooth muscles of organs and vessels, dilates the vessels and exerts an anesthetic effect (prescribed for example in renal colic, menstrual syndrome).
Antibiotics are substances of biological or semi-synthetic origin that selectively inhibit the vital functions of microorganisms. Appointed with pain in the abdomen, caused by an infectious-inflammatory process (for example, with cystitis, cervicitis, endometrium).
Before the appointment of an antibacterial treatment, a woman will need to perform a bacteriological study that will help identify the infectious agent that caused the disease, as well as determine its sensitivity to the antibiotic. Thus, treatment for infectious-inflammatory diseases is assigned individually depending on the results of the study.
Antibiotic drugs can be a broad and narrow spectrum of action. Broad-spectrum antibiotics affect both gram-positive and gram-negative flora, while narrow-spectrum drugs act selectively on gram-positive or gram-negative flora.
Also, these drugs differ in the mechanism of action. They can have a bactericidal or bacteriostatic effect. Bactericidal drugs act destructively on infectious agents, leading to their death. Bacteriostatic, in turn, stops the growth and reproduction of microorganisms.
Prolonged and incorrect intake of antibacterial drugs can cause suppression of normal microflora (eg, vagina, intestine) and lead to the development of fungal infection. Therefore, in parallel with taking antibiotics, a woman can be prescribed antimycotic (antifungal) drugs, for example, ketoconazole, fluconazole.
Sex hormones are progesterone, estrogen and testosterone. Each of them is unique. Estrogen, for example, is responsible for the development of primary and secondary sexual characteristics. Progesterone ensures the onset and retention of pregnancy. Testosterone, in turn, is responsible for libido and capacity for work.
It is very important that these hormones exist in strictly defined quantitative ratios. The change in the quantitative ratio of hormones leads to the development of hormonal disorders in women.
A high level of estrogen with a concomitant lack of progesterone can lead to hyperplasia, a cystic-ferruginous degeneration of the endometrium to the growth of hormonal tumors (eg, uterine fibroids).
In this case, if the woman lacks her hormones, doctors prescribe hormonal correction in the form of tablets or injections.
Depending on the disease and the doctor’s testimony, a woman may be prescribed estrogen or progestational medication. Estrogenic remedies can be prescribed in menopause, infertility, ovarian failure. Progesterone can be prescribed at risk of premature termination of pregnancy, yellow body hypofunction, uterine bleeding, endometriosis, algodismenorea and amenorrhea (absence of menstruation for more than six months). Also with the help of hormonal therapy, functional cysts of the ovary, follicular cyst and cyst of the yellow body are effectively treated.
Preparations, dosage and duration of treatment are appointed individually by the attending physician-gynecologist and endocrinologist.
It should be noted that if the hormonal imbalance led to the development of the tumor, then conservative treatment is usually not enough, and a woman can be assigned surgery to remove it.
Depending on the existing disease, a woman may be assigned to:
Colonoscopy with abdomen pain
Before the procedure, the patient must initially prepare the body. To do this, a woman is prescribed a diet (refusing to eat the day before the operation), consuming a large amount of water (a minimum of three liters), and taking laxatives.
During the procedure the patient lies on his side, undresses to the waist. The colonoscope is inserted through the posterior opening into the rectum. To expand and better visualize the walls of the intestine, the body is injected with carbon dioxide. At the end of the procedure, this gas is discharged through the endoscope channel. With the help of a colonoscopy it is possible:
- remove benign (for example, polyps) and malignant formations (in the early stages);
- stop intestinal bleeding (coagulate ulcerative defect).
Before the procedure, the patient must carry out a thorough toilet of the external genitalia. During the cystoscopy, the patient is administered an endoscope through the urethra.
The cavity of the bladder is filled with saline solution to improve the visualization of the organ.
After the procedure, a woman in the next few days can feel discomfort and burning during urination. In order to prevent the development of an infectious process, a doctor can prescribe antibacterial drugs. With the help of cystoscopy it is possible:
- remove benign (for example, polyps) and malignant formations (in the early stages);
- stop the bleeding;
- to eliminate blockage of the bladder (with urolithiasis);
- crush and remove concrements;
- eliminate abnormal narrowing of the urethra or ureteral orifice.
During the procedure, the hysteroscope is inserted through the cervical canal into its cavity. The operational hysteroscope is somewhat wider than the diagnostic hysteroscope.
If necessary, during the operation, surgical instruments (for example, a laser, scissors) are inserted through it. To expand the uterine cavity, carbon dioxide or saline may be introduced into it. This allows you to better visualize the walls of the organ. Hysteroscopy can be performed both outpatiently and permanently. After surgery, a woman may be prescribed anesthetics and antibiotics (to reduce the risk of infection). With the help of hysteroscopy, it is possible:
- remove polyps;
- to make a curettage of the uterine cavity;
- dissect spikes in the uterine cavity;
- remove the submucosa of the uterine fibroids;
- cut the septa in the uterine cavity;
- remove the remains of the intrauterine device.
These endoscopic interventions can be performed both under local anesthesia and under general anesthesia.
When carrying laparoscopy into the abdominal cavity, through three small incisions, special instruments and an optical system are introduced, which transmits the image of the organs to the monitor. To better visualize the organs under study, carbon dioxide is injected into the abdominal cavity during the operation, which is released after the procedure is over.
With laparoscopy in gynecology, the uterus, the appendages of the uterus, the ligamentous apparatus and the peritoneum are available for inspection.
Indications for laparoscopy are:
- neoplasms of the uterus, fallopian tubes and ovaries;
- chronic inflammatory processes of the pelvic organs;
- adhesive process;
- ovarian cyst;
- chronic pelvic pain;
- ectopic pregnancy;
- abnormalities of the uterus.
With the help of laparoscopy it is possible:
- remove benign (eg, cyst) and malignant ovarian formations;
- remove benign (eg, myoma, endometriosis) and malignant tumors of the uterus;
- dissect the spikes;
- remove the fetal egg in ectopic pregnancy;
- restore the patency of the fallopian tubes;
- to tie the fallopian tubes;
- remove uterus, fallopian tubes, ovaries;
- to eliminate bleeding (for example, with rupture of the cyst, fallopian tube in ectopic pregnancy);
- correct the abnormal structure of the uterus.
Laparoscopy can also be used to perform laparoscopic appendectomy (appendectomy). However, in comparison with the traditional appendectomy (removal of appendicitis through an incision in the anterior abdominal wall) it is produced much less often.
For treatment of pains in the lower abdomen, the following physiotherapeutic methods of treatment can be prescribed to a woman:
- ultrasound therapy;
- UHF (ultrahigh-frequency) – therapy.
Ultrasound therapy is characterized by the use of ultrasonic vibrations with a therapeutic and preventive purpose. During the procedure, a contact medium (for example, glycerin, gels) is applied to the area of action, through which further ultrasound is carried out.
Ultrasound has the following therapeutic effects:
- improves the regeneration of tissues;
- produces anti-inflammatory action;
- has analgesic and antispasmodic effect;
- improves blood supply of tissues;
- stimulates metabolic processes.
It is prescribed for the following diseases that cause pain in the lower abdomen:
- erosion and pseudo-erosion of the cervix;
- urolithiasis disease;
It is not used in malignant formations and acute inflammatory processes.
Electrophoresis is characterized by the effect on the human body of a constant electric current and the drug administered with it. This procedure is carried out with the help of special electrodes, on which there is a hydrophilic gasket.
Between the gasket and the skin of the patient, a gauze moistened with a medicinal product is installed. The dose of the drug will depend on the concentration of the agent used and its electrophoretic mobility (at what speed the molecule moves under the influence of an electric current).
