Lower Abdominal Pain with Mild Urge to Defecate - Gastroenterology and Hepatology

Q: Lower Abdominal Pain with Mild Urge to Defecate

Hello： If symptoms persist, it is recommended to consult a gastroenterologist, as it may be necessary to repeat the fecal occult blood test and, if needed, even perform a colonoscopy. <br>This is especially important if there is a family history of colorectal cancer and weight lo

Lower abdominal pain with a slight urge to defecate, but no actual bowel movement occurs?

Hello Doctor: I had a duodenal ulcer in high school, and during a gastrointestinal examination, the doctor mentioned that my bowel motility is slow.
About a year and a half ago, I underwent stool and blood tests, and the doctor said there were no symptoms warranting an endoscopy, but I could have one if I was concerned.
However, I have been experiencing constipation, usually having a bowel movement every 2 to 3 days, and on those days, I tend to go 2 to 3 times.
My stools are mostly formed and tubular, with occasional soft stools.
For about the past six months, I have been seeing a traditional Chinese medicine practitioner for body conditioning.
During each visit, the practitioner checks my abdomen, and I experience significant pain in my lower left abdomen and lower abdomen.
Typically, I have a dull pain in my lower left abdomen that lasts for a few minutes and then subsides, but it recurs after some time.
It feels like I need to have a bowel movement, but the urge is not very strong.
When I try to use the toilet, I don’t always manage to have a bowel movement.
I usually drink water (about 1000 to 1500 cc) and have a balanced diet.
The traditional Chinese medicine practitioner suggested that I may not be fully evacuating my bowels.
I would like to ask the doctor if I should undergo further examinations.

Yi, 30~39 year old female. Ask Date: 2016/09/05

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If symptoms persist, it is recommended to consult a gastroenterologist, as it may be necessary to repeat the fecal occult blood test and, if needed, even perform a colonoscopy.
This is especially important if there is a family history of colorectal cancer and weight loss.
Additionally, if there is a history of abdominal surgery, one should consider the possibility of adhesions.
Furthermore, when the cause remains unclear, issues related to obstetrics/gynecology or urology should also be taken into account.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun

Reply Date: 2016/09/05

More Info

Understanding lower abdominal pain, especially when accompanied by a mild urge to defecate, can be complex and multifactorial. Given your history of duodenal ulcers and slow intestinal motility, it is essential to consider several potential causes for your symptoms.

Firstly, your description of experiencing left lower abdominal pain that feels like a mild urge to defecate could be indicative of several gastrointestinal issues. One possibility is that you may be experiencing symptoms related to constipation. Chronic constipation can lead to abdominal discomfort, bloating, and a sensation of incomplete evacuation. The fact that you have a bowel movement every 2-3 days, and that it is often in the form of narrow stools, suggests that your bowel may not be functioning optimally. This could be due to a variety of factors, including dietary habits, hydration levels, and possibly the effects of previous gastrointestinal issues like your duodenal ulcer.

In addition to constipation, your symptoms could also be related to conditions such as irritable bowel syndrome (IBS), which is characterized by abdominal pain and changes in bowel habits. IBS can cause cramping and discomfort, often relieved by defecation, but it can also lead to feelings of urgency without a strong urge to go. Another possibility is the presence of diverticular disease, which can cause localized pain and changes in bowel habits, particularly in the left lower quadrant.

Your mention of seeing a traditional Chinese medicine practitioner who has noted tenderness in your left lower abdomen is also significant. This could indicate an underlying issue that may require further investigation. It is essential to consider that abdominal pain can sometimes be a sign of more serious conditions, such as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. These conditions can cause chronic abdominal pain, changes in bowel habits, and other systemic symptoms.

Given your history and current symptoms, it would be prudent to pursue further evaluation. A comprehensive approach may include:
1. Consultation with a Gastroenterologist: A specialist can provide a thorough evaluation of your symptoms and history. They may recommend diagnostic tests such as a colonoscopy, which can help visualize the colon and identify any abnormalities.

2. Imaging Studies: Depending on your symptoms, imaging studies such as an abdominal ultrasound or CT scan may be helpful in ruling out structural issues or complications.

3. Dietary Assessment: Working with a dietitian can help identify any dietary factors contributing to your symptoms. Increasing fiber intake, ensuring adequate hydration, and possibly incorporating probiotics may help improve bowel function.

4. Medication Review: If you are taking any medications that may affect gastrointestinal motility or contribute to constipation, discussing alternatives with your healthcare provider could be beneficial.

5. Lifestyle Modifications: Regular physical activity can promote bowel motility and alleviate constipation. Additionally, establishing a regular bowel routine may help.

In conclusion, while your symptoms may be related to chronic constipation or another functional gastrointestinal disorder, it is essential to rule out any serious underlying conditions. A thorough evaluation by a healthcare professional, including appropriate diagnostic testing, will provide clarity and guide effective management strategies. It is crucial to address these symptoms proactively to improve your quality of life and prevent potential complications.

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