Lower Abdominal Pain

Q My colonoscopy was normal but the pain continues, and I was only told it is "nerves".

A. Tests examine the lining and structure of the intestine. A state in which its movement has become over-sensitive is not captured. This is not a matter of a sensitive personality — the intestine is tuned to react strongly to stimuli.

Q The pain has gone on so long that I fear something serious. How do I tell?

A. If weight falls on its own, if there is blood in the stool, if pain wakes you at night, or if anaemia appears, testing comes first. Conversely, pain that rises and falls with meals, bowel movements and tension, with normal tests, is more likely functional.

Q As a woman, my lower abdomen hurts more around my period. How do I tell whether this is digestive or gynaecological?

A. If it overlaps regularly with your cycle, gynaecological assessment is needed as well. If it worsens only around the period regardless of bowel movements, or if flow and duration have changed, that side carries more weight. Many people have both, so addressing one alone solves only half.

Q Along with the pain I alternate between diarrhoea and constipation, feel bloated with gas, and am often anxious. Are they connected?

A. They frequently arise from the same root. When intestinal movement becomes irregular, pain, gas and changes in bowel habit arrive as one bundle. Add anxiety and the intestine grows more sensitive, and that sensitivity feeds the anxiety back.

Q Is there anything I can try at home?

A. Keep the lower abdomen warm, hold meal times steady, and fix your bowel routine to the morning. A warm compress for 10 to 15 minutes helps settle acute pain. Drink enough water and raise fibre gradually rather than all at once.

Q The morning commute is what I dread most. Is there a way to get through it?

A. Moving your morning 10 to 15 minutes earlier to create room is the most practical step, because rushing out is itself a signal that tightens the intestine. Securing time to finish a bowel movement at home greatly reduces anxiety while travelling.

Q When does lower abdominal pain mean going to the emergency room?

A. Pain that starts suddenly and keeps worsening, pain with fever, or pain so severe you cannot bear the abdomen being touched needs immediate care. The same applies to pain that begins around the navel and migrates to the right lower abdomen, blood in the stool or black stools, and repeated vomiting. Severe lower abdominal pain when pregnancy is possible must be assessed without delay.

Q I take painkillers and anti-diarrhoeals whenever it hurts. Is it fine to continue?

A. Using them urgently differs from using them constantly. Anti-inflammatory painkillers burden the stomach and intestinal lining, and frequent anti-diarrhoeals can disturb the intestinal rhythm further. Please tell us what you take and how much.

Q I take bowel medication and an anti-anxiety medication. Can I take herbal medicine alongside them?

A. In most cases yes, but you must tell us everything you are taking. Depending on the type, we advise spacing doses one to two hours apart. Do not stop existing medication on your own — we decide together when to reduce it.

Q How long until it feels easier with treatment?

A. Usually the frequency falls before the intensity. Daily pain spreads to once every few days, and urgent dashes to the toilet become rarer. Symptoms of a few months often change within weeks; long-standing ones take longer to assess.

Q My lower abdomen hurts often. Where does pain in this area come from?

A. The lower abdomen houses the large intestine, the uterus and ovaries in women, and the bladder, so pain there has several possible origins. Location alone cannot identify the cause. Separating its relationship with bowel movements, periods and urination is the first step.

Q The moment the subway doors close on my commute, my stomach cramps and I break into a cold sweat. Why does tension do this?

A. The intestine is the organ that responds fastest to tension. Under stress its movement becomes hurried or irregular, and the sensitivity with which you feel pain rises too. This is not weak willpower — your intestine is set to react that way.

Q The pain settles after I use the toilet. Does that mean it is an intestinal problem?

A. If pain eases after a bowel movement, an intestinal origin is likely. Whether stool becomes looser or harder, and whether gas and a sense of incomplete emptying move with it, are also key clues. But pain unrelated to bowel movements, or severe enough to wake you at night, calls for other causes to be checked.

Q Which foods make the lower abdominal pain worse?

A. Fatty food, spicy food, alcohol and caffeine are the main ones. Some people react strongly to milk and dairy or to wheat. Rather than deciding what to cut, it is more practical to find the two or three you react to most.

Q Cold food or a cold belly sets the pain off immediately. Why?

A. Cold stimulation hurries intestinal movement, which easily leads to pain and loose stools. The reaction is clearer in those whose lower abdomen tends to be cold. Simply keeping the abdomen warm often reduces how often the pain comes.

Q I work in Dong-gu, Incheon. How often should I come in?

A. Early on we shorten the interval to two or three visits a week to settle pain and bowel habits first. Once stable, we widen the interval and raise the share of herbal medicine and lifestyle management. At the first visit we set a realistic plan around your work schedule.

Q In what order does the clinic treat lower abdominal pain?

A. We first screen for danger signs, then press the abdomen to see where it is stiff and cold. Next we restore the intestinal rhythm, clear what has accumulated, warm the lower abdomen to lift circulation, and settle the over-sensitised nerves. Acupuncture and moxibustion release abdominal tension, with herbal medicine matched to your constitution and state.

Q I have taken probiotics and anti-diarrhoeals for a long time with no change. Why do they not work?

A. Probiotics support the intestinal environment, so the effect is modest when tension has made intestinal movement hurried. Anti-diarrhoeals suppress the symptom briefly without restoring the rhythm. Identifying which side the cause sits on determines what is actually needed.