What causes constant lower right abdominal pain?
Patient: I have had constant pain in lower right abdomen area for the past three months - the pain varies from tolerable to intolerable and depends upon stress and other factors I do not know b.c. i do  experience the pain when I am in a low-stress environment. Please also note that I look tired all the time even if I get sleep [pronounced dark circles].  Everyone always tells me I look like crap even if I feel ok at that moment [i.e. the pain is dull or at a tolerable level -mild discomfort is the best it gets]. I have had the following images taken: 1) CT 2) ultrasound.  I have had blood work and urine work done more than once.  The images show two kidney stones in right side.  But, the urologist is CERTAIN that the stones are NOT causing my pain, but he does not know why I have this pain, the source of this pain or how I got this pain.  The urologist referred me to the Gastro doctor - we did blood work and urine - ultrasound - took the RX Prilosec ---reviewed the CT -- Gastro says everything [all anatomy depicted in the full abdominal ultrasound] is fine and that he does NOT know why I have this pain - Gastro says next step is to look inside stomach or do a endoscopy on both ends but that he says highly highly unlikely that the endo will shed any light on this right side abdominal pain that is definitely NOT muscular or tied to my obliques.    So, here I am, still with this pain and left without answers.  I am going for yet another opinion and peak next week at a Cedars Sinai Gastro.  Please, any ideas what this pain is due to and why I have it, what it is etc? Also, what should I do at this point.  Again, assume urologist is correct in that my stones are NOT at this point lodged in a manner to cause the lower-right ab pain I speak of.  WHAT IS THIS?????? Thank you in advance. Doctor: Hi ! Good morning. I am Dr Shareef answering your query.As you have not mentioned anything about the size of the stones in kidney, it might not be possible to opine if they were the culprits for your pain or not. Other investigations being normal, if I were your doctor, I would advise you to stop eating from out side if you do, as many components of food from outside, specially the fast food might contain some ingredients to which your intestines might be more sensitive and give rise to such symptoms. I would advise you to add more of roughage and enough liquids in your diet,and to avoid any alcoholic beverages and smoking if you do. In addition, I would advise you to go for a routine test of your stool for ova and cyst, which when treated surprisingly cure many of the chronic abdominal pain. I am sure your clinician must have examined your abdomen clinically to rule out chances of any recurrent appendicitis. Also I would go for a routine/microscopic and culture sensitivity test for urine to rule out a silent UTI which is not uncommon. In case of female patients, a PID (pelvic inflammatory disease have to be ruled out) by a gynaecologist. Till then, you could go for some anti spasmodic drug and a proton pump inhibitor and a probiotic drug for a symptomatic relief.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef