Assessing Abdominal Pain for Higher Gain
From pain and discoloration to growth and disfigurement, all of these symptoms can indicate various other conditions that could only be distinguished with the help of a pertinent laboratory test or the keen eye and clinical judgment of an experienced physician. Lower abdominal pain is one such symptom that qualifies under this category, correlating with various conditions that could all be as crucial as they are similar in their baseline presentations. The lower abdominal area of the body contains several organs that could precipitate pain on occasions where some level of damage has been produced in these areas. Considering that pain is a telltale sign of damage within the tissues or nerves, crossing out one particularly “unlikely” condition is moot without a holistic examination of all other symptoms associated with that particular disease.
Sexually transmitted conditions are notorious for their tendency to present themselves in the vaguest way possible – generating presentations that could easily hit the mark in several situations that would inevitably confuse laypersons. STDs are known for their ability to mimic the symptoms of other conditions, STDs and non-STDs alike, in their presentations, making it difficult even for professionals to diagnose from the manifestations of the patient alone. It goes without saying that creating self-diagnoses is highly discouraged as it could simply lead to the improper use of known management strategies – causing more harm than good in the long run, with the slight chance that the condition may not be even addressed at all throughout the process. However, to aid your understanding of your health, supplement your awareness of the potential conditions that need to be addressed immediately, and reinforce your long-term health plans with the knowledge of likely underlying conditions to symptoms such as abdominal pain, this outline aims to educate and empower the public to, once and for all, eliminate the stigma that STDs are only meant to be kept in wraps instead of learning from it.
Do note that this outline does not, in no way, encourage you to self-medicate and address the conditions of your own volition. Although a comprehensive outlook into the disease would provide you with the necessary details regarding its diagnosis and management, distinguishing one infection over the other with precision and accuracy would still require an experienced physician’s clinical judgment and a laboratory’s accurate results.
Lower abdominal pain can be defined just as how its name suggests – it is a painful sensation that could often be experienced in the lower abdominal area, particularly in the entire area below the belly button of a patient. It is different from bloating, a common symptom confused with lower abdominal pain, in the sense that the sensation resembles more pressure, fullness, or distention in the abdominal area. Bloating is often caused by constipation, consumption of high-fat foods, stress, and swallowing too much air, but lower abdominal pain can coexist with bloating, making the causes of the two conditions somehow overlap in this sense.
Categorized under lower abdominal pain is pelvic pain – a symptom that is often associated with women, and it is usually indicative of a problem in a patient’s reproductive organs in the pelvic area. It is sometimes a symptom of an infection, a painful pelvis, or a damaged non-reproductive internal organ, but its underlying causes vary widely depending on the patient’s exposure and habits. Do note, however, that pelvic pain could often be experienced during or after sex, but it is not immediately indicative of a sexually transmitted condition that you have obtained from your partner. A careful observation of your symptoms, their duration, and the potential causes that you could recall could go a long way in narrowing down the conditions causing the presentation you have experienced.
As previously mentioned, experiencing lower abdominal pain is not indicative of a sexually transmitted infection right away due to the myriad of conditions that could cause such a presentation, especially in such an area with a comprehensive collection of organs that could precipitate a painful sensation following a particular abnormality. From your urinary and digestive systems to your reproductive organs, all of these soft tissues could all be influenced by a specific abnormality – precipitating pain that could radiate, be tender, or even be very subtle in the sense that it is not immediately noted as a sign of concern until it is too late to address the condition already. To know whether a sexually transmitted infection causes a particular manifestation you have, the most effective way to distinguish the disease is by assessing other accompanying symptoms of a specific illness or using a particular laboratory diagnostic test to provide a more conclusive outlook into your condition. We reiterate, do not self-medicate, especially considering how variable the presentations and underlying conditions are in this aspect.
Suppose you suspect a sexually transmitted condition as the potential cause of your abdominal or pelvic pain. In that case, the following testing centers offer testing kits and procedures that could help you obtain a more conclusive outlook into what is specifically causing your presentations.
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To rule out other underlying conditions that may have precipitated the lower abdominal pain you have experienced, the following outline may be essential in determining whether a non-infectious situation precipitates your pain in a highly superficial sense. After all, preventing further transmission is the core importance of deciding whether a sexually transmitted infection causes your condition.
A common symptom that most women experience during the menstrual period is abdominal cramps, which is extremely close to the manifestation of lower abdominal pain tendencies. During a woman’s monthly period, they are known to experience abdominal cramping that can be confused with other painful sensations and vaginal discharge before and during this period of their cycle. This painful sensation is commonly known as dysmenorrhea, and it is associated with the shedding of the uterine lining during this period in their process. To distinguish this particular presentation, it may also be related to vaginal discharge with color and consistency that often varies depending on the ovulation stage.
Due to the stretching of the ligaments caused by pregnancy to support the baby's position in the abdomen, abdominal pain is often observed during pregnancy, along with gas, bloating, constipation, and abdominal cramps as its associated symptoms. However, always do note that an unusual painful sensation in the abdominal area among pregnant women, especially if it is coupled with blood or unusual vaginal discharge, warrants a doctor’s visit to ensure no problems with the patient’s pregnancy.
