Urinary tract infection
A urinary tract infection, or UTI, can involve any or all parts of the urinary system but most often affects the bladder and urethra.
Bacteria from the gastrointestinal tract – especially Escherichia coli (E. coli) – are the most common cause of UTIs. These bacteria spread from the anus to the urethra. Sexual activity can do this, but a UTI is not considered a sexually transmitted disease.
Women are more at risk for UTI than men. Due to female anatomy, the urethral opening is a short distance from the anus. Anyone who uses catheters to urinate is also prone to UTIs.
Common symptoms of less-serious UTIs include lower abdominal discomfort and pressure; burning or discomfort on urination; and cloudy or discolored urine.
Left untreated, the infection could spread to the kidneys and cause a medical emergency.
Diagnosis is made by having the patient describe the symptoms and by testing a urine sample for bacteria.
UTIs are caused by bacteria and so can be treated with antibiotics.
Prevention involves good hygiene and drinking plenty of water.
The earliest sign of a pregnancy is typically a missed period, but many women do experience symptoms shortly after conception:
- Implantation bleeding may occur after six to twelve days, when the fertilized egg implants itself into the lining of the uterus. This can cause mild cramping with light bleeding or spotting.
- Fatigue and increased desire to sleep may happen within a week.
- Breast tenderness can start as soon as one to two weeks.
- Nausea ("morning sickness") can occur after two to eight weeks.
If pregnancy is suspected, testing should be done so that proper prenatal care can begin. It's important to avoid some behaviors during pregnancy, such as drinking alcohol or using certain drugs or medications, so an early diagnosis should be made.
Over-the-counter home pregnancy tests are available at any drugstore. A positive test is almost certainly correct, but a negative test in the face of other symptoms may be a false negative and should be tried again after a week.
Top Symptoms: fatigue, nausea or vomiting, stomach bloating, bloody vaginal discharge, vaginal bleeding
Symptoms that always occur with possible pregnancy: missed period
Symptoms that never occur with possible pregnancy: painful urination, severe abdominal pain
Pelvic inflammatory disease
Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.
PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.
Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.
Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.
Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.
Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.
Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.
To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.
Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain
Symptoms that always occur with pelvic inflammatory disease: fever, abdominal pain or unusual vaginal discharge
Urgency: In-person visit
Ovulation pain (mittelschmerz) or midcycle spotting
Mittelschmerz is a German word that translates as "middle pain." It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.
Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.
This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.
Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.
Diagnosis is made through patient history.
Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.
Top Symptoms: abdominal pain (stomach ache), last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain
Symptoms that always occur with ovulation pain (mittelschmerz) or midcycle spotting: last period approximately 2 weeks ago
Ovarian torsion, also called adnexal torsion or tubo-ovarian torsion, is the twisting of the "stem," or supporting fleshy pedicle, of the ovary.
This condition can occur when a mass forms on the surface of the ovary and pulls it over. This is most often a complication of cystic ovaries.
It is most common in women under thirty or past menopause. It can occur during pregnancy.
Symptoms include severe, one-sided, lower abdominal pain with nausea and vomiting.
Diagnosis is made by ultrasound. The ovary will appear enlarged due to the torsion cutting off the circulation. There will be free pelvic fluid and a twisted pedicle.
Ovarian torsion is a medical emergency. The ovary can die due to loss of circulation, causing infection, abscess, or peritonitis. Surgery must be done to prevent tissue death and subsequent complications. In the majority of cases the affected ovary must be removed, which also removes the cyst or mass that caused the torsion.
Proper treatment of polycystic ovary syndrome (PCOS) can help prevent at least one cause of ovarian torsion.
Top Symptoms: abdominal pain (stomach ache), nausea or vomiting, nausea, moderate abdominal pain, loss of appetite
Symptoms that never occur with ovarian torsion: diarrhea, pain below the ribs, mild abdominal pain
Urgency: Hospital emergency room
During her reproductive years, a woman's ovaries release a single egg cell each month. But sometimes the egg remains on the surface of the ovary, where the follicle that enclosed it continues to grow. It then becomes a fluid-filled ovarian cyst.
Ovarian cysts may be caused by hormonal imbalances; by endometriosis tissue, if it attaches to the ovary; and by severe pelvic infections that spread to the ovaries. Cysts may also form during pregnancy.
