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Ask Dr. Amir Javed Your Own Question
Dr. Amir Javed
Dr. Amir Javed, Doctor
Category: Health
Satisfied Customers: 8844
Experience:  Master in Internal medicine (London), MBBS, expert in health and fitness (six years experience)
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I began experiencing a strong, dull ache in my lower right

Customer Question

Hello. I began experiencing a strong, dull ache in my lower right abdomen about 10 days ago. It was very uncomfortable for a couple of days so my primary care physician ordered a CAT scan to rule out appendicitis or kidney stones.
Since that time, the discomfort has greatly dissipated to the point where it is not really noticeable, but I am having a pelvic ultra sound tomorrow. I am 53 - last period was 14 months ago. Any ideas on what this could be? Needless to say, I am worried. Thank you for any advice.
Submitted: 4 years ago.
Category: Health
Expert:  Dr. Amir Javed replied 4 years ago.

Thanks for the question and coming on Just Answer. I would like to say that sometimes big fibroids can give such pain in the lower abdominal region. I would also like to investigate further kidney or ureteric stones (sometimes can be missed in scan), salpingitis, lower disc disease with nerve compression. Yes pelvic ultrasound can be very helpful & might need to have further tests such as x-ray KUB, x-ray lower back. If nothing will found in these tests except the large fibroid then you may need to see Gynecologist for detail evaluation. I will also suggest to repeat full blood count, c-reactive protein, blood hormones including blood estrogen/progesterone level. As you are not having periods along with big fibroid urterus which can be the reason for this pain and I will highly suggest to see Gynecologist in either case. Remember if you are having severe pain right now please visit to ER for evaluation to rule out any thing serious.

If you would like any additional information or have more questions please don't hesitate to ask!

Please remember to only rate my answer when you are satisfied. If you feel the need to click either 2 "poor service" or 1 "bad service", please stop and reply to me via the REPLY or CONTINUE CONVERSATION button with the issue you have. My goal is excellent service which is rating 5. Rating of 4 or 5 is highly highly appreciated as this is the only way we doctors can get credit here. I will be happy to continue further and do everything I can to provide you with the service you seek.

Best wishes

Dr. Amir Javed.

Customer: replied 4 years ago.

Hello again.

The pain was strong and dull when I had it but it has now pretty much gone away.

My blood work at the time of the CAT Scan last Thursday was normal, although I don't know how exhaustively it was tested - I have not seen the results myself to see if hormone levels and C125 was looked at.

My OBGYN ordered the pelvic ultrasound, which I am having tomorrow.

As I have been in menopause for a year now, I wouldn't think this is salpingitis. The pain is in my right pelvic area and definitely feels like its in the soft tissue behind the bone, so I don't think its lower disc disease with nerve compression either.

I am hopeful that it is nothing, but from everything I've read, it sounds potentially serious. Any other ideas beside the worst case scenarios?

Expert:  Dr. Amir Javed replied 4 years ago.
Thanks for coming back. I would say that salpingitis can occur at any age and even after menopause because it is inflammation of fallopian tube due to bacterial infection most of the time so this definitely comes in differential list. It is important to rule out kidney stones like I mentioned above and this pain can also be seen in females with large uterine fibroid. I will also want to add IBS which is functional bowel syndrome (irritable bowel) can give such pain but this is a disease of exclusion. In case of IBS nothing to worry about any thing. Your pelvic scan will be very helpful.
If you would like any additional information or have more questions please don't hesitate to ask!
Please remember to only rate my answer when you are satisfied. If you feel the need to click either 2 "poor service" or 1 "bad service", please stop and reply to me via the REPLY or CONTINUE CONVERSATION button with the issue you have. My goal is excellent service which is rating 5. Rating of 4 or 5 is highly highly appreciated as this is the only way we doctors can get credit here. I will be happy to continue further and do everything I can to provide you with the service you seek.
Best wishes
Dr. Amir Javed.