Electrophoresis has anti-inflammatory, analgesic and vasodilating effects. Also with the help of this procedure improves metabolism and local blood circulation. It is prescribed for the following diseases that cause pain in the lower abdomen:
It is counter-indicative to use electrophoresis in malignant formations and infectious processes in the stage of exacerbation.
Characterized by the effect on the body of the magnetic field.
It has the following therapeutic effects:
- improves metabolism;
- reduces swelling of tissues;
- accelerates the regeneration of tissues;
- has anti-inflammatory effect;
- improves blood circulation.
It is prescribed for the following diseases that cause pain in the lower abdomen:
- urolithiasis disease;
It is characterized by the use of an alternating electromagnetic field of high and ultra-high frequency, fed through capacitor plates.
It has the following therapeutic effects:
- produces a pronounced anti-inflammatory effect (with acute and subacute inflammatory diseases);
- has a bacteriostatic effect;
- increases local immunity;
- improves blood circulation.
It is prescribed for the following diseases that cause pain in the lower abdomen:
Why do women have pain in the lower abdomen on the left side?
In women, the pain in the lower abdomen on the left may occur for the following reasons:
- sigmoid colon disease;
- left-sided renal colic;
- ectopic pregnancy;cyst of the le
- ft ovary.
Diseases of the sigmoid colon
The sigmoid colon is the terminal compartment of the colon. It is located in the left ileal region, the rectum extends downward from it.
The sigmoid colon plays an important role in the digestive process. It is here that a large amount of water is absorbed and the process of forming stools continues. If this part of the intestine is damaged, the bowel work as a whole is disrupted.
In a person with a lesion of the sigmoid colon, such symptoms as violation of defecation (constipation or diarrhea), false and painful urge to defecate (tenesmus), and pain in the lower abdomen on the left are observed.
The pain in the lower abdomen on the left can be observed with the following sigmoid colon diseases:
It is characterized by inflammation of the mucous membrane of the sigmoid colon. This disease can develop independently or due to other diseases (eg Crohn’s disease, ulcerative colitis, dysentery).
Independent development of sigmoiditis can be facilitated by anatomical defects of the intestine, as well as congestion and mucosal trauma. The inflammatory process can spread both to the overlying parts of the large intestine, and to the underlying parts. The disease can occur in acute and chronic form.
With sigmoiditis, marked pains in the left iliac region, flatulence, tenesmus and stools (frequent loose stools) are noted. The patient also has a fever, weakness, sleep disturbance.
Acquired disease, in which the formation of blind saccular formations that extend beyond the intestine, developing due to increased intestinal pressure, is observed. In the process of promoting intestinal contents, feces can enter the protrusion data.
In this case, the abundant flora of the contents of the intestine when it enters the diverticulum can cause an inflammatory process, called diverticulitis. In this disease, a person may have symptoms such as lower abdominal pain in the left region, flatulence, colic, constipation, or diarrhea. It should be noted that diverticulosis may be asymptomatic for a long time.
Benign and malignant tumors
Among the benign sigmoid colon formations, polyps are most common. The polyp is an outgrowth from the mucous layer of the intestine that opens into its lumen. The danger of polyps is that they can be malignant, that is, they degenerate into cancer.
The presence of a tumor can lead to the development of the patient’s intestinal obstruction, pain in the left ileal region, intestinal bleeding and discharge of blood with feces, flatulence and stool (diarrhea or constipation).
Left-sided renal colic
Renal colic is a syndrome characterized by the development of a painful attack due to a violation of the outflow of urine. In most cases, this syndrome occurs with urolithiasis.
Urolithiasis is characterized by the formation of stones (stones) in various parts of the urinary system (for example, the kidneys, the bladder). The danger of this disease is that the stone at any time can clog the lumen of the ureter. Obturation of the ureter leads to a violation of the outflow of urine and blood circulation, and also to an increase in the intrarenal pressure.
