Treatment of chronic lower abdominal pain by obstetrician-gynecologist Vitaliy Grigorievich Kostenko in the city of Dnipro

When dealing with chronic lower abdominal pain, patients often complain of constant discomfort, menstrual cycle irregularities, and recurrent pains that interfere with daily life.

The doctor conducts a thorough clinical evaluation, reviews complaints and medical history, and, if necessary, orders additional tests to determine the cause.

The patient receives a clear and understandable action plan — what to do at the moment, which examinations are mandatory, and how to monitor changes in their condition.

Vitaliy Grigorievich Kostenko pays special attention to the differential diagnosis of pain causes and manages patients dynamically, ensuring timely adjustment of therapy and prevention of exacerbations.

When to See a Doctor

Chronic lower abdominal pain can have various causes and may present differently in each patient. Sometimes the discomfort is constant, sometimes it occurs periodically but still significantly disrupts daily life. It is important to consult an obstetrician-gynecologist in a timely manner for symptom evaluation and, if necessary, diagnostic testing.

You should make an appointment with an obstetrician-gynecologist if, along with chronic lower abdominal pain, you notice:

• Constant dull or aching pain in the lower abdomen
• Increased pain during menstruation or before it
• Periodic sharp or cramping pains that interfere with work or rest
• Irregular or changed menstrual cycles accompanied by pain
• Pain during sexual intercourse
• A feeling of discomfort or heaviness in the pelvic area
• Symptoms worsen after stressful situations or physical exertion
• Pain does not go away or intensifies despite self-care measures or previously prescribed treatment
• Recurring pain that returns after some time
• Newly onset pain that causes concern
• Chronic course with periods of exacerbation
• Pain interferes with normal sleep and daily activities

If you notice one or more of these signs, consulting a doctor will help clarify the situation, choose the optimal approach, and monitor your condition. Do not postpone the visit — timely consultation contributes to a more accurate understanding of the causes of pain and reduces the risk of complications.

Emergencies or When to Urgently See a Doctor

• Sudden severe pain in the lower abdomen that rapidly worsens
• Pain combined with fever, chills, and weakness
• Vaginal bleeding with a large amount of blood or clots
• Acute pain that prevents movement or normal breathing
• Sudden worsening of condition against the background of chronic pain

If you experience any of these symptoms, do not wait for a scheduled appointment—seek emergency care immediately. Our clinic offers a home visit service for a quick assessment of your condition.

Causes and Risk Factors of Chronic Lower Abdominal Pain

Chronic lower abdominal pain can arise from various causes that need to be understood and evaluated by a doctor. This section will help clarify the mechanisms most commonly associated with this problem and highlight what to pay attention to in order to reduce the risk of its progression.

Main Causes / Mechanisms (Brief)

• Inflammatory processes in pelvic organs
• Menstrual cycle and hormonal imbalances
• Pathologies of the uterus and ovaries, including cystic formations
• Adhesions and scar tissue changes after surgeries or inflammations
• Impaired vascular circulation in the pelvic area

Risk Factors

• Age over 30–35 years with active reproductive function
• Unhealthy lifestyle, including stress and low physical activity
• Chronic inflammatory diseases or infections of the reproductive organs
• Frequent gynecological interventions and surgeries
• Previous pelvic injuries
• Menstrual cycle and hormonal balance disorders
• Planning or current pregnancy as a condition of increased risk
• Genetic predisposition to gynecological diseases

Reversible Causes That Should Be Ruled Out

• Infections of the urinary and reproductive organs
• Dysfunction of the pelvic floor muscles
• Menstrual cycle disturbances caused by temporary hormonal changes
• Inflammations that respond well to medical treatment

The causes of chronic lower abdominal pain are diverse; therefore, a professional evaluation and examination are necessary for an accurate understanding of the situation and to choose the appropriate management strategy.

Diagnostics

The diagnosis of chronic lower abdominal pain is aimed at identifying possible causes and developing a plan for further action. The doctor systematically gathers information and orders necessary tests to understand what exactly is causing the discomfort.

