Diagnosis | Pulling in the lower abdomen

Diagnosis

Often the physician can already make a suspected diagnosis through a detailed conversation and a subsequent physical examination and treat accordingly. To confirm the diagnosis, an ultrasound examination is recommended, especially to assess the lower abdomen. With the help of this gentle method, not only the internal female sexual organs, bladder and kidneys can be examined, but also the prostate, for example, using certain techniques. In some cases, the use of other imaging techniques, such as computer or magnetic resonance tomography, is useful for further clarification. If a bacterial infection is suspected, various laboratory tests, including blood tests and smear tests, are used for general detection of the infection and pathogen detection in order to be able to start a targeted antibiotic therapy.

Therapy

The therapy depends on the triggering cause of the pulling lower abdominal pain. In case of appendicitis, surgical removal of the inflamed appendix is attempted. In contrast to earlier procedures, the procedure can now be performed in a minimally invasive manner.

This means that only a few incisions of a few centimeters in length are necessary and the appendix is removed. Especially in children, gastrointestinal infections are usually caused by viruses. For this reason the use of antibiotics is ineffective.

In these cases, care should be taken to ensure a sufficient supply of fluids and electrolytes, as both are lost through diarrhoea and vomiting.Preparations prepared for this purpose are available in pharmacies. In very severe cases, a “replenishment” of the fluid balance via the vein must be carried out in a hospital. If a bacterial cause is suspected, especially in the case of severe abdominal pain with severe diarrhea, antibiotic therapy may be useful.

This decision is, however, the responsibility of the treating physician and depends above all on the current condition of the person concerned. Light food during the illness facilitates, independently of the cause, the recovery. Inflammation of the renal pelvis is mainly caused by ascending bacteria and must usually be treated with an antibiotic.

If the inflammation has developed as a result of an obstruction in the urinary tract, often caused by a ureteral stone, the obstruction is removed if possible and the excess urine is drained away using various catheters. Ureteral calculi, if small on the right side, occasionally come out of the ureters on their own with the urine. Often, however, a sufficient fluid intake, antispasmodic drugs such as Buscopan® and the application of a ureteral splint are necessary to remove the stone from the ureter.

In the case of a single bladder infection, immediate antibiotic administration is not always necessary, but should be considered if pain occurs during urination. As with the other complaints listed, a sufficient fluid intake is important for recovery. By urinating frequently, the kidneys and urinary organs are given the opportunity to “cleanse” and “flush” themselves.

If there are known previous illnesses of the kidneys or the heart, the amount to be drunk should be discussed with your doctor. If menstrual problems or pain occur during menstruation, local heat on the lower abdomen is usually helpful, for example with the help of a spelt cushion or a hot-water bottle. Relaxing medication, which is now also available in combination with an analgesic, can also help to achieve fast, pain-relieving results.

Light gymnastic exercises or yoga help to relax and can also contribute to a long-term reduction in pain. Inflammation of the ovary and fallopian tubes (pelvic inflammatory disease) is often caused by certain sexually transmitted bacteria, chlamydia. This is easily treatable with antibiotics.

If an advanced infection causes pus to accumulate in the lower abdomen or if the inflammation has spread to other organs in the surrounding area, a laparoscopy is usually necessary, i.e. a small operation in which the pus is removed and the abdominal cavity is rinsed and cleaned. There are specific protocols for chronic inflammatory bowel diseases, which are mainly aimed at drug therapy and are constantly adapted to the current state of health of the person affected by the treating physician. If the course of the disease is pronounced, surgical removal of the inflamed section of the intestine can bring about improvement.

In Crohn’s disease in particular, recurrent inflammation can lead to constriction of the bowel. These constrictions are called strictures. In the worst case, this can result in an intestinal obstruction which, if left untreated, can be fatal for the person affected. In order to avoid this serious complication, the constrictions are also widened or removed in a small operation.