If your lower abdomen hurts for a long time. There may be pain. What kind of pain is called nagging

If a patient complains that “the lower abdomen hurts,” the doctor knows what characteristics of the pain should be determined first. Indication only of localization is of little significance in diagnosis. The lower abdomen includes organs of different systems, but they can hurt in the same way.

Therefore, in order to determine the diagnosis and prescribe the correct treatment, consultations with various specialists (gastroenterologist, gynecologist, neurologist, urologist) will be required. additional examination and mandatory laboratory diagnostics.

To convince the reader of the need for these measures, we present brief information about the most common pathology encountered with pain in the lower abdomen. Let's start with anatomy and figure out what can hurt in the lower abdomen.

What organs are located in the lower abdomen of a person, the significance of their functions for the body

The lower part (floor) of the abdomen is separated from the middle by a conventional horizontal line connecting the iliac crests. Anyone can feel them on the most prominent pelvic bones. In the central zone above the pubis there is a bladder with attached ureteric orifices. This is where the loops come down small intestine.

When overfilled, the bubble protrudes above pubic bone. It includes 0.5 liters of urine produced by the kidneys and delivered by the ureters. The narrowest section is provided with a muscular sphincter. The bladder accumulates urine with waste substances and excess fluid that the body does not need. The timely opening and closing of the emptying channel into the urethra depends on the work of the sphincter.

The excretion of urine is regulated by the nervous system. The urethra ends the urethra. Important feature There is a high probability of infection in women due to its wide and short shape. And for men, the problem of why the lower abdomen hurts cannot be avoided without finding out the condition of the prostate gland.

It is located in the upper part of the urethral canal below the bladder, produces seminal fluid to ensure the viability of spermatozoa. Enlargement of the organ leads to compression of the urethra, which can impede the flow of urine.

In women immediately after bladder the uterus is located with appendages ( fallopian tubes and ovaries). Diseases of the genital organs are often associated with a violation hormonal balance, age, are accompanied by pain, have their own distinctive signs and examination methods.

The small intestine partially touches the center of the lower abdomen. If it is affected, pain and impairment should be expected. digestive process. Thanks to the special structure of the wall, beneficial substances are absorbed through it. nutrients directly into the blood. This means that with pathology, a person loses the route of supply of vitamins, proteins, carbohydrates, and fats.

Diarrhea contributes to the uncontrolled removal of necessary salts and fluids, and all body systems suffer.

The iliac zones are the lower lateral parts of the abdomen, adjacent to the pelvic bones of the same name. On the right it includes: the cecum with the appendix, the ureter, and loops of the small intestine. Left - except for the left ureter and small intestine, sigmoid and straight.

Only part of the large intestine is included in the lateral projection; gender differences are visible

The role of the large intestine is to reabsorb the required volume of fluid, form feces and provide the necessary peristalsis for its excretion. In area sigmoid colon there are curves that slow down the movement feces. It is this zone that is most susceptible to the effects of excreted toxic substances and has the highest risk of developing malignant tumors.

Pain in the lower abdomen causes damage to the lumbar and sacral vertebrae. The destruction of bodies, the formation of “spikes” leads to compression and overirritation of the nerve roots emerging from spinal cord. Irradiation is usually observed in the lower back, thighs, abdomen.

In order not to return to neurological reasons, we note that such pain in nature is described by patients as “shooting”, forming zones of impaired skin sensitivity on the back, buttocks, and thighs. A significant proportion of diseases are characteristic only of men or women, but there are causes of pain in the lower abdomen that equally affect any person.

When can the lower abdomen hurt in people of both sexes?

As we found out from the anatomy section, people of both sexes may experience pain in the lower abdomen when affected digestive tract and urinary organs. Symptoms are not specific in women and men. Called:

• intestinal damage (inflammation, tumor growth, developmental abnormalities);
• diseases of the lower urinary organs ( Bladder, ureters).

Pain caused by intestinal pathology

Most often, intestinal loops suffer from an inflammatory process caused by infection, not specific reaction. Especially if infection occurs in areas with a damaged wall structure.

Irritable bowel syndrome

The syndrome is considered functional disorder. It is important that despite intense spasmodic pain along the intestines, no changes are detected. The main reason is usually associated with an excessive specific reaction to stress.

Suffering mainly are young people with an emotional perception of the environment, overloaded with study and work, not following a diet, and without active physical activity. Patients are concerned about stool upset, bloating and a feeling of fullness in the intestines.

Acute gastroenteritis

The most common disease among adults and children. More often occurs in the form of outbreaks in organized children's groups. It is caused by a violation of food processing technology, the spread of infection from a bacterial excretor that has contact with catering units, packaging and transportation. Why it hurts in the lower abdomen becomes clear after bacteriological examination and isolation of a specific pathogen.

Gastroenteritis is caused by Salmonella, pathogenic strains coli, staphylococci, enterobacteria, proteus and others

Signs of the disease:

• temperature increase;
• pain in the stomach, along the intestines;
• nausea and repeated vomiting;
• diarrhea;
• bloating and rumbling in the stomach.

How younger child, the more severe the disease is. On examination, pain is determined not only in the lower abdomen, but also around the navel. Dehydration caused by vomiting and diarrhea in children cannot recover quickly, so convulsions and impaired consciousness are observed.