Diagnostic Approach

• Taking medical history — discussing complaints, disease history, and risk factors
• Physical examination to assess the condition of the pelvic organs
• Ordering basic laboratory tests as indicated
• Conducting instrumental examinations when necessary
• Analyzing the collected data and forming a preliminary examination and treatment plan
• Referring to specialized consultations if needed
• Discussing the approach to monitoring and managing the condition with the patient

Typical Tests as Indicated

Diagnostics may include:

• Ultrasound examination of the pelvic organs
• Blood and urine tests to assess inflammatory processes
• Swabs and bacteriological cultures to rule out infections
• Hysteroscopy if intrauterine changes are suspected
• Additional imaging methods as prescribed by the doctor

What to Bring to the Appointment

• Previous test results and examination reports
• A list of currently taken medications and supplements
• A symptom diary indicating the timing and characteristics of the pain episodes
• Medical records of past gynecological or surgical interventions

Each step in diagnosing chronic lower abdominal pain is important for accurately understanding the situation and choosing the optimal strategy for monitoring and treatment.

Treatment

The treatment of chronic lower abdominal pain is aimed at reducing symptoms and improving the patient's quality of life. The therapy plan is tailored individually, taking into account the causes of pain, the overall situation, and any comorbid conditions.

Therapy Goals

• To reduce the intensity of pain and discomfort
• To address possible underlying causes affecting the condition
• To improve the functional state of the pelvic organs
• To prevent potential complications and exacerbations

Main Treatment Approaches

• Therapy is individualized and may combine pharmacological agents as indicated
• Use of non-drug methods, including physiotherapy and rehabilitation
• Minimally invasive procedures may be performed if necessary
• Consideration of comorbidities in the overall treatment plan
• Regular monitoring and adjustment of therapy based on results and patient's well-being

Physician's Role

• Selects and adjusts the therapeutic plan depending on disease progression
• Assesses the impact of comorbid conditions on treatment
• Monitors for possible side effects of therapy
• Explains to the patient the criteria for evaluating treatment effectiveness
• Coordinates interaction with other specialists as needed

What to Expect: Planning and Monitoring

• Regular assessment of symptom dynamics and general well-being
• If no improvement occurs, the physician individually adjusts the treatment plan
• Follow-up visits are scheduled as indicated for monitoring and therapy correction
• Decisions on additional examinations are made based on observation and symptoms

Detailed information about treatment options can be obtained during a consultation with Dr. Vitaly Grigoryevich Kostenko.

Prevention

Prevention of chronic lower abdominal pain is important to reduce the risk of flare-ups and worsening of the condition. The prevention plan is tailored individually, taking into account health specifics and identified risk factors.

Main primary prevention measures

• Monitoring and treatment of chronic inflammatory diseases as indicated
• Maintaining a healthy lifestyle and balanced diet
• Prompt consultation with a doctor upon the appearance of new symptoms
• Moderate physical activity recommended by a specialist
• Avoidance of harmful habits, including smoking
• Stress reduction and maintaining psychological balance

Screening and secondary prevention / regular monitoring

• Regular gynecological examinations according to the doctor's recommendations
• Ultrasound examinations of the pelvic organs as indicated
• Monitoring the menstrual cycle and discussing any changes with the doctor
• Examination and treatment of concomitant diseases as necessary

Practical advice

• Discuss any changes in your condition or new complaints with your doctor
• Keep a symptom diary to help analyze the dynamics
• Try to avoid physical overexertion and sudden stress
• Follow recommendations for taking prescribed medications
• Schedule regular doctor visits to update examinations in a timely manner

Preventive measures help reduce the influence of factors contributing to the development or exacerbation of chronic lower abdominal pain and require regular discussion with your doctor.

Important to Know

Chronic lower abdominal pain is a common problem that can have various causes and consequences. It is important to identify not just the pain itself, but also the factors and conditions that cause or worsen it. Early consultation helps determine the best approach and reduces the risk of complications or disease progression. Sometimes ongoing monitoring and adjustment of the treatment plan based on results are necessary. The course of symptoms is influenced by different factors—physical activity level, stress, sleep quality, and presence of comorbidities. Self-medication can hinder diagnosis, mask the true causes, and cause side effects.

• Identifying the cause and provoking factors is more important than simply suppressing symptoms
• Early assessment helps choose an effective course of action
• Monitoring and regular treatment adjustments contribute to stable pain control
• Factors such as stress, physical workload, and comorbidities influence symptom progression
• Self-administration of medication can obscure the clinical picture and delay diagnosis
• A comprehensive approach and attention to detail increase the chances of improvement

For more detailed information and an in-depth overview, it is recommended to refer to the general women’s health and gynecology page on our website.