Left-sided renal colic is characterized by occlusion of the lumen of the left ureter. In this case, a sharp pain occurs in the lower back and lower abdomen on the left, that is, along the ureter (it can give into the inguinal region). Painful sensations are so pronounced that the patient often rushes around the room. In addition to pain, symptoms such as nausea and vomiting, bloating, clouding of urine, and the appearance of blood in it can be observed.
The fertilized egg descends into the uterus and attaches to its wall. However, in rare cases, the egg can remain in the fallopian tube and continue its growth and development in its cavity, which is called ectopic pregnancy.
The danger of this pregnancy is that the growth of the embryo can lead to rupture of the fallopian tube. In this case, a woman can develop internal bleeding, and getting a fetal egg and blood into the abdominal cavity can cause peritonitis and death of the pregnant woman.
Initially, an ectopic pregnancy is symptomatic not different from a normal pregnancy. However, later a woman has sharp pains in the lower abdomen on one side.
The painful sensations on the left will indicate that an ectopic pregnancy develops in the left fallopian tube. Pain can be given to the shoulder, scapula and anus. Also, a woman experiences uterine bleeding due to a fall in the level of the hormone progesterone, pallor of the skin and a decrease in blood pressure.
Cyst of the left ovary
In the ovaries, the follicle containing the egg is ripened monthly. When a sufficient degree of maturity is reached, the follicle bursts, and the woman is ovulated, that is, the egg is released from the ovary.
On the spot of the bursted follicle begins to form a yellow body, which produces a hormone of pregnancy – progesterone. In the absence of pregnancy, the yellow body gradually resolves.
Due to certain factors (for example, hormonal imbalance, stress), the yellow body or follicle can continue to grow in size, which leads to the formation of a cyst in a woman. These types of cysts are functional, with the passage of time they dissolve independently and do not require surgical intervention. Cysts requiring surgical removal are cystadenomas, dermoid and endometrioid cysts.
With an ovarian cyst, the woman has irregularities in the menstrual cycle and aching pains in the lower abdomen from one side of the abdomen. The pain in the lower abdomen on the left will indicate that the cystic formation is in the left ovary. With the development of such complications as torsion or rupture of the cyst, the pain becomes more pronounced, as a result of which a woman may experience nausea and vomiting.
Why do women have pain in the lower abdomen on the right side?
The pain in the lower abdomen on the right side can occur due to the following diseases:
- right-sided renal colic;
- ectopic pregnancy;
- cyst of the right ovary.
This disease is characterized by an inflammation of the appendix. Appendicitis is most often seen in people between the ages of ten and thirty. The disease can occur in acute and chronic form. Appendicitis develops within one day. Initially, the pain does not have a clear localization, that is, a person can hurt at the top of the abdomen, in the navel.
However, after a while, the pain gradually turns into the right iliac region (the lower abdomen on the right). In addition to pain, the patient may also experience an increase in body temperature, general weakness, stool disorder, nausea, vomiting.
Right-sided renal colic
Renal colic is a pain syndrome, which in most cases develops with urolithiasis. Urolithiasis, in turn, is characterized by the formation of stones in the organs of the urinary system due to metabolic disorders. The appearance of renal colic in case of urolithiasis causes a sharp attack of pain in the patient.
The pain in the lower abdomen on the right is due to a blockage in the lumen of the right ureter. This leads to a violation of the outflow of urine and increased pressure inside the kidney. Also, a person in addition to pain may experience nausea, vomiting, flatulence, clouding of urine and the appearance of blood in it.
Ectopic pregnancy case
This pregnancy is characterized by the fact that the fetal egg grows and develops outside the uterine cavity. The fertilized egg may be in one of the fallopian tubes, the ovary, and also in the abdominal cavity. Most often there is a tubal pregnancy.
Predisposing factors for the development of ectopic pregnancy are surgical interventions on the organs of the abdominal cavity or small pelvis, hormonal disorders, infectious and inflammatory diseases, tumors, as well as anatomical defects of the internal genital organs. At first, tubal pregnancy by symptoms is no different from a uterine pregnancy.
