y Chapter 4.4: Lower Abdominal Pain, Population Reports, Series L, Number 9

CONTENTS

          Chapters
  1. The Toll of STDs
  2. Reducing the Toll of STDs
  3. Managing STDs
  4. Diagnostic and Treatment Tips
  5. Getting Services to the People
  6. Getting People to Services
  7. Promoting Prevention—Condoms and Monogamy

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXI, Number 1
June, 1993

Lower Abdominal Pain

 Diagnostic Tips

  • Check for emergencies and refer immediately to a hospital if septic abortion, intestinal obstruction, ruptured bowel, appendicitis, or ectopic pregnancy is suspected.

  • In addition to lower abdominal pain pelvic inflammatory disease can cause pain during intercourse or urination, heavy or prolonged menstrual bleeding, pain during menses, nausea, and vomiting.

  • On speculum exam, an open cervix indicates pregnancy or abortion.

  • Look for signs of STDs—ulcers or vaginal discharge.

  • Ask the patient if she is using an IUD. Women using IUDs have a higher risk of pelvic inflammatory disease than women using no contraception, particularly if the IUD was inserted recently (106).

Treatment Tips

  • Also treat sexual partners for gonorrhea and chlamydia.

  • Metronidazole treats anaerobic bacteria that may be contributing to pelvic inflammatory disease.

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