Endometriosis is a chronic condition that mainly affects the patient's uterus – being coined as such when the uterine lining tissue grows in a location where it does not usually grow. It can be seen growing on the ovaries, behind the uterus, bowels, and even on the bladder in affected patients. Due to the displacement of the tissue, it is often associated with symptoms such as pain, infertility, and instances of heavy menstrual flow, with the pain radiating mainly within the abdomen, lower back, and pelvis. It is widely asymptomatic in most cases, and it is most common among patients who have already been through menopause.
Bacterial vaginosis is essentially an infection in the vagina of the patient that usually occurs when the normal balance of the vaginal flora skews towards the overpopulation of bacteria – causing a condition that may be characterized by symptoms such as a thin white or gray discharge, itchiness, a burning sensation, pyuria, a fishy-odor in the vagina, and of course, pain. In most cases, bacterial vaginosis is self-limiting. It is therefore easily treatable with proper hygiene and cleaning habits. Still, an appropriate consultation of a physician is necessary to ensure that you are appropriately diagnosed and advised regarding the steps you should take to speed up your recovery.
Interstitial cystitis is a condition characterized by an ongoing bladder inflammation that is then known to cause pelvic pain and symptoms such as painful urination, urinary frequency, and a painful sensation during sex. Although the presentations are relatively known to physicians, the exact cause of this condition is not accurately known due to the lack of a direct causative link between the manifestation and a particular underlying disease. In treating interstitial cystitis cases, physicians would often focus on managing the symptoms instead.
Coined with the German term “mittelschmerz,” pain during ovulation is not essentially normal, but it does occur in some patients – often characterized with pelvic pain on one side of her pelvis during the middle of their menstrual cycle. According to experts, the cause of painful ovulation is the spread of the fluid released along with ovulation cycles within the pelvic area, irritating the site, and subsequently, pain if the patient responds negatively to the fluid release. It is usually experienced for minutes to hours, and the location would sometimes shift to the other side depending on which ovary released the egg during the patient’s ovulation cycle. No treatment is necessary for such cases, and the sensation is usually temporary.
Cystitis is a condition where the patient's bladder is inflamed due to a bacterial infection, occurring particularly if the patient has an underlying urinary tract infection. The exact cause of this infection is multi-faceted, but it is often due to the entrance of the vaginal, skin, or bacteria in the urethra, making its way up to the bladder and causing an infection in this particular organ. While related to each other in most cases, a urinary tract infection is distinct from cystitis as it can affect the entire urinary system, while cystitis only occurs in the bladder. Nevertheless, the coexistence of both is often the cause of abdominal pain in patients.
Irritable Bowel Syndrome is a chronic gut disorder that causes abdominal pain as its main symptom, along with constipation, diarrhea, and bloating. In some cases, IBS tends to flare up depending on the patient’s exposure to specific triggers, but it may likewise go away on its own. Both of these instances may occur right after one’s bowel movement, and there is no known cure for IBS. Efficient management of one’s diet, stress, and lifestyle are considered one of the most effective management strategies for IBS.
Appendicitis is a condition that is notorious for its prevalence despite the lack of any predisposing factors – occurring in patients despite the subtlety of any causative factor altogether. It is characterized by the inflammation of the appendix, which is an organ located in the lower-right abdomen, and infections that cause this condition are considered severe due to the risk of having the appendix rupture if the situation is not managed immediately. Appendicitis may be associated with a sharp painful sensation in the lower right abdomen along with fever and vomiting. It is highly advised that patients with a suspected case of appendicitis be sent for immediate medical care since time is of the essence in preventing the perforation of the appendix in these cases.
Stones found in the kidney are often confused with regular rocks found on the earth’s surface due to the term being a massive misnomer in the field. Kidney stones are composed of clumped-up minerals and salts that have been deposited in the kidney, with a vast proportion of its composition being mainly made-up of calcium. When these minerals build up, they form crystals that cause pain in the pelvis or the lower back area as it moves through the urinary system. Some cases have observed a reddish-pink discoloration to the crystals that may be associated with the blood released from passing the stones through the urethra. In some cases, treatment is not necessary, albeit passing them through the urinary tract is extremely painful, but medications or other invasive and non-invasive procedures may be utilized to break down the stones and make it easier to remove them.
Ovarian cysts occur when the ovaries fail to release the eggs during a patient’s ovulation period, causing fluid build-up within the ovaries and forming a cyst in the area. When this happens, a patient may experience bloating, pressure, or pelvic pain in the side of the body where the cyst is located. Most cysts are non-cancerous but do note that they may bleed or burst, causing severe pain and requiring prompt medical treatment.
Ectopic pregnancies are instances where the fertilized egg or embryo implants anywhere outside of the uterus and still begins growing. Due to this abnormal growth, affected patients may experience very sharp pain and cramp within the pelvic area coupled with nausea, vaginal bleeding, and dizziness.