Self-Care Before the Appointment: What You Can and Cannot Do

Before your visit to Dr. Vitaliy Grigorievich Kostenko, it is important to follow safety measures to avoid worsening your condition or distorting the clinical picture. If your condition deteriorates, seek medical help immediately.

What You Can Do Before the Appointment

• Write down when and how the pain started; specify its nature and intensity
• Keep a symptom diary, noting the time and factors that increase the pain
• Bring a list of medications you are taking and their dosages, if known
• Measure and record your temperature and pulse, if you know how
• Reduce physical activity and rest if you experience significant discomfort
• Drink plenty of water to avoid dehydration
• Avoid stressful situations and overexertion
• Take safe pain relievers as needed and according to your doctor's recommendations

What You Should Not Do Before the Appointment

• Do not stop or change previously prescribed medications without consulting your doctor
• Do not start taking several new medications on your own simultaneously
• Do not use folk remedies without consulting a healthcare professional
• Do not try to interpret test results or examinations by yourself
• Do not delay seeing a doctor if your condition worsens
• Do not ignore new or intensifying symptoms
• Do not self-medicate by hiding symptoms or changing their nature

If you notice signs of worsening or urgent symptoms, contact Dr. Vitaliy Grigorievich Kostenko immediately.

How I Can Help as a Doctor with Chronic Lower Abdominal Pain

Chronic lower abdominal pain requires a comprehensive approach that takes into account various possible causes and factors. During the consultation, I will carefully review your symptoms and medical history, assess your condition, and develop an optimal management strategy. This approach helps not only to relieve symptoms but also to understand the root of the problem and maintain control over its progression.

In a consultation regarding chronic lower abdominal pain, I can assist you with the following:

• Analyze your complaints and medical history to identify possible causes of the pain
• Assess the severity of symptoms and identify risk factors for complications
• Review current prescriptions and medication tolerance, making adjustments if necessary
• Develop a phased plan for examinations and treatment measures
• Consider comorbidities and current medications for a comprehensive approach
• Provide recommendations on lifestyle and daily routine tailored to your situation and indications
• Discuss control criteria and explain when you need to return for a follow-up consultation
• Conduct initial diagnostics and differential diagnosis to explore possible causes of the pain
• Adjust treatment if there is insufficient effect or the emergence of side effects

Such a comprehensive approach helps gradually improve your condition, while timely monitoring prevents exacerbations and the development of complications. An individualized plan is tailored to the specifics of your health and current state.

What questions can I ask the doctor about chronic lower abdominal pain?

During a consultation regarding chronic lower abdominal pain, you can discuss the following issues with Vitaliy Grigoryevich Kostenko:

• Constant or periodic pain in the lower abdomen that interferes with daily life
• Changes in the menstrual cycle and related discomfort
• Pain during sexual intercourse or physical activity
• Recurring pain that returns after treatment or self-managed relief attempts
• General malaise accompanying chronic pain
• Searching for causes when symptoms have persisted for a long time and previous treatments have been ineffective
• Seeking a second opinion on already prescribed therapy or examinations
• Accompanying inflammatory or infectious conditions of the reproductive organs

In case of sudden severe pain, heavy bleeding, or fever — urgent medical attention is required; do not wait for a scheduled appointment.

Questions you can discuss during your appointment

• What is happening to me and what could it be?
• Why did the pain start now?
• How can I tell that the pain is related to chronic lower abdominal pain and not another condition?
• What examinations are necessary in my case?
• Which tests or investigations are truly essential, and which can be omitted?
• How should I properly prepare for the examinations and the appointment?
• What treatment options are available, and how do they differ?
• Is it possible to completely get rid of the pain, or is this more likely a chronic condition?
• What should I do if the prescribed treatment does not help?
• Can I manage without medication or surgery?
• How long does treatment usually last, and how often should I undergo follow-up?
• What signs indicate improvement or deterioration of my condition?
• What should I do if symptoms suddenly worsen or flare up?

If your symptoms match the descriptions above or you want to clarify your current situation, consulting a doctor will help you get clear answers and determine the next steps. In urgent cases, the doctor will also refer you for necessary examinations or to specialized professionals for prompt intervention.

