Persistent pain in the lower abdomen

Women should distinguish between stomach pain and persistent lower abdominal pain. Stomach pain is related to the stomach and intestines, while lower abdominal pain should be considered as a gynecological disease. Dysmenorrhea is a problem that many women suffer from. When dysmenorrhea occurs, the feeling of bloating and pain in the lower abdomen is very obvious. Some women even cannot work and live normally due to dysmenorrhea. In addition, ovulation abdominal pain is also one of the aspects, but this is physiological pain and can be recovered without treatment.

Ovulation abdominal pain When adolescent girls ovulate, the follicle ruptures and the follicular fluid may have a certain stimulating effect on the peritoneum, so they sometimes experience mild abdominal pain that alternates between the left and right sides once a month. This is physiological, and the symptoms are mostly unilateral lower abdominal pain, dull pain or heaviness-like pain. Some girls also have a small amount of vaginal bleeding, that is, ovulation bleeding, which usually disappears on its own after one or two days, and generally does not exceed seven days. This type of abdominal pain usually does not cause any pathological changes, and gynecological examination is completely normal. It is physiological abdominal pain.

Dysmenorrhea is divided into two types: primary dysmenorrhea and secondary dysmenorrhea. Primary pain is often seen in adolescent girls. It is related to the level of prostaglandins in the body, cold, emotional and psychological factors, but there is no organic disease. It can generally heal itself with age or after marriage and childbirth. Common causes of secondary pain are endometriosis and adenomyosis. The symptoms include gradually increasing pain, often in a cyclical pattern, or dull pain in the lower abdomen during non-menstrual periods that worsens before and after menstruation. In addition, it is often accompanied by infertility and menstrual disorders.

Ovarian corpus luteum rupture is caused by excessive bleeding in the corpus luteum, accompanied by sudden onset of lower abdominal or one-sided abdominal pain, and in severe cases, shock may occur. Most cases of ovarian corpus luteum rupture occur between the 20th and 26th days of the menstrual cycle, and lower abdominal pain may occur at the onset, with varying degrees of severity. Before the corpus luteum of the ovary ruptures, the ovary will experience congestion and swelling. This process can be triggered when the ovary is affected by external or indirect external forces, especially when it is congested before menstruation, such as due to straining during bowel movements, trauma, sexual intercourse, or strenuous activity.

The pedicle of the ovarian cyst may twist or rupture. This is because the pedicle of the cyst is long and large, has no adhesions to the surrounding area, and is highly mobile. It twists when affected by intestinal peristalsis or changes in body position. When the pedicle of an ovarian tumor is twisted, pain suddenly occurs on one side of the lower abdomen, which is persistent colic, often accompanied by nausea and vomiting; there may be obvious tenderness and muscle tension in the abdomen; digital rectal examination may reveal swollen and tender appendages. Ovarian cysts may also rupture, and the contents of the cysts may irritate the peritoneum and cause severe pain. B-ultrasound examination can confirm the diagnosis.

Abdominal pain caused by pregnancy-related diseases can be seen in threatened abortion, ectopic pregnancy, etc. Taking ectopic pregnancy as an example, dull pain or distension in the adnexal area of ​​the affected side may occur. When the ectopic pregnancy occurs miscarriage or ruptures, it can cause intra-abdominal bleeding. The pain symptoms vary depending on the amount and speed of bleeding. If it is a tubal pregnancy miscarriage, the abdominal pain is often limited to one side of the lower abdomen, and blood accumulates in the rectouterine pit, which can cause anal pain. When the tubal pregnancy ruptures, the amount of bleeding is large and the speed is fast. The blood quickly spreads to the entire abdominal cavity and causes pain in the whole abdomen.

Acute appendicitis is a common lower abdominal pain in adolescent girls. It is a surgical disease, but it needs to be differentiated from gynecological diseases. About 70% to 80% of patients initially feel pain in the upper abdomen or around the navel, which then moves to the right lower abdomen a few hours later. The pain of simple appendicitis is limited to the right lower abdomen and may be continuous or paroxysmal. The abdominal pain of suppurative appendicitis worsens, often presenting as paroxysmal severe pain or bloating. Necrotizing appendicitis begins with persistent throbbing pain, and the area of ​​abdominal pain expands and the severity becomes more severe. In the early stages, there is often mild nausea and vomiting of food, often accompanied by loss of appetite and constipation. Abdominal distension may occur when inflammation is severe. The presence of migratory right lower abdominal pain is a characteristic of appendicitis.