Vague inflammation affecting all parts of the digestive system. It is characterized by the growth of granulomas (tubercles) on the mucous membrane, which is why the endoscopic picture is called "cobblestone". The reasons remain unclear.

If areas of the small and large intestines adjacent to the lower departments abdominal cavity, cause severe pain in the lower abdomen. At the site of inflammation, the intestinal wall is destroyed from superficial ulcers to through penetration into neighboring organs and the abdominal cavity.

The disease, even with a decrease in symptoms, can recur within 20 years. It often occurs in boys with a burdened heredity, a sharp decrease in immunity. The pains are constant, felt like bursting, aggravated by violation of the diet, unrest.

Other symptoms include:

• bloating;
• frequent loose stool;
• nausea and vomiting;
• slight increase temperature;
• weight loss;
• weakness.

Macroscopic view of a remote section of the intestine: characterized by cracks, ulcers, scars with structural disturbances, fistulous tracts, abscesses

Local pulsation is caused by formed interintestinal abscesses.

Acute and chronic appendicitis

Inflammation of the appendix classic signs localized in the right iliac region. Chronic course occurs when the process is spontaneously limited by adhesions that make it difficult to spread throughout the peritoneum.

Details of the symptoms and clinical course of appendicitis and other diseases localized in the right lower abdomen can be found.

Nonspecific ulcerative colitis

The disease is one of the pathologies with an unclear cause. It has been established that the lesion concerns the mucous and submucosal layer of the large intestine. It starts from the sigmoid and rectum and spreads upward.

Pain in initial stage localized in the left iliac region, are spastic in nature, radiate to the left side, worsen after eating. Patients constantly have pain in the lower abdomen and decreased appetite. Additional symptoms: pus, mucus and blood in the stool, frequent loose stools, elevated temperature, weight loss, weakness.

Diverticulosis

The disease is caused by the formation of saccular formations in the wall of any part of the intestine that protrude outward. The main reasons are considered:

• abnormalities in the development of the intestinal tube;
• impaired blood supply and loss of tone in the intestinal wall in elderly people prone to constipation;
• lack of water and fiber in the diet;
• excess weight and low physical activity.

It is asymptomatic until the diverticula become infected and inflammation occurs. An abscess forms inside the “bag”; the outlet to the intestines is quickly blocked by edematous walls. A throbbing pain appears in the lower abdomen at the site of the diverticulum projection.

Complications include rupture, peritonitis, or gradual formation intestinal obstruction.

Colon cancer

The causes of malignant transformation are considered precancerous diseases(Crohn's disease, chronic inflammation, ulcerative colitis), impaired quality and diet, unfavorable heredity.

Malignant neoplasms are most often localized in the area of ​​the sigmoid and rectum

In the clinic, it is important that when the lower abdomen hurts on the left and radiates to the side, lower back, the tumor is already in the advanced stage. Early signs almost impossible to detect. Tumor growth is accompanied by:

• constant dull pain in the lower abdomen on the left;
• bloating;
• constipation;
• temperature increase;
• loss of appetite and weight.

Inguinal hernia

A hernia is a prolapse of the abdominal contents into a ring formed by the divergence of the muscle aponeurosis. In patients, a soft formation protrudes in a standing position and during tension is determined from below in the iliac region on the left or right.

Possibly congenital due to insufficient structure and composition connective tissue. Or it is acquired during life with increased pressure inside the abdominal cavity (smokers' cough, ascites, obesity).

A loop of intestine gets into the hernial orifice. Loss can be triggered by sudden lifting of weight, straining and constipation. While self-reduction of the hernial sac is quite convenient, patients are bothered by a slight tingling sensation. But if the prolapsed loop of intestine is pinched by muscle contraction, there is a danger of developing necrosis.

Patients appear:

• very severe pain in the area of ​​the hernia in the groin;
• vomit;
• bloating in upper divisions(picture of intestinal obstruction), constipation.

Diseases of the urinary system

Pain in the lower abdomen due to pathology of the urinary organs is caused by: inflammation, stretching of the wall of the bladder and ureter due to stagnation of urine or mechanical obstruction, changes in the composition of secreted electrolytes with the formation of salt stones.

Infection of the bladder is possible through blood, urine from the kidneys with pyelonephritis, from the urethra. It leads to inflammation of the mucous membrane.

Pain begins when the process spreads to the submucosal layer

Possible factors risk:

• hypothermia, especially of the legs;
• hormonal imbalance;
• taking medications that injure the mucous membrane;
• decrease in protective forces;
• stagnation venous blood in the pelvic area.

The pain is constant, dull, bursting or aching in nature, accompanied by fever, nausea, feeling incomplete emptying. Cystitis is usually combined with inflammation of the urethra, so patients experience frequent urination with pain, mucus, blood or pus in the urine.

Urolithiasis disease

The disease is a consequence of the precipitation of salt crystals (oxalates, phosphates, urates, less often than others), their gluing into conglomerates. The advancement of the stone in the lower urinary tract is accompanied by an attack of severe pain.

It is provoked by shaking in transport, physical activity. The pain is unilateral. They radiate to the side, lower back, groin, labia in women and scrotum in men. Last for several hours. At the end of the attack, drops of blood are released in the urine. Due to pain, patients experience urinary retention and vomiting.