However, the further development of ectopic pregnancy leads to the fact that the villi of the chorion begin to destroy the tissue of the tube. This is manifested by the development of a woman’s sharp pains in the lower abdomen on one side. Painful sensations on the right will be observed if the pregnancy develops in the right fallopian tube. In addition to pain, both internal and uterine bleeding can occur, a decrease in blood pressure and an increase in heart rate.
Cyst of the right ovary
Cyst is a cavity formation filled with serous or hemorrhagic (bloody) fluid. Ovarian cysts can be divided into those that require surgical intervention (dermoid, cystadenomas, endometrioid cysts) and those that pass over time independently (functional cysts). When developing in the right ovary cysts, the woman will experience painful aching in the right iliac region (lower abdomen on the right), as well as a violation of the menstrual cycle.
The danger of the ovarian cyst is that a woman can develop complications such as torsion or rupture of the cyst. In this case, the patient will have a sharp severe pain, accompanied by nausea and vomiting.
What are the most common causes of lower abdominal pain in women?
Pain in the lower abdomen is one of the most frequent complaints with which women turn to a gynecologist. Proceeding from this, diseases of internal genital organs most often lead to the development of a woman’s pain in the lower abdomen.
For gynecological diseases are characterized by:
- sharp, irradiating (giving off) pain (eg, algodismenorea);
- cramping pain (may be associated with menstruation);
- pulling pain, intensifying during sexual intercourse and gynecological examination (typical for inflammatory diseases).
There are the following most common causes, leading to lower abdominal pain in women:
- Infectious and inflammatory diseases of internal genital organs. Due to the penetration of the infectious agent into the internal sexual organs, the woman develops an inflammatory process.
- When the cervix is affected, cervicitis develops, uterus – endometritis, fallopian tubes – salpingitis and ovaries – oophoritis.
- The development of the inflammatory process in these organs leads to the development of specific features in the woman, such as lower abdominal pain, profuse vaginal discharge, and an increase in body temperature with the development of intoxication syndrome (weakness, decreased appetite, headache, dizziness).
Expressed pain in the lower abdomen and lower back, arising a few days before menstruation. Painful sensations can be accompanied by headache, dizziness, and also vomiting and vomiting. Pain passes independently with the onset of menstruation.
Benign tumor, which is characterized by cavity formation. In the cyst cavity a serous or hemorrhagic secret is collected. In the presence of a cyst, a woman has regular pulling pains in the lower abdomen, as well as a menstrual cycle.
This is a benign tumor that manifests itself in the growth of endometrial tissue beyond the mucous membrane of the uterus (for example, in myometrium, ovaries, fallopian tubes). This disease can develop as a result of scraping or surgical interventions, when endometrial tissue is transferred to nearby organs. The main symptoms of endometriosis are pain during menstruation, menstrual bleeding, infertility, as well as spotting during the intermenstrual period.
Also, a frequent cause of pain in the lower abdomen in women is cystitis.
This disease, which causes inflammation of the mucous layer of the bladder. In acute cystitis, the woman has pain in the lower abdomen, pain and burning sensation during urination, as well as an increase in body temperature.
Causes of pain in the lower abdomen, giving in the foot in women
Causes of pain in the lower abdomen, giving in the foot of women, can be:
- renal colic in case of urolithiasis;
- inguinal or femoral hernia.
Renal colic in urolithiasis is characterized by obstruction of the ureteral lumen by concrement (stone). This causes the development of a sharp harsh pain in a person, which is localized in the lumbar region and in the lower abdomen along the urinary tract. Painful sensations can radiate (give away) into the external genitalia and the inner surface of the thigh.
With appendicitis (inflammation of the appendix), pain initially has a diffuse character. First, the patient feels constant pain, localized, usually in the epigastric region or near the navel. After several hours, the pain senses move to the right iliac region. In some cases, for example, with sudden movements, walking, coughing or sneezing, the pain can be irradiated (given) to the lower back, to the right leg, to the groin area.
