Left Lower Abdominal Pain and Discomfort: A Gastrointestinal Perspective

Swelling and intermittent pain in the lower left abdomen, with sharp pain on the left side of the lower back?

Hello, doctor! I had frequent constipation when I was younger, and there is a family history of cancer; my father passed away from colon cancer.
However, since early last year, my bowel movements have become very regular, going from every three to five days to now having a daily bowel movement, which confuses me.
In July of last year, I also underwent a colonoscopy due to hemorrhoid surgery, and the doctor said everything looked fine.
Post-surgery, everything was normal.
However, starting from early last month, I've been experiencing intermittent pain in my lower left abdomen.
Although it's not very painful, it feels quite uncomfortable.
By the beginning of this month, I also started to feel sharp pain in my left flank and discomfort in the left posterior area.
When lying down, I can feel a noticeable bulge on the left side, which is much larger than the right, and pressing on it causes pain.
Additionally, in the past few days, I've been experiencing significant bloating and flatulence, but my bowel movements remain normal, without being particularly hard or infrequent.
On April 10th, I visited the hospital, but since the doctor was about to finish for the day, I could only have an X-ray done and was told to wait for the next appointment for further examination.
The doctor prescribed a stool softener, suggesting that my stool might be too hard, among other possibilities.

Wenhao, 30~39 year old female. Ask Date: 2017/04/12

Dr. Lin Minghui reply Gastroenterology and Hepatology

Left lower abdominal swelling with intermittent pain, sharp pain in the left flank.
Differential diagnoses include enteritis, diverticulitis, urinary stones, bowel obstruction, urethritis, and irritable bowel syndrome.
There is a family history of colorectal cancer, so attention to bowel health is important.
It is recommended to consume more fruits and vegetables, maintain adequate hydration, and engage in regular exercise.
If abdominal pain persists, a follow-up visit to a healthcare provider is advised.

Reply Date: 2017/04/12

More Info

Understanding left lower abdominal pain and discomfort can be quite complex, especially given your medical history and family background. It’s important to consider various factors that could contribute to your symptoms, particularly since you have a history of constipation and a family history of colorectal cancer.

From what you’ve described, your symptoms began with a change in bowel habits, transitioning from infrequent bowel movements to daily regularity. This change is generally positive, as regular bowel movements can help prevent complications such as hemorrhoids or diverticulitis. However, the onset of left lower abdominal pain, discomfort, and associated symptoms like bloating and gas can indicate several potential gastrointestinal issues.

1. Irritable Bowel Syndrome (IBS): Given your history of constipation and recent changes in bowel habits, IBS could be a possibility. IBS is characterized by abdominal pain and changes in bowel habits, which can include diarrhea, constipation, or alternating between both. Stress and dietary factors often exacerbate IBS symptoms.

2. Diverticular Disease: The presence of diverticula (small pouches) in the colon can lead to diverticulitis, which can cause pain, especially in the lower left abdomen. Although you had a colonoscopy that showed no significant issues, diverticulosis can develop over time, and symptoms may not always be present.

3. Musculoskeletal Issues: The pain you feel in your left side, especially when lying down or pressing on it, might not be solely gastrointestinal. Musculoskeletal pain can mimic abdominal pain, particularly if there’s any strain or injury to the muscles in that area.

4. Kidney Issues: Given the pain radiating to your left side and back, it’s also worth considering kidney-related issues, such as kidney stones or infections. These conditions can cause referred pain to the abdomen and may require imaging studies for proper diagnosis.

5. Gastrointestinal Obstruction: Although less likely given your recent colonoscopy, any obstruction in the intestines can lead to pain and bloating. This could be due to scar tissue from previous surgeries or other factors.

6. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis could also present with abdominal pain and changes in bowel habits. These conditions often require more extensive testing, including imaging and possibly repeat colonoscopy.

Given your family history of colorectal cancer, it’s crucial to maintain regular screenings and follow up with your healthcare provider about your symptoms. While your previous colonoscopy showed no issues, the presence of new symptoms warrants further investigation. You might consider discussing the following with your doctor:
- Repeat Imaging: Since your symptoms have changed, a repeat abdominal ultrasound or CT scan could help visualize any structural issues that might not have been apparent during your last examination.

- Referral to a Specialist: A gastroenterologist can provide a more in-depth evaluation of your symptoms and may recommend additional tests, such as a repeat colonoscopy or specific blood tests to rule out inflammatory markers.

- Dietary Changes: Keeping a food diary to track what you eat and any associated symptoms can help identify potential food intolerances or triggers for your discomfort.

- Stress Management: Since stress can exacerbate gastrointestinal symptoms, exploring stress management techniques such as mindfulness, yoga, or therapy might be beneficial.

In conclusion, while your symptoms may not indicate a severe condition, they warrant further exploration, especially considering your medical history. Regular follow-ups and open communication with your healthcare provider are essential in managing your health effectively.

Similar Q&A

Understanding Gastrointestinal Issues: Causes of Left Lower Abdominal Pain

Hello doctor, I often experience diarrhea and have been feeling a vague discomfort in my lower left abdomen for the past few months. There was one occasion when I was lying in bed and felt a dull pain. When I pressed on the right side and the upper area, the pain was still in the...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, a 22-year-old female is experiencing frequent diarrhea, left lower abdominal pain, and negative fecal occult blood tests. Considering her age, the most common causes are likely to be enteritis and irritable bowel syndrome. It is important to pay attention to dietary habits...

Understanding Left Lower Abdominal Pain: A Comprehensive Guide

Hello, Doctor: About two months ago, I started experiencing intermittent dull pain in my left lower abdomen at night, which later became a constant pain. I also felt soreness in my left back. I have consulted several specialists: 1. Family Medicine - The doctor pressed on my abdo...

Dr. Hou Angting reply Family Medicine
Hello, Miss Barley. Given your current situation, it is advisable to wait for the culture report to come back and discuss it with your doctor for the best course of action. Additionally, if you frequently experience symptoms after menstruation, it is recommended to consult with a...

Understanding Left Lower Abdominal Pain: When to Seek Help

Hello Dr. Chen: In the past two days, I have experienced pain in the lower left abdomen when pressure is applied, but there are no other abnormalities when not under pressure.

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Left lower abdominal pain is usually related to intestinal issues, commonly associated with bloating or constipation. If the symptoms persist, please consult a gastroenterologist. Best regards, Dr. Chi-Feng Chen, Taoyuan Hospital, Department of Health.

Understanding Left Lower Abdominal Discomfort: Causes and Solutions

Hello doctor, I often experience a dull pain in my lower left abdomen for no apparent reason. When I go to the bathroom, I frequently pass gas, and after doing so, the pain subsides. This has been ongoing for quite some time. Could you please explain why this is happening?

Dr. Lin Minghui reply Gastroenterology and Hepatology
It may be irritable bowel syndrome (IBS), which is related to diet, stress, emotions, and gastrointestinal function. It is recommended to eat slowly and avoid talking while eating. Limit the intake of gas-producing foods, as well as spicy foods and beverages. Engage in moderate e...