Bladder cancer

The pathology is more common in men. The tumor begins from the mucosal epithelium and grows throughout the entire wall. There is a connection between the lesion and occupational hazard(work in the production of synthetic materials, rubber, in the coal mining industry). Increased risk in patients with urolithiasis, men with chronic prostatitis.

The onset of the disease does not have specific symptoms. As the tumor grows, complaints appear that the lower abdomen above the pubis hurts greatly, urination is accompanied by pain and blood in the urine.

"Male" pain in the lower abdomen

Prostate diseases in men manifest themselves as severe pain in the lower abdomen.

Prostatitis

Inflammation of the prostate gland is characterized by a long, persistent course. At the same time, the seminal vesicles become inflamed. Inflammation varies for reasons:

• caused by penetration into the prostate pathogenic microorganisms(bacteria, viruses, fungi);
• provoked by factors that impede the flow of secretions into the urethra (sedentary work, low physical and sexual activity).

The disease can be triggered by hypothermia, decreased immunity, injury, hormonal disbalance.

Men feel constant dull pain in the lower abdomen, radiating to the tailbone, anus, scrotum. When the organ is swollen, the patency of the urethral canal is impaired and urination is delayed, so the pain syndrome is accompanied by:

• painful urge to urinate;
• burning in the urethra;
• temperature increase;
• chilling;
• constipation, pain during bowel movements.

TO common features Chronic inflammation includes: muscle, joint and headaches, fatigue, insomnia, irritability. The disease affects potency, causes pain in the head of the penis, and decreased erectile ability.

The main reason adenomas are considered a hormonal imbalance in old age

Adenoma and prostate cancer

Adenoma is a benign neoplasm. The tumor is formed from epithelial cells. The proliferation of prostate tissue, enlargement of the organ leads to stagnation of urine and infection of the urinary structures. Men feel a constant heaviness in the lower abdomen and an unsuccessful desire to urinate.

For prostate cancer initial signs no different from adenoma. Then the pain becomes stronger, visible blood appears in the urine. IN late stage Metastases form, so men feel severe constant pain in the spine, pelvic and femur bones. Weakness increases, weight falls.

Women's diseases

Gynecologists consider pain in the lower abdomen the most common complaint in practice. Pain syndromes are distinguished:

• acute and chronic;
• pregnancy related and not related;
• cyclical (during menstruation) and acyclic.

Can the lower abdomen hurt during pregnancy? According to the mechanism of formation, such a symptom is associated with stretching of the ligamentous apparatus. Typical for the first and late pregnancy. The woman feels nagging pain when moving. Acute pain causes great concern among specialists. They can signal an unfavorable course.

Sudden pain during pregnancy

Sudden pain syndrome occurs in women:

• with spontaneous abortion- manifested by contractions of varying intensity, bleeding from the vagina. If an artificial abortion is performed, then the signs indicate incomplete removal of the fertilized egg and the onset of sepsis. The woman's temperature rises and chills appear.
• ectopic pregnancy- 95% ovum is fixed in the pipes, the pain is one-sided, gradually increases, intensifies with bowel movements and movements.

If the pain is not related to pregnancy

Acute pain caused by ovarian pathology. Bleeding from the ovary occurs as a result of rupture of a vessel due to inflammation. Irritation of the peritoneum by blood and overstretching of the organ capsule cause severe pain on the affected side.

The rupture of the cyst releases fluid, which acts on the layers of the peritoneum and contributes to pain. Torsion of the cyst is accompanied by ischemia and further tissue necrosis. The pain is one-sided, accompanied by nausea, vomiting, fainting, and shock.

Hyperstimulation syndrome - caused by large doses of hormones during the treatment of infertility. The ovaries are enlarged and contain multiple cysts. The woman is worried about weight gain, shortness of breath, decreased urination, and ascites appears.

Cyst growth causes nagging pain

Inflammatory diseases of the uterus and ovaries (salpingoophoritis, endometritis) are caused by infections such as mycoplasma and chlamydia. Pain occurs if a woman has a cold in the lumbar region, pelvis, or leg. If it is determined that the pain is throbbing, encysted suppuration (abscess) is suspected. The temperature rises sharply, accompanied by chills and severe intoxication.

In women, pain can be caused by menstruation, fluctuations hormonal levels. A gynecologist can decide exactly what to do if the lower abdomen hurts after an examination. The problem of pain in the lower abdomen cannot be postponed. Not only the health, but also the lives of patients depend on identifying the cause and treatment.

Pain in the lower abdomen in women, according to statistics, is the reason for frequent visits to the hospital. Sometimes such pain indicates serious problem surgical in nature or even pathology.

Sharp pains, if they continue to intensify and do not go away for a long time, are a serious reason to consult a specialist as soon as possible.

Since there are several causes of cutting pain in the lower abdomen in women, and they are all different, a separate large article will be devoted to this topic. It will help to understand why the symptoms occur, as indicated by the discomfort after having sex, during pregnancy.

Why does the lower abdomen hurt in women on the right and left?

All women's pains are divided into 2 categories:

Functional:

1. There was a violation of the monthly cycle. It is also called algodismenorrhea. This also includes bleeding of a dysfunctional nature.
2. The pain is somehow associated with approaching ovulation.
3. Blood stagnation has occurred. This sometimes happens with pronounced bending of the uterus and hematometra. Blood accumulates in the uterine cavity, its outflow is disrupted.

