Persistent Left Lower Abdominal Pain: Causes and When to Seek Further Evaluation

Q: Persistent Left Lower Abdominal Pain: Causes and When to Seek Further Evaluation

Hello： Possible causes of discomfort in the left lower abdomen in males, aside from issues with the large intestine and small intestine, include problems with the urinary system (such as stones, etc.). <br>Additionally, it is important to consider the possibility of an inguinal h

Persistent dull pain in the lower left abdomen?

Hello doctor, I have been experiencing persistent dull pain in my lower left abdomen for about 4 weeks.
The pain occurs daily and can last for several hours at a time.
The most noticeable area is approximately 5 centimeters to the left of my navel and 5 centimeters down.
The pain is localized, and sometimes it affects a spot about 2 centimeters below the navel (though this is less common).
My bowel habits have not shown any significant changes (in terms of frequency, color, or shape...).
Occasionally, I may have an extra bowel movement in a day, and sometimes the stool is looser and more mucous-like, but these occurrences are infrequent and not very pronounced.
I have undergone routine stool tests at the clinic, and all results were normal.
The doctor diagnosed me with irritable bowel syndrome and did not prescribe any medication.
However, I am still concerned due to the lack of noticeable improvement.
Could this possibly be another condition, or do I need further examinations? Thank you for your kind assistance, doctor.

Niming, 30~39 year old female. Ask Date: 2016/08/16

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Possible causes of discomfort in the left lower abdomen in males, aside from issues with the large intestine and small intestine, include problems with the urinary system (such as stones, etc.).
Additionally, it is important to consider the possibility of an inguinal hernia.
If no issues are found, it may be a functional gastrointestinal problem.
If necessary, consult a gastroenterologist and a urologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/08/16

More Info

Persistent left lower abdominal pain can be a challenging symptom to evaluate, especially when it has lasted for several weeks without a clear diagnosis. Based on your description, it seems that you have already undergone some preliminary evaluations, including a stool test, which returned normal results. The physician's initial assessment of irritable bowel syndrome (IBS) is a common diagnosis for such symptoms, particularly when there are no significant findings from other tests.

Irritable bowel syndrome is a functional gastrointestinal disorder characterized by symptoms like abdominal pain, bloating, and changes in bowel habits, without any identifiable structural or biochemical abnormalities. It can be triggered by various factors, including stress, diet, and gut motility issues. Given that your bowel habits have not shown significant changes, it is still important to consider other potential causes for your persistent pain.

There are several conditions that could lead to left lower abdominal pain, including:
1. Diverticulitis: This condition occurs when small pouches (diverticula) in the colon become inflamed or infected. It can cause localized pain, often accompanied by changes in bowel habits.

2. Ovarian Issues: In females, ovarian cysts or other gynecological conditions can cause referred pain to the lower abdomen. If you have not had a recent pelvic ultrasound, it may be worth discussing with your physician.

3. Hernias: An inguinal or femoral hernia can present as localized pain in the lower abdomen, especially when straining or lifting.

4. Musculoskeletal Pain: Sometimes, pain in the lower abdomen can be related to muscle strain or issues with the pelvic floor or lower back.

5. Gastrointestinal Disorders: Conditions such as inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can also present with abdominal pain, although they typically have additional symptoms like diarrhea or weight loss.

6. Kidney Stones or Urinary Tract Issues: Although you mentioned that kidney issues have been ruled out, it might be worth re-evaluating if there are any urinary symptoms or if the pain radiates to the back or groin.

Since your symptoms have persisted for four weeks without significant improvement, it is advisable to seek further evaluation. Here are some steps you might consider:
- Consult a Gastroenterologist: A specialist can provide a more in-depth evaluation and may suggest additional tests, such as a colonoscopy, to rule out any underlying gastrointestinal conditions.

- Imaging Studies: An abdominal ultrasound or CT scan can help visualize the organs in the abdomen and identify any structural abnormalities.

- Pelvic Examination: If you are female, a thorough pelvic examination can help rule out gynecological issues that may be contributing to your symptoms.

- Dietary Review: Keeping a food diary to track your diet and any associated symptoms can help identify potential triggers related to IBS.

- Stress Management: Since stress can exacerbate IBS symptoms, consider exploring stress management techniques such as mindfulness, yoga, or counseling.

In conclusion, while irritable bowel syndrome is a plausible explanation for your symptoms, it is essential to remain vigilant and pursue further evaluation if your pain persists or worsens. Open communication with your healthcare provider about your concerns and symptoms will be crucial in guiding the next steps in your evaluation and management.

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