Male, severe pain in low right abdoment, periodic ...

Hi Customer (name blocked for privacy). Thank you for asking your question on Just Answer. There was a specific question in your post. Are you seeking information on conditions presenting with these symptoms, and suggested testing, or did you have a different question in mind?

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No doctor through my HMO can seem to or wants to direct me as to what could be problems, they simply put me on anti biotics and send me on my way for 2 years now. My question is what possible problems could cause this type intermitten ongoing pain in the lower right abdoment, sometimes pain goes down into the right leg also. today new symptom appeared(muscle spasms in right lower side with spasm going up to rib cage. I just need direction so next time I go to these idiot doctors I can tell them what I want or need tested and what perhaps to look for.

How are your bowel movements? Any diarrhea or constipation? How about blood in your stools? You may have Crohn's disease. The most common symptom of Crohn's disease is inflammation characterized by right lower quadrant abdominal pain and tenderness. The symptoms of Crohn's dz mimic appendicitis.


Edited by DrHanson on July 3 2006 at 10:52pm

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No problem urinating, no diarrea, constipation. Doctors said once perhaps there is pressure building up causing infection in epiditimitus from a small knot in scrotum (knot is not growing,ultra sound does not show what it is-perhaps scaring from when I was hit between the legs 10 years ago)Only symptoms is severe pain mainly in the AM in lower right abdomen around the hip bone. With the severe pain nausia and vomiting is present. Ejaculation with help releave the pain after some time but still remains a dull but severe ache for a few hours after leaving the side extremely sore and tender all day. A constant daily does of collodial silver(natural antibiotic ) seems to keep pain down to 1-2 x weekly.

Another odd thing happening in the past 2 years is my stomach, abdomen area seems to be growing/swelling (like a pot belly pig)I do not eat bad,and have a normal rounded diet. I have no blood in the stools. Have a reqular constitution.Is crohns Dz the only illness this problem could be associated with?

Edited by Customer (name blocked for privacy) on July 4 2006 at 12:04am

#1---"severe pain in low right abdomen, periodic episodes 1-2 times weekly"

You most likely have what is called a "sports hernia" which is different from an "inguinal" hernia. A sports hernia occurs when there is a weakening of the muscles or tendons of the lower abdominal wall in the same region where an inguinal hernia occurs but there is no "palpable" hernia; therefore, you can't see the hernia (bulge). A sports hernia begins with a slow onset of aching pain in the lower abdominal region in the groin and pain in the testicle. Sports hernias are most common in athletes that have to maintain a bent forward position for example hockey players.

You also have a "groin pull" which is causing you to have referred pain in your thigh and muscle spasms in your right side up to your rib cage.

I recommend that you take Motrin, rest, avoid sports activities until your symptoms subside, and apply ice to the painful area for 20 minutes an hour. Don't leave the ice on for more than 20 minutes because it will cause tissue necrosis if it's left on too long.

If these measures do not relieve the symptoms of your sports hernia, surgery may be recommended to repair the weakened area of your abdominal wall.

#2---"perhaps there is pressure building up causing infection in epiditimitus from a small knot in scrotum (knot is not growing,ultra sound does not show what it is. . . . .With the severe pain nausia and vomiting is present."

In patients older than 35, coliform bacteria predominate because underlying obstructive urinary disease is often present. However, sexually transmitted pathogens
e.g. Chlamydia trachomatis and Neisseria gonorrhea are also considerations.

I recommend that you be examined and treated by a urologist who can assesses perfusion of your testicle and anatomy of the scrotal contents using a doppler.
A normal testicle with diminished doppler wave pulsations represents testicular torsion.
A thickened enlarged epididymis with increased doppler wave pulsations represents epididymitis. Testicular torsion is an emergency that only a urolgist can treat.

A physician can prescribe appropriate antibiotic coverage e.g. Ceftriaxone (Rocephin), Doxycycline (Bio-Tab, Doryx, Vibramycin), Azithromycin (Zithromax),Trimethoprim, sulfamethoxazole (Septra DS, Bactrim DS), or Ciprofloxacin (Cipro)

In the meantime I recommend immobilization and elevation of your scrotum, an ice pack, Motrin, limit activity, and a screening test and treatment for possible STD's for yourself and your sexual partners.

#3---"stomach, abdomen area seems to be growing/swelling"

You might have ascites. Ascites is excess fluid in the the peritoneal cavity (the space between the membranes lining the abdomen and abdominal organs). This is typically caused by liver disease. The treatment of ascites depends on it's cause. The basic treatment for ascites is rest, dietary sodium restriction, and diuretics.

Besides being examined and treated by a urologist immediately to rule out a possible testicular torsion, I also recommend that you have a "complete" physical exam as soon as possible to examine your heart and liver and appropriately treat your ascites.

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Thank you for your direction. STD's have been tested for and that is not the case. I myself thought testicular torsion and sports hernia could be the underlying causes but these idiot HMO doctors I have to deal with just say epiditimitus and don't want and think they need to go any further with helping this problem get resolved and find the underlying cause until it becomes an emergency. Thankyou greatly for the research you have compiled for me.

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