Organic reasons:

1. The intrauterine device was not inserted correctly.
2. There is a pathology. For example, surgical or related to gallbladder diseases, excretory system(from cystitis to pyelonephritis).
3. Diseases “female style”. These include endometritis, adnexitis, a cyst in any of its forms, fibroids, ovarian torsion and some other diseases.

Each cause will be discussed in detail to help you better understand the source of your pain. By the way, in addition to cutting, patients describe the pain as sharp, tingling, unpleasantly aching, or simply dull.

Appendages become inflamed

It shows itself to be very revealing. First, the temperature rises sharply and signs of intoxication appear. If the patient has adnexitis, the lower abdomen on the left/right side may hurt. Endometritis is characterized by pain below, but in the middle. The examination reveals pasty appendages. The uterus enlarges and becomes soft. When palpated, the patient feels pain. IN chronic stage endometritis together with salpingo-oophoritis occur together with pain in the lower abdomen. Patients complain of heaviness where the appendages are located. Upon palpation, the doctor determines that the uterus is becoming quite dense and reacts sharply to any influence.

How to cure inflammatory diseases? For this, there is a whole range of remedies, including antibiotics, treatment with vitamins and suppositories aimed at relieving inflammation. Infusion-type therapy is prescribed.

Endometriosis

Genital endometriosis spreads to the uterus as well as the adnexa, the space behind the cervix. Cells resembling the human endometrium in their structure spread beyond the organ. Before the onset of menstruation, pain begins to increase and reaches its peak during menstruation. Localization is mainly in the lower middle if it is endometriosis. In case of problems with the appendages, not the most pleasant sensations are observed in the groin area. Even retrocervical endometriosis is possible, when patients complain of pain behind the pubis.

Due to the development of the adhesive process, the pain syndrome in the pelvic area only gets worse. Women may be concerned about cycle failure. The discharge also changes; in the future, all this may result in infertility.

A disease such as endometriosis is treated hormonal drugs, however, it is possible surgery at advanced stages.

Ovarian apoplexy

Hemorrhage in soft fabrics ovary in medicine is called apoplexy. Associated with ovulation, as it occurs during the intermenstrual period. When the follicle ruptures, blood enters the ovary.

Why does apoplexy occur? It can be triggered by intense physical activity and even sexual intercourse. With intra-abdominal bleeding, the pain below is cutting, localized in the area of ​​the affected organ. Symptoms present posthemorrhagic anemia, including pallor of the skin, loss of consciousness. The victim's blood pressure may drop seriously. In most cases, emergency surgery will be required.

Uterine fibroids

Another disease that affects women. With a large tumor, compression occurs on nearby organs – hence the pain. If the submucosal myomatous node is inflamed, the pain is cramping, accompanied heavy bleeding. generates aching pain. In both the first case and the second, surgery cannot be avoided.

Ovarian twisted

This can happen when bending or overexerting. When torsion is ninety degrees, the outflow from the vein is disrupted and aching pain appears. If the torsion is more severe (three hundred and sixty degrees), arterial blood access is limited. The so-called picture of an “acute” abdomen is observed: cutting, cramping pain, intoxication. The temperature rises sharply, the patient begins to take a forced body position.

There can be only one treatment in this situation. successfully removed, the leg does not unwind.

Appendicitis

Doctors jokingly call him the “monkey” of all diseases. It can hide behind symptoms of other diseases. Most often it manifests itself as a low-grade fever, pain in the epigastrium, and right iliac region. A person’s appetite may decrease or completely drop, and vomiting may occur. If emergency surgery is not performed, it can cause peritonitis and result in the death of the patient.

Cholecystitis

Most often, the bladder becomes inflamed for one single reason - stones appear in the organ. The disease is quite acute, with an increase in temperature and all the ensuing consequences. The level of bilirubin in the blood increases, causing the skin to itch. Vomiting and nausea, characteristic pain in the lower abdomen and hypochondrium on the right appear. The pain radiates to the back, but can also radiate to the collarbone. Symptoms worsen after eating.

To cure cholecystitis, you need to review your diet and start taking special drugs, which have a beneficial effect on the flow of bile. If the stones are in gallbladder large, the person is indicated for surgery.

Cystitis or pyelonephritis

It is known that women suffer from cystitis much more severely than men. Cutting pain is observed in the area above the pubis. It intensifies even more when urinating. may remind you of itself with terrible pain in the lumbar region. When the kidneys become inflamed along with the bladder, the temperature rises and problems appear during urination. Tests also indicate inflammation.

Effective treatment of cystitis and pyelonephritis is possible only with nitrofurans and serious antibiotics.

Ectopic pregnancy

One of the most dangerous gynecological diseases. After fertilization, the egg is implanted, but not in the uterus, but behind its cavity. This could be the ovary, abdominal cavity, fallopian tube, etc. Rupture of the fallopian tube is accompanied as a consequence periodic pain paroxysmal in nature. It hurts in the groin area, but also sharp pain may radiate into the vagina, supraclavicular area or rectum.

If an ectopic pregnancy is diagnosed, immediate surgery will be required. Pregnancy outside the uterus can also be indicated by delayed menstruation and spotting from the vagina.