How the Consultation Takes Place

A consultation with an obstetrician-gynecologist involves a detailed review of your complaints and symptoms, assessment of your current condition, and the development of a plan for further action. The extent of necessary examinations is determined individually, based on indications, and depends on your complaints and the results of the initial examination. It is important to understand that the doctor may not be able to provide a definitive diagnosis during a single visit, but will be able to determine the direction for further diagnosis and treatment.

1. Clarifying complaints and the purpose of the visit: the doctor finds out exactly what bothers you, how long the symptoms have lasted, and which factors affect your condition.
2. Medical history taking: analysis of concomitant diseases, menstrual cycle characteristics, past gynecological problems, and risk factors.
3. Review of previous examinations and treatments: you should bring the results of tests, imaging studies, or descriptions of previously prescribed treatments, as well as a list of medications you are using.
4. Examination and evaluation of the pelvic organs – performed if necessary and indicated, using safe methods.
5. Preliminary conclusions: the doctor outlines possible causes of your complaints and important points that need to be ruled out.
6. Examination plan: depending on the situation, ultrasound, blood and urine tests, smears, hysteroscopy, and other procedures may be required.
7. Development of a treatment plan and recommendations for managing your condition, including lifestyle and daily routine advice.
8. Follow-up and next steps: the doctor will explain when to come for a follow-up visit and how to assess changes in your well-being.

If this is your first visit regarding chronic pain, special attention will be given to clarifying symptoms and searching for possible causes. If treatment has been previously prescribed but was ineffective, the consultation will analyze the reasons for the lack of effect and adjust the plan if necessary.

This step-by-step and attentive approach helps to build effective communication and provides an individualized plan that takes into account the specifics of your health and the progression of your condition.

Preparation for the Appointment

Preparing for an appointment with an obstetrician-gynecologist helps you make the most of your consultation time and receive an accurate plan for examination and treatment. Follow these simple guidelines to stay organized and not forget anything.

• Bring a list of all current medications, including names and dosages, if known
• Bring results of previous examinations, tests, ultrasound images, and medical records
• Note when and how symptoms started, and what worsens or improves your condition
• Come on an empty stomach; do not eat or drink for 8–12 hours before the appointment unless otherwise instructed
• Do not stop taking prescribed medications without consulting your doctor
• Avoid using cosmetics, creams, or sprays on the abdominal area on the day of the appointment
• Come without contact lenses if the exam will include procedures requiring it (as indicated)
• If in doubt, clarify preparation details with the registration desk when booking
• Bring questions or notes you want to discuss with the doctor
• If possible, bring a companion for support and help remembering recommendations

If you are unsure which documents or tests to bring, confirm this when booking. Do not change your medication intake without consulting your doctor — this is important for your safety and diagnostic accuracy.

About the Doctor

Vitaliy Grigoryevich Kostenko is a top-tier obstetrician-gynecologist with over 15 years of experience. He specializes in treating patients with chronic lower abdominal pain, particularly those experiencing recurring symptoms and complications following previous treatments. He places special emphasis on differential diagnosis of causes and ongoing patient management.

This approach helps to more accurately identify the source of problems and adjust treatment as necessary. During the consultation, you will receive a clear analysis of your situation along with recommendations for the next steps.

Why Patients Choose Dr. Vitaliy Grigoryevich Kostenko

When working with chronic lower abdominal pain, Dr. Vitaliy Grigoryevich Kostenko applies a comprehensive approach that helps quickly identify the causes and select the appropriate management strategy. Patients appreciate his systematic approach and attention to detail, which are crucial in chronic and complex cases. The possibility to come with results from previous examinations allows for efficient use of existing data for a more accurate assessment and treatment planning.

• A clear treatment plan with step-by-step inclusion of tests and ongoing condition monitoring
• Examinations are prescribed strictly based on indications, avoiding unnecessary procedures and strain
• Consideration of comorbidities and current medications to ensure safety and effectiveness
• Monitoring symptom dynamics and timely therapy adjustments if there is no effect or side effects occur
• Review of previous prescriptions and assessment of drug tolerance to help avoid unnecessary mistakes
• Explanation of treatment goals, risks, and possible alternatives in an accessible and understandable language
• Ongoing patient follow-up with regular evaluations and plan adjustments as needed
• Emphasis on preventing exacerbations and complications to minimize risks and improve quality of life

This approach ensures comprehensive support for patients with chronic lower abdominal pain. The doctor combines attention to detail with pragmatism, making the treatment process manageable and transparent for the patient.

