<s>[INST] I have physiologically distended gall bladder shown in my sonography in October when I had similar lower right abdominal pain and lower back pain. No Cysts were found any where and everything was normal. The pain subdued after some medication given by physician. Now it has come back again. And it is more painful than last time. Should I get a CT Scan done? [/INST] Hello! Thank you for the query. Gallbladder rather gives upper right abdominal pain radiating to the back with nausea and vomiting. Lower right abdominal pain and back pain can be caused by urinary tract infection or urinary tract stones. Frequent urinating and burning while urinating can be also present. Lower right abdominal pain should be always checked with possible appendicitis. With this condition nausea appears, the pain can aggravate while coughing or walking, heart rate is accelerated (above 100/min). Other possible reasons of such pain are ovarian cyst, ectopic pregnancy. Abdominal CT is not a necessary test. More valuable can be urinalysis, blood work, CRP, pregnancy test and abdominal ultrasound. Hope this will help. Regards. </s>