Sigmoiditis (inflammation of the mucous membrane of the sigmoid colon) is characterized by the development of intense pain in the left ileal region. Painful sensations in this disease can be given to the left leg and lower back.
Inguinal hernia in women is much less common than in men. The inguinal canal is a cavity, in women there is a round ligament of the uterus. In the presence of a hernia, the patient complains of severe pain in the inguinal region, which during movement can radiate (give) in the leg.
Femoral hernia, in turn, in women is more common than in men. The portal for the hernia is the femoral ring under the inguinal ligament. The nature of painful sensations in the femoral hernia is the same as in the inguinal hernia.
Causes of pain in the lower abdomen, giving back to women
There are the following most common causes of pain in the lower abdomen, giving in the lower back of women:
Renal colic in urolithiasis
When the stone is obstructed by the lumen of the urinary tract, severe pain occurs in the lumbar region, as well as in the lower abdomen along the ureter. The pain is so strong that the patient rushes around the room trying to reduce its severity.
With this disease, there is an acute infectious-inflammatory process in the appendix, which causes the patient a severe pain syndrome. Initially, the pain is localized in the epigastric region and the navel, then descends into the right iliac region. Painful sensations, depending on the localization of the appendix in the human body, can be irradiated (given) to the lumbar region and the leg.
Characterized by the development of a woman expressed pain in the lower abdomen and in the waist a few days before the menstrual period. Severe pain can provoke the appearance of nausea, vomiting, dizziness, weakness.
Ectopic pregnancy. The development of the embryo outside the uterus cavity leads to the development of a woman with severe pain on one side of the abdomen. Painful sensations can give back, shoulder, shoulder blade, rectum.
Apoplexy of the ovary
Characterized by the onset of hemorrhage in the ovary due, for example, rupture of the mature follicle, functional cyst. Typically, this is observed in the middle of the menstrual cycle. The woman thus has a sharp sharp pain in the lower abdomen from one side (right or left), giving to the lumbar region and rectum.
Due to the acute inflammatory process in the sigmoid colon, the person develops symptoms such as painful sensations in the left ileal region, which give back to the right leg. Also, a woman has a stool disorder, severe weakness and fever.
With this disease, there is a lesion of the mucous membrane of the bladder. The woman thus has pains in the lower abdomen and lower back, painful and frequent urination, fever, general weakness.
It is characterized by inflammatory damage of the fallopian tubes and ovaries. In acute forms of the disease, a woman is disturbed by severe pain in the lower abdomen and lower back. As a result of the inflammatory process, there is an increase in body temperature, general malaise and weakness, headache.
Why can the abdomen hurt during pregnancy?
The causes of pain in the lower abdomen during pregnancy can be:
- disruption of the intestine;
- gynecological diseases;
- surgical diseases;
- ectopic pregnancy;
- pontaneous abortion;
- premature placental abruption.
Lower abdominal pain in the second and third trimester of pregnancy can indicate stretching of tissues and ligaments as a result of increased uterine size.
The supporting apparatus of the uterus includes the following ligaments:
- round ligaments (moving away from the corners of the uterus);
- wide ligaments (away from the ribs of the uterus).
During pregnancy, the uterus increases significantly in size. Bundles that hold it, parallel stretch and become longer and straighter. At the moment of abrupt movement (for example, when performing physical exercises, when changing the position of the body) a woman may have a sharp pain in the lower abdomen. Painful sensations last not for long, up to several minutes.
In order to ease the pain in the lower abdomen when the ligament is tight, the woman is recommended to make smooth movements, and also it is necessary to take a sitting or lying position.
Disruption of the bowel
During pregnancy, a woman may have such intestinal problems as bloating, indigestion, colic, constipation.
The causes of disruption of the intestine during pregnancy are:
- malnutrition of the pregnant (for example, overeating, consumption of fatty and fried foods);
- pressure of the enlarged uterus on the intestine;
- existing or exacerbated bowel disease;
- hormonal changes (the effect of progesterone leads to a decrease in intestinal motility).