Case Studies

Initial consultation for persistent lower abdominal pain

A middle-aged female patient presented with complaints of periodic pulling pains in the lower abdomen, lasting several months and affecting her quality of life. It was important to exclude inflammatory processes, structural changes, and hormonal disorders. The physician conducted a thorough history taking and ordered a comprehensive examination, including ultrasound and laboratory tests. Over time, the pain became less severe, and recommendations were given for monitoring and symptom control with possible therapy adjustments in the future.

Treatment adjustment in the absence of positive effect

A woman with chronic lower abdominal pain, who had previously undergone treatment without noticeable improvement, sought a follow-up consultation. A review of prior prescriptions and medication tolerability assessments was performed. The physician modified the management approach and paid attention to concomitant factors influencing the symptoms. Within a month, pain stabilization and overall condition improvement were observed, with a plan for regular monitoring and possible therapy adjustment as needed.

Chronic course with comorbid conditions

A middle-aged female patient with a long history of chronic lower abdominal pain complicated by coexisting inflammatory conditions. The physician took all comorbidities into account when developing the treatment plan. Sequential diagnostics and phased treatment were organized. Follow-up examinations showed a reduction in symptom severity and improvement in the patient’s functional status. The plan includes dynamic observation and preventive measures to avoid exacerbations.

Symptom exacerbation and need for condition stabilization

A woman presented with a sudden intensification of pain and worsening general condition. The physician assessed the current situation, ruled out emergency conditions, adjusted the treatment, and prescribed a necessary monitoring plan. Over the following weeks, the pain decreased and the condition stabilized. The patient was advised to undergo regular follow-ups and to adapt therapy if new symptoms appear or the clinical picture changes.

Recurrent pain after self-treatment attempts

A young woman repeatedly experienced periodic lower abdominal pain which she tried to manage on her own. The physician paid special attention to reviewing her medical history and previous interventions, conducting necessary examinations to exclude serious causes. Based on the results, a management program focusing on symptom control and patient education was prescribed. The patient reported gradual improvement and a reduction in painful episodes with regular monitoring.

How long does the consultation last?

The average consultation lasts 30–60 minutes; please confirm the exact time when booking.

How should I prepare for the appointment?

It is recommended to write down your complaints, medical history, and prepare questions for the doctor.

What should I bring to the appointment?

Bring results of previous examinations, scans, discharge summaries, and a list of current medications.

Do I need to come on an empty stomach?

Usually, fasting is not required unless instructed otherwise when booking.

How many visits are usually needed?

The number of visits depends on the case and condition dynamics; typically, several visits are required.

When can I expect the first results of the treatment?

Timing is individual and depends on the cause and chosen treatment approach.

What should I do if my condition worsens before the appointment?

If your condition worsens, contact your doctor, especially if you experience severe pain, bleeding, or a high fever.

Can the treatment be combined with my current medications?

Discuss compatibility with your doctor; do not stop or add medications on your own.

Is it possible to have an online consultation?

Yes, online consultations are available with the opportunity to discuss symptoms and the examination plan.

Can I come with already completed tests?

Yes, bring all existing test results for a more comprehensive assessment.

Do I need to come for follow-up visits and how often?

Follow-up visits are scheduled based on your condition’s progress and the doctor’s recommendations.

Can I get a second opinion?

Yes, you can receive a consultation for an additional opinion on your case.

What should I do if symptoms return after improvement?

Contact your doctor for evaluation and possible treatment adjustment.

What examinations are needed for chronic lower abdominal pain?

Examinations are individually determined by the doctor based on the initial assessment.

How can I tell if the treatment is working?

Effectiveness is assessed by symptom reduction and overall improvement in condition.

Can treatment be combined with folk remedies?

Discuss any additional methods with your doctor before use.

What should I do if there is no effect from the prescribed treatment?

Be sure to consult your doctor to review the situation and adjust the plan.

Can I bring children to the appointment?

Discuss this when booking; arrangements can be made to accommodate your needs.