Lower Abdominal Discomfort: When to Seek Gastrointestinal Care - Gastroenterology and Hepatology

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When considering the appropriate steps to address your mother's abdominal discomfort, especially given her complex medical history, it's crucial to approach the situation methodically. Your mother's symptoms, including abdominal pain, changes in appetite, and previous diagnoses, suggest that a comprehensive evaluation is necessary.
Firstly, the abdominal pain your mother is experiencing could stem from various sources. Given her age (73 years) and existing medical conditions such as diabetes, hypertension, and heart issues, it is essential to rule out any serious underlying conditions. The pain localized to the lower abdomen, particularly near the thighs, could potentially involve several organs, including the intestines (colon), bladder, or even gynecological structures if she has not undergone a hysterectomy.

Since your mother has already undergone an endoscopy and ultrasound, which revealed mild inflammation and fatty liver, it is important to consider further evaluations. The fact that she has experienced a urinary tract infection (UTI) and elevated white blood cell count indicates that her body is responding to some form of infection or inflammation. The persistent abdominal discomfort, especially after eating, could suggest gastrointestinal issues such as irritable bowel syndrome (IBS), constipation, or even a more serious condition like bowel obstruction or diverticulitis.

Given the complexity of her symptoms, it would be advisable to consult a gastroenterologist. This specialist can perform additional tests, such as a colonoscopy, to evaluate the condition of the colon and rule out any polyps, diverticula, or other abnormalities that may not have been visible during previous examinations. Additionally, a CT scan of the abdomen may provide more detailed images of the organs and help identify any potential issues that could be causing her pain.

Regarding the pain above the navel, which radiates and may be concerning for cardiac issues, it is essential to consider that while some abdominal pain can be referred from cardiac problems, the nature of the pain and accompanying symptoms will guide the diagnosis. If the pain is sharp, associated with sweating, or accompanied by shortness of breath, it would warrant immediate evaluation by a cardiologist. However, if the pain is more localized and related to digestive issues, a gastroenterologist would be the appropriate specialist to consult.

In summary, your mother should see a gastroenterologist for her ongoing abdominal pain and gastrointestinal symptoms. It may also be prudent to have a thorough evaluation of her cardiovascular health, especially given her history of hypertension and diabetes. Keeping a detailed record of her symptoms, including when they occur, their intensity, and any associated factors (like food intake), will be beneficial for her healthcare providers in making an accurate diagnosis.
Lastly, it’s important to maintain open communication with her healthcare team, ensuring that all her symptoms are discussed and that she receives comprehensive care tailored to her unique health needs. Regular follow-ups and monitoring of her conditions will be crucial in managing her health effectively.