Causes of cutting pain before and after menstruation

Why do girls complain so often about painful menstruation? Typically, such symptoms indicate algodismenorrhea. She is found in adolescence, but can also bother older girls. Associated with the development of the body and the final establishment of hormonal levels. A tilted uterus can also cause pain in the lower abdomen shortly before menstruation. Known to almost everyone, the girl PMS, and endometriosis of the uterus, inflammatory processes occurring in the pelvic area. After menstruation, the endometrioid cyst tends to increase. With endometriosis, blood circulation increases, so discomfort is also possible after menstruation.

Pain in the lower abdomen during ovulation

Pain syndrome during ovulation it is weakly expressed. It occurs in the middle of the cycle and causes almost no discomfort. Minor bleeding and mild abdominal pain may be observed for one to two days.

IN medical practice There are cases where patients did not ovulate as such. After making an appointment for laparoscopy, women were admitted to the hospital with bleeding in the abdominal cavity. A more detailed examination and operation revealed that the problem was apoplexy. As a result, it was necessary to perform resection, but using the laparotomy method.

Cutting pain in the lower abdomen after sexual intercourse in a woman n

Some women come to the doctor and complain of pain of an incomprehensible nature that occurs after intimate intercourse. Frustration is to blame for everything - the pain is most often aching, accompanied by dissatisfaction (moral and physical).

An intimate relationship can end in pain in other situations:

• Chronic adnexitis
• Cervicitis
• Damage to the vagina. For example, after fairly rough sex.
• Oncological diseases
• Endometriosis
• Adhesive disease

Pregnancy: cutting pain in the lower abdomen

In general, any incomprehensible pain at any stage of pregnancy should already be alarming. There are two main reasons why women in an “interesting position” are worried cutting pain:

• Pregnancy may be interrupted

When there is a serious threat of losing a child (miscarriage), pulling sensation in the lower abdomen due to premature contractions of the uterus. As a result, bloody discharge appears. The greatest risk occurs before 22 weeks.

• The placenta detaches prematurely, but it is located normally.

Another pathology characteristic feature which is severe pain in the abdominal area during pregnancy. This occurs when the placenta begins to separate in the lower segment. External bleeding is possible. It is good if it is mild, but there are known cases of quite severe internal bleeding with the appearance of a retroplacental hematoma. In this case, urgent intervention is indicated to save the child ( C-section).

Now you know why cutting pain occurs in the lower abdomen. But never rush to make a diagnosis yourself. If it hurts for a long time, it is better to see a doctor.

Pain in the lower abdomen in women is the most common reason contacting a gynecologist. However, such pain syndrome may be a sign of acute surgical or neurological pathology. If pain occurs, especially acute, unbearable pain, you should consult a doctor as quickly as possible.

Why does the lower abdomen hurt in women on the right and left?

The causes of pain in women can be divided into 2 groups: organic and functional.

Organic reasons:

• diseases of the female genital organs (adnexitis, endometritis, endometriosis, ovarian apoplexy, ovarian cyst, torsion of the peduncle of an ovarian cyst, uterine fibroids);
• usage intrauterine device;
• acute surgical pathology, pathology of the urinary system, gall bladder (appendicitis, cystitis, cholecystitis, pyelonephritis);
• the woman's health condition related to pregnancy (threat of miscarriage, premature,).

Functional reasons:

• - algodismenorrhea (see) and dysfunctional uterine bleeding;
• pain associated with ovulation (see also);
• stagnation menstrual blood(curvature of the uterus, hematometer).

Pain in the lower abdomen may be different character and be both sharp, cutting or piercing, and dull, aching.

Inflammatory processes in the appendages and uterus

The inflammatory process in the uterus or appendages, as a rule, begins acutely, with an increase in temperature, the appearance of symptoms of intoxication and pain in the lower abdomen. With salpingo-oophoritis (adnexitis), the left or right side of the lower abdomen hurts, and with endometritis, the lower abdomen hurts in the middle. During a vaginal examination, pasty and sharply painful appendages are determined, and with endometritis, an enlarged, softened uterus is felt, painful on palpation and displacement behind the cervix. Chronic salpingoophoritis and endometritis occurs with aching, dull pain in the lower abdomen. In the area of ​​the appendages, heaviness is determined, and the uterus is palpated as a dense and sensitive formation.

Treatment for inflammatory diseases genital organs consists in prescribing antibiotics, infusion therapy, vitamins,.

Endometriosis

Genital endometriosis can affect the uterus, appendages and the retrocervical space. Endometriosis is the spread of cells similar in structure to the endometrium outside the uterus. Pain appears before menstruation and increases during it. With endometriosis of the uterus, pain is localized in the mid-lower abdomen, with endometriosis of the appendages in groin areas, with retrocervical endometriosis behind the pubis (see). Significant adhesive process in the pelvis with this disease aggravates the pain syndrome. In addition to pain, a woman is worried about a violation menstrual cycle, change in the nature of menstrual flow and (see).

Treatment of endometriosis is hormonal, in some cases surgery is indicated.

Ovarian apoplexy

Apoplexy or hemorrhage in the ovarian tissue occurs in the intermenstrual period (in the middle of the cycle) and is associated with ovulation. When the main follicle ruptures, the ovarian vessels are damaged and bleeding begins in the tissues of the organ and the abdominal cavity. Apoplexy can be provoked by sexual intercourse or physical activity. Intra-abdominal bleeding is accompanied intense pain in the lower abdomen, localized at the site of the affected ovary and symptoms of posthemorrhagic anemia (pallor skin, a fall blood pressure, ). Emergency surgery is indicated.

