Lower abdominal cramps, or shofukukyuketsu in Japanese, are thought to be one indication to use tokakujokito for the abdominal symptom of oketsu. To clarify the condition, anatomical analysis was performed using 3 D imaging.There were 20 women and11men entered in this study who consulted our hospital for lower abdominal pain or a sense of discomfort. Width and the thickness of the rectus muscle of the abdomen were analyzed. Moreover, gas images and feces in the intestinal tract under the abdominal wall were also observed. In addition, the presence of rectus abdominal muscle separation, or shofukufujin in Japanese, was evaluated. In the women, where lower abdominal cramps were a complaint, young age (53.1 ± 18.3 vs. 30.4 ± 9.8, p < 0.05), low parity (1.5 ± 1.0 vs. 0.25 ± 0.5, p < 0.05), and thickness of the abdominal rectus muscle (8.14 ± 2.5 mm vs. 12.4 ± 1.6 mm, p < 0.05) were confirmed. Also in several cases of lower abdominal cramps, feces were seen at the sigmoid colon. A significant difference was seen in the male group. Cases with lower abdominal cramps suggest involvement of local muscle spasms at the bottom of abdominal rectus muscle, which may contribute to the seemed symptom of abdominal formation. On the other hand, a mechanism different from that in women was considered in the men. This suggests that it is necessary to consider gender differences when making a Kampo diagnosis.