Adjust the manifestation of pain in the lower abdomen due to disruption of the intestine, perhaps by adjusting the diet. A woman is recommended to revise her usual diet, to exclude foods that cause a feeling of discomfort.
A woman during pregnancy is recommended:
- exclude overeating and hungry diets;
- to cook food for a couple;
- reduce or eliminate the consumption of fatty and fried foods;
- eat often, but little by little;
- thoroughly chew food;
- increase consumption of fruits and vegetables;
- consume enough water (about eight glasses a day);
- daily walk in the fresh air.
It should also be noted that a woman should consume more sour-milk products, cereals, dried fruits, seafood and low-fat meat (for example, chicken, lamb).
The pain in the lower abdomen can be triggered by exacerbation of chronic gynecological diseases.
During pregnancy, it is important for a woman to closely monitor personal hygiene, as during this period there is an increase in sweating, an increase in the intensity of vaginal discharge and frequency of urination.
A woman during pregnancy is recommended:
- wash with moderate temperature water, since hot water promotes vasodilation;
- use hypoallergenic hygiene products;
- moderately use soap, as it can overdry the skin and cause allergies.
During pregnancy, infectious and inflammatory processes can threaten the fetal condition of the fetus and disrupt its development. Therefore, when a woman has such signs as pain in the lower abdomen, abundant discharge from the vagina with a change in color and smell, itching, pain when urinating, you urgently need to see a gynecologist. Based on the testimony, the doctor will prescribe the necessary studies, and also decide whether it is possible to begin treatment of the disease before delivery or to leave for a period after them.
During pregnancy, such diseases as, for example, acute appendicitis, cholelithiasis and urolithiasis, intestinal obstruction.
With these diseases, pain is pronounced and permanent. Also, a woman may have an increase in body temperature, nausea and vomiting, dizziness, weakness. In addition to the existing threat to the life of the mother, these diseases also endanger the fetus. They are capable of causing premature birth and even fetal death.
That is why, when these symptoms are manifested, a woman needs to see a doctor as soon as possible for help.
It is a separate case of manifestations of pain in the early stages of pregnancy. Characterized by the fact that the fertilized egg does not descend into the uterus, but continues to grow and develop in the lumen of the uterine tube.
The pregnancy test in this case gives a positive result. Initially, a woman will find in herself all the signs of a normal pregnancy, but if she pulls with an appeal to a women’s consultation, she can not determine for herself what pregnancy is an ectopic pregnancy.
In this case, the pain that appears on one side of the abdomen may indicate that the egg that has increased in size does not fit into the narrow lumen of the tube. Further delays can lead to pipe rupture and severe consequences.
Pipe pregnancy, as a rule, is interrupted in the period from two to three to ten to twelve weeks of pregnancy.
Spontaneous abortion (or miscarriage) is the spontaneous termination of pregnancy until twenty-two weeks. If spontaneous abortion is repeated two or more times, then it is already a habitual miscarriage.
All signs of spontaneous abortion occur due to rejection of the fetus from the uterine wall, the opening of the cervix, as well as bleeding of a different nature (eg, smearing, mild, abundant).
There are following stages of the flow of spontaneous abortion:
It is characterized by the beginning of detachment of the fetal egg. At the woman at the given stage dragging pains in the bottom of a stomach are observed. Bloody discharge is absent. At palpation the uterus is soft and painless.
The detachment of the egg progresses. The pregnant woman has cramping pains in the lower abdomen, bloody discharge. There is an increase in the tone of the uterus. At a palpation the morbid sensations amplify, the channel of a neck of a uterus at survey is closed. If in this period the woman will be timely and appropriate medical assistance pregnancy can be saved.
Abortion in the course
There is an increase in the detachment of the fetal egg, as well as its displacement. The woman develops bleeding, accompanied by pains in the lower abdomen. Save pregnancy at this stage is impossible. However, timely seeking medical help will help to avoid large blood loss, as well as reduce the risk of infection (blood is a favorable environment for the development of infection).
