Hello doctor, I am 23 years old. I have pains in the right side of the abdomen. Sometimes the pain is too much that I have to empty my bladder every now and then. I had unprotected sex with my boyfriend and I took one pill straight away. Could that be the cause of the pain or am I pregnant?  

Bridget

Dear Bridget

You have not specified the site of the pain on the right side of the abdomen. Does the pain on the lower side of the abdomen come with a strong desire to pass urine? If so, this is an indication of urinary tract infection.

Women are prone to urinary tract infection due to multiple reasons like frequent blood loss during menstruation, short length of urethra, pressure and congestion during pregnancy and trauma during child birth among other things. 

The diagnosis is very easy. A simple microscopic examination of the urine reveals the microbes causing infection. A morning midstream sample (urine collected after discarding a few initial drops) gives very accurate results. Urinary tract infection is completely curable by taking suitable antibiotics. As such, drinking a lot of water prevents urinary tract infection.

Pelvic infections, which commonly occur due to poor menstrual or sexual hygiene, can also cause this kind of pain. As the pelvic parts and urinary bladder and urethra are in close proximity inside the body, infection of one part can easily pass on to another. 

Hence pelvic and urinary infections can co-exist. It is diagnosed by clinical examination and excludes urinary infection.  To prevent both these types of infection it is vital to maintain good hygiene during menses and to keep dry all the time. After sexual intercourse one should wash the perineum and pass urine. This helps to prevent contamination and concentration of infectious germs at that site.

Protozoal infections like amoebiasis and giardiasis can also cause pain in various sides of the abdomen depending on the site affected. But with such infections, pain is intermittent, cramp like and associated with constipation, diarrhea and/or vomiting. 

Chronic appendicitis is also one of the reasons for pain in the right mid or lower part of the abdomen. Diagnosis is established by complete blood count and at times by abdominal sonography.

Coitus pills usually do not cause this kind of pain.  Pain related to pregnancy will usually occur in the mid lower abdomen or as cramps in the legs, mostly in the calf muscles. But if there is apprehension about pregnancy, it is better to get a pregnancy test. Though the current pain is not related to pregnancy there are other precautions to be taken if pregnant.

Nowadays kits are available which confirm pregnancy immediately after fertilization occurs, even before a menstrual period is missed. If a pregnancy test turns negative, you have to be careful in the future so that unwanted pregnancies can be prevented.

Dr. Rachna is a specialist in Internal Medicine at Ruhengeri Hospital