Left Lower Abdominal Pain: Causes and Concerns - Gastroenterology and Hepatology

There is a dull pain in the lower left abdomen or to the left of the navel?

Hello doctor, recently I've been experiencing a dull pain in my lower left abdomen and to the left of my navel, which comes and goes (it's not very painful, more like a mild discomfort).
I previously had issues with blood in my stool, but after visiting the hospital, the doctor diagnosed it as hemorrhoids and prescribed medication for topical use.
After using it, I haven't had any bleeding (so far).
However, I'm wondering why I'm experiencing this dull pain in my lower left abdomen and to the left of my navel (which is not very painful).
Most of the discomfort occurs to the left of my navel, and it doesn't happen very frequently—less than ten times a day.
I have been taking probiotics, and my stool is yellow-brown, though it varies sometimes.
I have a regular bowel movement at the same time every day.
Could this be a sign of colon cancer? I'm really worried...
Also, what is the likelihood of this happening at 19 years old? Many doctors have said it's not a concern and the probability is very low, but I still feel anxious...

Taker, 10~19 year old female. Ask Date: 2017/02/08

Dr. Chen Qifeng reply Gastroenterology and Hepatology

It's really very low...
I have 25 years of experience in gastroenterology, and I have only encountered one case in individuals under 20 years old.
If you are truly concerned, you can undergo a barium enema or even a colonoscopy in the gastroenterology department.

Reply Date: 2017/02/08

More Info

Understanding left lower abdominal pain can be complex, as it can arise from various causes, some benign and others more serious. Your symptoms of intermittent pain in the left lower abdomen and near the navel, especially following a history of rectal bleeding attributed to hemorrhoids, warrant careful consideration.

Possible Causes of Left Lower Abdominal Pain
1. Gastrointestinal Issues: Given your history of blood in the stool, it’s essential to consider gastrointestinal causes. Conditions such as diverticulitis, irritable bowel syndrome (IBS), or even inflammatory bowel disease (IBD) could lead to discomfort in the left lower abdomen. Diverticulitis, in particular, is characterized by inflammation of diverticula in the colon and can cause localized pain, often accompanied by changes in bowel habits.

2. Musculoskeletal Pain: Sometimes, abdominal pain can be referred from musculoskeletal issues, such as muscle strain or ligamentous pain, especially if there has been any recent physical activity or strain.

3. Urological Issues: Conditions affecting the urinary tract, such as urinary tract infections (UTIs) or kidney stones, can also cause pain in the lower abdomen, although these are typically accompanied by other symptoms like dysuria (painful urination) or hematuria (blood in urine).

4. Gynecological Issues: In females, left lower abdominal pain can sometimes be related to gynecological conditions, such as ovarian cysts or endometriosis, although this is less likely given your age and the nature of your symptoms.

5. Psychosomatic Factors: Anxiety and stress can manifest as physical symptoms, including abdominal pain. If you have a tendency towards anxiety, it may be worth exploring whether your symptoms correlate with stress levels.

Concerns About Colorectal Cancer
Your concern about the possibility of colorectal cancer, especially at the age of 19, is understandable but statistically very low. Colorectal cancer is rare in young adults, with most cases occurring in individuals over 50. Risk factors include family history, certain genetic syndromes, and lifestyle factors. Given that you have been evaluated for rectal bleeding and diagnosed with hemorrhoids, it is reassuring that no serious pathology was found.

Recommendations
1. Follow-Up with Healthcare Providers: Since your symptoms persist, it is essential to continue discussions with your healthcare provider. They may recommend further investigations, such as a colonoscopy, especially if there are any changes in your bowel habits or if the pain worsens.

2. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any associated factors (like diet or stress levels). This information can be invaluable for your healthcare provider in diagnosing the issue.

3. Lifestyle Modifications: Continue with a healthy diet rich in fiber, stay hydrated, and consider regular exercise, which can help with gastrointestinal health. Probiotics may also be beneficial, but ensure they are part of a balanced diet.

4. Mental Health Considerations: If anxiety is a significant concern, consider speaking with a mental health professional. They can provide strategies to manage anxiety, which may help alleviate some of your physical symptoms.

In conclusion, while your symptoms are concerning, the likelihood of serious conditions like colorectal cancer at your age is low. However, persistent symptoms warrant further evaluation to rule out any underlying issues. Always trust your instincts and seek medical advice when in doubt.

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