To determine whether prompt abstinence is necessary, mainly when an STD potentially causes your condition, the following outline highlights the common STDs and their associated presentations to aid your determination of the potential cause of your symptomatic presentation.
Chlamydia is considered one of the most common sexually transmitted infections that affect both men and women. It is caused by the pathogen known as Chlamydia trachomatis, and the Centers for Disease Control and Prevention estimates that this is the most frequently reported bacterial sexually transmitted infection in the United States. It is widely asymptomatic, but in symptomatic cases, Chlamydia often presents as cervicitis in women and proctitis or urethritis in men and women. Being widely asymptomatic, Chlamydia is known as the “silent infection,” but symptomatic cases would often present with symptoms of cervicitis such as discharge and endocervical bleeding and urethritis such as pyuria, dysuria, and urinary frequency. The spread of its infection from the cervix to the upper reproductive tract causes a complication known as Pelvic Inflammatory Disease or PID, which causes acute cases of abdominal/pelvic pain along with cervical motion tenderness.
Chlamydia is diagnosed using a laboratory test known as Nucleic Acid Amplification Test or NAAT – one of the most sensitive diagnostic procedures in various laboratories that can provide a conclusive diagnosis using readily available specimens from the patients. Vaginal swabs and urine samples can be used to perform a NAAT in a laboratory, but cell culture may likewise be employed if resources prove to be scarce to administer this type of test for the patient.
According to the Centers for Disease Control and Prevention, antibiotic administration for seven days or the administration of a single dose antibiotic regimen is recommended for treating Chlamydia cases, despite the HIV status of the patient being treated. Furthermore, abstinence is recommended during the treatment period to ensure no transmission while the bacteria are still active in the patient’s system. Do note that sexual partners within 60 days of the patient’s diagnosis are advised to be tested or prescribed the appropriate prophylactic medications.
Gonorrhea is another prevalent infectious disease that primarily targets the mucosal membranes of an infected person – resulting in its manifestation not only in the genitalia but in other mucosal areas that likewise come in contact with the infected tissue. It is caused by the pathogen known as Neisseria gonorrhoeae, and it can be contracted by both men and women exposed to the pathogen. Most infected cases are asymptomatic throughout the infection, but it can present with the following symptoms in males:
On the one hand, symptomatic cases in women would often present with the following symptoms:
Rectal infections, meanwhile, may be characterized by symptoms of discharge, anal itching, soreness, bleeding, or painful bowel movements.
Similar to how Chlamydia is diagnosed, the most sensitive diagnostic procedure often used for Gonorrhea is a Nucleic Acid Amplification Test or NAAT. It can be performed using either a urine, urethral, endocervical, or vaginal sample from the patients, while a cell culture, which is utilized in cases where the resources do not permit the performance of a NAAT, will require an endocervical or urethral swap specimen to administer.
According to the Centers for Disease Control and Prevention, a single dose of 500 mg intramuscular dose of Ceftriaxone is recommended for treating Gonorrheal cases, albeit alternative regimens are likewise available in cases where the administration of Ceftriaxone is not recommended. However, do note that the administration of antibiotics will no longer reverse any structural damage that has been done to the corresponding affected tissues – making immediate treatment necessary to avoid any long-term complications.
According to the Centers for Disease Control and Prevention, Human Papillomavirus or HPV is considered the most common sexually transmitted infection. Contrary to the common misconception, HPV is different from HSV or herpes. In most cases, HPV infections are self-limiting and do not require appropriate treatment. However, symptomatic cases could cause genital warts, or in highly complicated cases, cause cervical cancer in infected female patients.
As of this writing, there is no one way to know a patient’s HPV status as there is currently no approved test that can be used to find HPV in the mouth or throat. However, screening methods for cervical cancer can be used to provide a conclusive diagnosis of HPV, but the test is only recommended for patients who are at least 30 years old. In most cases, unless a clear symptomatic manifestation such as genital warts is present, the virus remains unrecognized in the patient’s system.
There is no recommended treatment to eliminate the virus from the patient’s system, but the presentations can effectively regulate the patient’s condition and quality of life. For instance, genital warts can be removed using the appropriate medication to prevent them from growing or spreading, cervical cancer can be treated if recognized immediately through a Pap test, and other HPV-related cancers can be easily managed if treated and diagnosed early on.
Vaginal yeast infections are commonly mistaken with a Chlamydia infection and vice versa.
Yes, HPV can infect any sex and quickly spread through anal, vaginal, or oral sex with an infected individual.
Symptoms usually occur 2 to 3 months following exposure to the virus.
No. The virus usually clears after 1 to 2 years of management as the body fights off the virus in the body.
The usual incubation period is around 2 to 5 days following exposure, but sometimes symptoms may appear after 30 days or so.
American College of Obstetricians and Gynecologists
World Health Organization
Reviews in Obstetrics and Gynecology
Written by Mark Riegel, MD
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