Small ovarian cysts often cause no symptoms. Larger cysts may cause pelvic pain, backache, unexplained weight gain, abnormal vaginal bleeding, and/or pain during sex. Ovarian cysts are almost never a form of cancer.
Sudden, severe abdominal pain could indicate a ruptured cyst. This is a medical emergency and the patient should go to an emergency room or call 9-1-1.
Diagnosis is made through ultrasound.
Hormonal birth control, such as the pill, injection, or patch, prevents ovulation and therefore prevents the formation of cysts. Surgery to remove the cyst may be necessary in some cases.
Top Symptoms: stomach bloating, vaginal bleeding, pelvis pain, lower abdominal pain, lower back pain
Urgency: Primary care doctor
Normal variation of constipation
Constipation means bowel movements which have become infrequent and/or hardened and difficult to pass.
There is wide variation in what is thought "normal" when it comes to frequency of bowel movements. Anywhere from three times a day to three times a week is considered normal.
As long as stools are easy to pass, laxatives should not be used in an effort to force the body to a more frequent schedule.
Constipation is usually caused by lack of fiber in the diet; not drinking enough water; insufficient exercise; and often suppressing the urge to have a bowel movement.
A number of medications and remedies, especially narcotic pain relievers, can cause constipation.
Women are often affected, due to pregnancy and other hormonal changes. Young children who demand low-fiber or "junk food" diets are also susceptible.
Constipation is a condition, not a disease, and most of the time is easily corrected. If simple adjustments in diet, exercise, and bowel habits don't help, a doctor can be consulted to rule out a more serious cause.
Top Symptoms: abdominal pain (stomach ache), nausea, stomach bloating, constipation, constipation
Symptoms that always occur with normal variation of constipation: constipation
Symptoms that never occur with normal variation of constipation: vomiting
Intestinal inflammation (diverticulitis)
When the passage of food through the colon becomes sluggish, the food can stagnate, increase in bulk, create pressure, and cause diverticula – or pouches – to form in the walls of the large intestine. If these pouches become inflamed, the condition is called diverticulitis.
Risk factors are a low-fiber diet, smoking, obesity, chronic constipation, and lack of "good" bacteria in the gut.
Patients over 50, with a previous history of inflammatory disease of the colon, are most susceptible.
Symptoms include persistent abdominal pain; fever; nausea and vomiting; and constipation sometimes alternating with diarrhea.
Left untreated, diverticulitis can lead to intestinal blockage and scarring. Rupture of an inflamed pouch can result, leading to peritonitis. These are medical emergencies. If suspected, take the patient to the emergency room or call 9-1-1.
Diagnosis is made by ruling out other conditions through physical examination; blood, urine, and stool tests; and CT scan.
Less serious cases are treated with a high-fiber diet, fluids, probiotics, antibiotics, and lifestyle management. Others may require intravenous antibiotics and/or surgery.
Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation
Symptoms that never occur with intestinal inflammation (diverticulitis): pain below the ribs, pain in the upper right abdomen
Urgency: Hospital emergency room
Appendicitis is an inflammation of the appendix, the small, finger-shaped pouch projecting off the colon on the lower right side of the abdomen.
The inflammation is caused by anything blocking or irritating the appendix opening or walls, such as hard stool or damage from other bowel disease. The blocked appendix can quickly swell with bacteria and pus.
Appendicitis is most common from ages 13-30, but can happen to anyone.
Symptoms include sudden, severe pain in the abdomen that begins near the navel and soon moves to the lower right side. There may be low-grade fever; nausea and vomiting; feeling bloated; and constipation or diarrhea.
If not treated, an infected appendix can rupture and cause a life-threatening infection of the abdomen called peritonitis. This is why appendicitis is a medical emergency. If suspected, take the patient to the emergency room or call 9-1-1.
Diagnosis is made through patient history, physical examination, blood and urine tests, and imaging such as ultrasound or x-ray.
An inflamed appendix must be surgically removed as soon as possible.
Questions your doctor may ask about pain in the lower right abdomen
- Have you experienced any nausea?
- Any fever today or during the last week?
- Have you lost your appetite recently?
- How would you describe the nature of your abdominal pain?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.