Female Patient with Lower Abdominal Pain কী History নিবেন??

Writer : ডাঃ তানিয়া হাফিজ

Female patient come to your chamber with Lower Abdominal Pain (LAP).

Points of History taking :

1. Duration of pain :
   Example:
   => Long time (Leucorrhoea, prolapse, PID)
   => Sudden (Appendicitis, Torsion of ovarian cyst)
   => On ovulation time also pain
2. Site of pain :
   Example:
   => Right iliac fossa ( Appendicitis)
   => Pubic region (UB, PI etc)
   => Lumber region (Kidney)
   => Inguinal region ( Inguinal hernia, ovarian cyst, intestinal)
3. Onset of pain :
   Example:
   Dysmenorrhea (Cyclical pain)
4. Nature of pain :
   Example:
   => Crumping (Dysmenorrhea)
   => Colicky (Renal stone)
   => Burning (Dysuria, Dyspareunia)
5. Severity of pain :
   Example: Mild moderate, severe
   => Severe ( Ruptured or torsion ovarian cyst)
   => Mild (Vaginal candidiasis)
6. Radiation of pain :
   Example:
   => Around umbilicus (Appendicitis)
   => Back (Fibroid, prolapse)
7. Heaviness on L/A History :
   Example:
   Fibroid, IBS, Enlarged ovarian cyst or tumour
8. Urinary problem History :
   Example:
   => Frequency, burning sensation, Dysuria(UTI)
   => Haematuria (UB Kidney prb)
   => UB stone, mass prb etc etc.(Suprapubic pain)
   => Retension of urine
9. Associated fever, vomiting, swelling etc :
   Example:
   Appendicitis, UTI, cystitis, kidney prb etc
10. Dyspareunia (If married) history :
    Example:
    Prolapse, dry vagina, Bartholin abcess, bartholinitis
11. Vaginal discharge history :
    Example:
    Physiological
    Pathological
    => Types (Curd like candidiasis etc)
    => Colour ( Whitish- candidisis, yellowish/ greenish- BV trichomoniasis)
    => Odour ( Foul smelling-BV, Trichomoniasis)
    => Itching (STD, fungal)
    => OCP related
12. Sexual exposure History :
    Example:
    Syphilis, Gonorrhoea, trichomoniasis
13. Menstrual History :
    Example:
    =>Irregularity (PCOS, DUB)
    => Amenorrhoea (Ectopic pg, Abortion)
    => Menorrhagia (Fibroid, polyp, endometriosis, endometritis, adenomyosis)
    => Dysmenorrhea (Primary, 2ndary)
14. Bowel movement :
    Example:
    Prolapse, cobstipation, diarrhoea, IBS
15. Less fluid intake
16. H/O IUCD insertion
17. Previous H/O this type of LAP
18. Recent H/O NVD or C/S
19. H/O personal hygiene
20. Any history of trauma
21. H/O parasitic infection

Edited By : Nahid Hassan.