Why do I have right lower abdominal pain?

Hello,

I am 24 years old.

I have lower abdominal pain on the right side that started a little over a year ago.

The pain varies in intensity - times there is almost no feeling of pain and times when it is so painful that I am unable to walk or make sharp movements. When the pain attacks (lasting several days), I have to rest in order to get better - if I continue to behave normally and do not rest enough, my condition does not improve. If I press on the area, the pain increases and lasts for longer.

It is important to emphasize that when I do not have the pain I can do sports as usual without symptoms and I have an appetite.

I could not find a pattern of action that avoiding it would lead to the non-appearance of symptoms (e.g. not eating a particular food), but the pain did occur in the past after eating a large amount of food (mostly fried or dairy), after several days of diarrhea (as a result of eating outside for example), after restraint prolonged exhalation of many gases and fece, after training abdominal muscles, during a stressful period, after a massive ascent and descent of stairs.

I will further note that sometimes I have pain in my right testicle (on the same side) with long walk that usually disappears at rest (and for longer as the rest is longer), but even this pain is not permanent (i.e. I can sometimes strain a lot and not hurt at all).

I did a tummy tuck, I did a testicular and groin ultrasound, I did a bowel ultrasound, I did blood tests for chemistry and hematology (including sensitivity to celiac disease), I did a stool test, I did a colonoscopy and I did a CT scan of the abdomen with contrast material.

The results were normal in all tests and not abnormal except:

1. In the stool test there was calprotectin 65.
2. Lymphocytes in the blood were slightly above the normal upper extremity.
3. Small lymph nodes in the lower right abdomen (location of pain).
4. On CT, they identified an irregularity in the terminal ileum that goes towards the colon, and a suspicion of infection in the small intestine in particular (signs of inflammation).
5. CT revealed grade 1 spondylolisthesis at L5-S1 secondary to spondylolysis.
6. In a stool test they identified blastocysts hominis.
7. On abdominal ultrasound it was found that the appendix was 6 mm (borderline). However, on CT and intestinal ultrasound it looked normal.
8. On abdominal ultrasound, two polyps measuring 0.3 mm and 0.6 mm were identified in the gallbladder wall. Both have grown over the past six months (from ultrasound to another ultrasound) by 0.3 mm.
9. Outside the right testicle is a 5 mm acongic focal and adjacent a 6 mm cystic cavity. A urologist examination is not a significant finding.
10. When I was a teenager, a surgeon sensitively identified that I had a groin hernia and a (small) umbilical hernia, but a recent ultrasound examination found no such finding.

I am really suffering from the pain and right now I have no direction as to what to do to be able to lead a normal and healthy life. I take into account that maybe it is related to something else (a torn tendon maybe? A nerve that stretches in the area?).

I would love guidance and advice on what to do from here and what I should check out, thank you very much.

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