Uterine fibroids

Pain in the lower abdomen in women with uterine fibroids large sizes tumors and compression of neighboring organs and at birth of a submucosal myomatous node. Pain syndrome with large sizes of fibroids is aching, pressing or dull. At the birth of a myomatous node, the pain is cramping, pronounced, and is accompanied by intense bleeding. In both cases, surgical intervention is indicated (see)

Torsion of the pedicle of an ovarian cyst

The pedicle of an ovarian cyst can twist when bending, sharp turns, physical work. If the leg is twisted 90 degrees, the venous drainage in it, the cyst swells, and the pain is aching. When torsion is 360 degrees, there is no supply to the cyst. arterial blood and a picture of an “acute” abdomen develops: cramping, severe pain in the lower abdomen on the side of the cyst, signs of intoxication (nausea, vomiting), positive symptoms irritation of the peritoneum, fever, forced position of the patient's body. Emergency treatment - removal of an ovarian cyst, while the leg does not unwind (see).

Appendicitis

Pain in the lower abdomen during pregnancy

• Threat of miscarriage

With the threat of a miscarriage up to 22 weeks, aching or pulling pains in the abdomen occur due to uterine contractions, bleeding may occur. Treatment is aimed at maintaining pregnancy (antispasmodics, hormones, bed rest).

• Premature abruption of a normally located placenta

This pathology is accompanied by significant pain in the abdomen during pregnancy, if the placenta has exfoliated in the lower segment. Possible external bleeding from mild to intense and internal bleeding with a gradual increase in retroplacental hematoma. Emergency delivery (caesarean section) is indicated.

Nagging pain in the lower abdomen is common symptom, which bothers many people, both men and women. And if you have such a symptom all the time, and you cannot explain the nature of its origin, then it is better to visit a doctor to determine the causes of the pain. Since self-medication can drown out the pain, but also hide the disease, which will continue to develop on the sly.

What kind of pain is called nagging?

The pain can be localized in the lower abdomen, above the pubis, below the right side or left. Drawing pain is usually aching, lasts at least half an hour, moderately strong, but not sharp and not cramping. It brings significant discomfort to a person if taken comfortable position, then the pain may ease, but there will still be a pulling sensation. This pain usually lasts for some time, then subsides and returns again.

Tugging sensations often bother women more than men. This is due to the fact that, in addition to common reasons nagging pain, in women these sensations arise in a number of ways physiological reasons related to gynecology.

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Causes

The reasons why the lower abdomen hurts in men can be:

Aching unpleasant pain in women in the lower abdomen can be due to the following reasons.

Physiological state

With increased pressure on the bladder, a pregnant woman has different frequent urination. The enlarged uterus puts pressure on the intestines and therefore pain may occur in the right side, or the left side may be affected, depending on which has more pressure.

Previously, the abdominal muscles felt freer, but now due to “ interesting situation“Women feel constant tension. Sometimes the reason nagging pain constipation may occur, because the fetus interferes with the active movement of feces, compressing the intestinal walls.

Pathological conditions

For women, judging by the points mentioned, there may be much more reasons for concern. But their abdominal pain can also be caused by a physiological condition, while in men it is always a sign of pathology. So a man, feeling a nagging pain in the lower abdomen, should immediately consult a doctor to determine the cause of this phenomenon.

A woman may initially wonder if this symptom is normal, and if so, then there is no reason to visit a doctor. But if none of the woman’s physiological conditions are noted, or other symptoms are added to the abdominal pain (bloody discharge from the vagina, severe weakness, headaches, nausea), it is better to consult a doctor about this.

Women should know that during menopause, pain in the lower abdomen can appear only in the first and third periods, and a pulling sensation in the second period is a reason to consult a doctor.

Diagnostics

To find out why there is nagging pain in the lower abdomen you need to:

If you do go to the doctor, be prepared to undergo an examination; this is mandatory for women gynecological examination, men can be examined by a proctologist or urologist, if necessary.

You will definitely need to take the following tests and examinations:

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A gynecologist, proctologist, urologist, traumatologist, surgeon, and rheumatologist can examine the patient. The choice of specialist will depend on what disease is suspected.

Treatment

If you have established the physiological nature of abdominal pain, then here you can take an antispasmodic or painkiller, try to rest or sleep. The nagging feeling in this case goes away after a few hours and becomes less noticeable with each passing moment. But if you don’t know what it is, then it’s better not to self-medicate, so as not to stop the symptoms of an incipient disease, but to identify it in the early stages.

In this case, the doctor will conduct a diagnosis and prescribe treatment depending on the established diagnosis. It may be appropriate to use antiseptics for inflammation, antibiotics for bacterial infection, radiation and chemotherapy for malignant neoplasms, surgery in the presence of a hernia, or any other therapy selected individually.

Therefore, if you notice nagging pain in your lower abdomen, try to see a doctor as soon as possible, especially if they bother you for a long time, have chronic nature or occur simultaneously with other symptoms. Good doctor will select treatment for your disease, not the symptom, and this is much more effective than spending your whole life on painkillers without treating the cause. Having been treated in this way once, you will be able to forget about abdominal pain, if not forever, then certainly for a long time.