It is characterized by a complete detachment of the fetal egg from the walls of the uterus and a violation of the integrity of the amniotic membranes. The cervical canal is open. The woman has a discharge of amniotic fluid, as well as heavy bleeding. In this period, urgent hospitalization is necessary to remove the remains of the fetal egg.
At this stage, there is complete liberation of the uterine cavity from the elements of the fetal egg.
At the increased risk of spontaneous abortion, a woman should immediately call a doctor. He will determine the degree of blood loss, and also whether there is a threat of termination of pregnancy. A woman can be prescribed emotional peace, a sedentary lifestyle or a bed rest. If necessary, the doctor will prescribe the use of drugs that reduce the excitability of the uterus (for example, suppositories with papaverine).
Premature detachment of the placenta
Characterized by premature (before the birth of the child) separation of the placenta from the wall of the uterus.
The causes of premature placental abruption can be:
- gestoses (late toxicosis);
- diseases of the cardiovascular system (eg, hypertension);
- a large fruit or twins;
- short umbilical cord.
Placental abruption can occur centrally (without bleeding) or along the edge (with bleeding).
In women with premature placental abruption, the following symptoms are observed:
- pain in the abdomen (in the part of the uterus where the placenta is located);
- Increasing or decreasing fetal movements;
- bleeding (may be absent with placental abruption in the center);compa
- ction and tenderness of
- the uterus during palpation;
- pallor of the skin;
- Increase in heart rate and blood pressure.
Why can there be pulling pain in the lower abdomen in women?
Drawing pains in the lower abdomen can occur due to inflammatory diseases of the pelvic organs, as well as during menstruation.
Inflammatory disease of the pelvic organs is an infection that has spread to the mucous membrane of the uterine cavity, fallopian tubes or ovaries.
In connection with the vital activity of the microorganism, embedded in the mucous membrane, metabolic products are isolated, therefore the woman will have specific manifestations.
Symptoms of inflammation of the pelvic organs are:
- chronic pain in the pelvis (there are constant pulling pains in the lower abdomen);
- abundant discharge from the vagina (the nature of the discharge will depend on the microorganism or the virus that caused the pathological process);
Since the internal genital organs are adjacent to the urethra and rectum, a woman may experience urinary disorders (for example, frequent painful urination) and chair (for example, flatulence, loose stools or constipation).
Pain in menstruation
Ovulation occurs ovaries on a monthly basis. Getting into the fallopian tube, the egg prepares to meet with the sperm. If fertilization does not occur, the cycle ends and the woman begins menstruation, which is characterized by the rejection of the functional layer of the endometrium. Normally menstruation should be painless.
It should be noted that with normal menstruation, there may be a feeling of slight heaviness in the abdomen, bloating. However, these symptoms do not disturb the habitual rhythm of a woman’s life.
The appearance of pain during menstruation (algodismenorea) is a sign of any violation. Pain, as a rule, is located in the lower abdomen, but can also give back. As a rule, the pain is blunt.
The causes of algodismenosis can be anatomical defects of the uterus, its underdevelopment, inflammatory diseases of the internal genital organs, endometriosis.
Endometriosis is characterized by the fact that endometrial cells are not only in the uterine cavity, but also in its thickness, that is, the muscular layer. This tissue during menstruation also begins to swell and bleed, which leads to the development of a woman’s expressed menstrual pain.
It should be noted that in inflammatory diseases a woman has constant pain in the abdomen, regardless of the beginning of menstruation.
If you need help with a doctor, you should contact the following:
- when there is abundant menses (gasket does not stand the usual time);
- if large clots appear with blood secretions;
- if the temperature has risen;
- dizziness, nausea and vomiting;
- if the pain is growing.
To cope with the painful sensations during menstruation, a woman can take one tablet analgesic drug.