Many diseases in women often develop secretly, without making themselves known for years. Even such a symptom as nagging pain in the lower abdomen, if it does not bother women too much, may not alarm them. However, if mild pain occurs constantly, and in a certain place, there are unusual discharges, then a visit to the doctor should not be postponed until complications arise. Perhaps the physiological state of the woman plays a role. But sometimes pain is a signal of a serious illness that requires urgent examination and treatment.

Content:

Factors influencing the occurrence of pain

Nagging pain occurs in the lower abdomen, usually due to pathological conditions of the pelvic organs, including the uterus and ovaries (organic causes) or due to physiological processes occurring in a woman’s body (functional causes). To establish a diagnosis of a pathology, the symptom of which is nagging pain, it is necessary to know its exact location, intensity, whether it is constant or occurs periodically.

Organic factors contributing to pain

These factors include:

• diseases of the uterus and ovaries (endometritis, ovarian cyst, uterine fibroids);
• sexual infections;
• use of an intrauterine device;
• scarring after surgery;
• inflammatory and infectious diseases of the kidneys, bladder (cystitis, pyelonephritis), as well as intestines;
• pathologies during pregnancy.

Functional causes of lower abdominal pain

In this case, nagging pain appears in the lower abdomen due to dysfunction of the genital organs:

1. Algodismenorrhea (a condition associated with incorrect position or underdevelopment of the uterus, hypersensitivity), dysfunctional uterine bleeding and other menstrual disorders.
2. Ovulatory syndrome. Aching pain in the lower abdomen during ovulation bothers a woman for several hours after the follicle ruptures and the egg leaves it. It can be on one side (depending on which ovary, right or left, is involved in the process). Sometimes it bothers me on both sides at the same time. This happens when both ovaries produce eggs. In this case, a multiple pregnancy may occur.
3. Bend of the uterus, which causes stagnation of menstrual blood.

Video: Causes of pain in the lower abdomen. Self-medication is inadmissible

Organic factors

Aching pain in women can be a manifestation of inflammatory, infectious diseases or processes associated with deformation of organ tissues and circulatory disorders.

Diseases of the reproductive organs

Adnexit(salpingoophoritis). Inflammation occurs due to contact various infections into the uterus, its tubes and ovaries. Moreover, a dull aching pain in the lower abdomen appears when it becomes chronic. Only one ovary or both may be affected. Accordingly, pain occurs on the left, right or both sides at once. The ovaries cease to function normally, which is reflected in various irregularities in the menstrual cycle. In addition, discharge with impurities of pus or blood appears, and the woman’s temperature rises. It becomes impossible for the egg to fully mature, and tubal obstruction occurs. A woman may become infertile. Possible occurrence ectopic pregnancy.

Endometritis. Menstrual disorders, pain in the central part of the abdomen and below appear due to inflammation of the endometrium, the mucous membrane of the uterus, if the process becomes chronic. In this case, inflammation can easily spread to the appendages.

Endometriosis- proliferation of the endometrium (uterine mucosa) into adjacent parts of the uterus (tubes, cervix), ovaries and even intestines. It usually occurs as a result of hormonal imbalances in the body. Except the stupid ones constant pain in the lower abdomen, women experience painful, irregular menstruation. Possible heavy bleeding, brown discharge in addition to menstruation. Amenorrhea (lack of menstruation) may occur. Adhesions or complete overgrowth of the fallopian tubes form, which leads to infertility and ectopic pregnancy. Typically, nagging pain in the groin or pubic area precedes menstruation and becomes stronger during menstruation.

Ovarian apoplexy- hemorrhage into the ovary, which occurs due to tissue ruptures, damage small vessels. Usually observed in the presence of cystic cavities. It can be triggered by sexual intercourse or physical activity. The hemorrhage spreads to the peritoneum. The aching pain below, in the area of ​​the ovary, can be intense. Bleeding can only be eliminated surgically.

Polycystic ovary syndrome- the appearance of cysts in the ovary that violate them normal functioning. In this case, nagging pain in the back, lower abdomen, menstrual irregularities, hormonal imbalance, and obesity occur. The nature of abdominal pain may change if the cyst leg is twisted (which is possible when bending, turning the body, physical activity). If the torsion is small (up to 90°), then the pain may be aching due to poor circulation. When the torsion is complete, the blood supply to the cyst area is cut off. Due to tissue necrosis, nausea, vomiting, and fever occur. Painful sensations in the ovarian area become acute, spasmodic. Urgent removal of the cyst is required.

Colpitis- inflammation of the mucous membrane covering the vagina. The causative agents are streptococci, gonococci, trichomonas, fungi and other types of infection. The mucous membrane becomes thinner, papillae and blisters appear on the surface, which causes nagging pain in the lower abdomen, profuse leucorrhoea, and itching in the vagina.

Myoma - benign tumor. Single or multiple nodes of varying sizes appear both outside and inside the uterus. As the tumor grows, it begins to compress nearby vessels, causing disruption of the blood supply. This causes heaviness and discomfort in the lower abdomen and lower back. Uterine bleeding may occur. Complications of this disease are premature birth, possible infertility. The tumor is hormone dependent. To eliminate it is used hormone therapy or operation.

Video: Pain in the lower abdomen due to inflammation of the fallopian tubes

Pathologies in other organs

Appendicitis. IN chronic form is the cause of aching pain that is felt in the stomach area. Associated symptoms are nausea, vomiting, weakness, fever. Urgent surgery is necessary, as the inflamed appendix can burst, and pus entering the peritoneum leads to peritonitis.

Urolithiasis disease. As a result of the deposition of various salts in the ureters, kidneys or bladder, conglomerates are formed that obstruct the passage of urine. In this case, both dull nagging pain in the lower abdomen and sharp, very strong pain in the lower back and groin area can occur. Stones are removed medically or surgically.

Cystitis- cystitis. With this disease, nagging pain of varying intensity occurs in the lower abdomen, burning in the bladder area, and pain when urinating. In women, cystitis, as a rule, accompanies infectious inflammatory processes in the genital organs, since due to the characteristics anatomical structure genitourinary system infection spreads easily.

Note: Aching pain in the lower abdomen can also be felt in diseases of the digestive system (intestines, gall bladder). For example, with cholecystitis, pain occurs in the hypochondrium, as well as in the lower abdomen.

Nagging pain during pregnancy

They may occur on different dates pregnancy. If aching pain occurs before 22 weeks and is accompanied by bleeding, then the cause is a threat of miscarriage. The doctor, having assessed the woman’s condition, prescribes treatment aimed at maintaining the pregnancy. The threat of interruption arises due to increased tone of the uterus, the presence of scars on it after previous cauterization or curettage, and hormonal disorders. The woman is recommended bed rest, treatment with antispasmodics and hormonal drugs.

The initiator of lower abdominal pain in women during pregnancy can be placental abruption at less than 37 weeks. In this case, not only pain appears, but also bloody discharge, as well as signs of internal bleeding (dizziness, nausea, pallor, headache). In this case, a caesarean section is performed, otherwise the child may die from hypoxia.

Mild pain in the lower abdomen during pregnancy is normal, it is caused by muscle strain, an increase in the size of the uterus and the heaviness of the fetus. If a sharp, increasing pain appears with increased temperature and bleeding, this may indicate the presence of an ectopic pregnancy, uterine rupture and other complications.

Video: Causes of pain in the lower abdomen

Functional reasons

These include situations in which pain occurs due to different periods menstrual cycle.

Lower abdominal pain associated with menstruation

Nagging pain in the groin that occurs before menstruation is usually associated with premenstrual syndrome(the influence of hormones on the nervous system, increased sensitivity, vegetative-vascular disorders). Reason discomfort There may be underdevelopment of the genital organs (especially in young girls), changes in the shape of the uterus after abortion, childbirth, or operations.

If a woman has endometrial hyperplasia or inflammatory diseases of the uterus, then aching pain may remain after menstruation. Growth occurs at this time cystic formations associated with changes in hormonal levels.

Video: Pain in the lower abdomen during menstruation

Pain during ovulation

At the moment of ovulation (the rupture of the follicle and the release of the egg), women may experience mild nagging pain in the lower abdomen and the appearance of traces of blood. Such symptoms are normal and disappear after 1-2 days.

The meaning of accompanying symptoms

When determining the cause pain great importance have accompanying symptoms:

1. Bloody or other discharge that occurs in the middle of the cycle, unrelated to menstruation, indicates the presence of inflammatory diseases of the internal genital organs (endometritis, salpingoophoritis).
2. Copious colored discharge with unpleasant smell, increased temperature combined with pain in the lower abdomen are characteristic of infectious diseases of the genital organs (trichomoniasis, gonorrhea and others).
3. Cramping, burning, frequent urination, combined with pain in the lower abdomen, indicate the presence of pathologies in the urinary system.
4. Nausea, vomiting, bloating, nagging pain are signs of intestinal infections.
5. With appendicitis, pain is usually localized in the right lower abdomen.

Diagnosis and treatment

To establish the cause of pulling pains, an examination is usually prescribed by the following methods:

• a general test for leukocytes and blood clotting, which allows you to detect the presence inflammatory processes, suggest the cause of bleeding;
• urine test for leukocytes, protein and bacteria;
• Ultrasound of the pelvis;
• cytological examination mucus from the vagina and cervix (smear);
• blood tests for latent sexual infections (chlamydia, gonococci, mycoplasmas, Candida fungi and others);
• biochemical analysis blood for antibodies to various infectious agents.

Depending on the location of the pain, its nature and the assumption of the disease, other examination methods are used: tissue biopsy, colposcopic examination of the uterus. Computed tomography (CT) or magnetic resonance imaging (MRI) is used to detect tumors.

After clarifying the diagnosis, if necessary, the doctor prescribes medications antibacterial, hormonal or antispasmodic action. In some cases, only surgery(curettage of the uterus, cauterization of the cervix, removal of tumors, cystic formations).

Warning: If you experience nagging pain in the lower abdomen self-treatment unacceptable, as it may cause great harm health. A heating pad is strictly contraindicated for inflammatory diseases, appendicitis, as this leads to peritonitis and blood poisoning. Any delay when pain in the lower abdomen intensifies, signs of body poisoning or internal bleeding appear can be life-threatening. They occur with ectopic pregnancy, uterine rupture, damage to ovarian tissue, and also with kidney disease.