Lower Abdominal Discomfort: When to Seek Further Evaluation

Lower abdominal distension?

Hello, Doctor: Since last week, I have been feeling a sense of heaviness and bloating below my navel, which is particularly noticeable when sitting down.
I initially thought it might be an issue with my uterus, but after a gynecological examination, the doctor said there was nothing wrong.
Given that my father and grandfather both passed away from colorectal cancer, I underwent a full colonoscopy four years ago, and the doctor said everything was normal.
I'm unsure if I need to have further examinations.
Currently, I have bowel movements two to three times a day, and I have been experiencing mild diarrhea since last week.

Ms. Zhang, 30~39 year old female. Ask Date: 2017/07/13

Dr. Xu Kaixi reply Surgery

If you have undergone a colonoscopy and no abnormalities were found, the possibility of colorectal cancer has essentially been ruled out.
The abdominal symptoms are more likely to be functional abnormalities, and it is recommended to consult a gastroenterologist.

Reply Date: 2017/07/13

More Info

Lower abdominal discomfort can be a complex issue, especially considering your family history of colorectal cancer. It's understandable to be concerned about any persistent symptoms, particularly when they involve changes in bowel habits or discomfort in the abdominal area.
Given your symptoms of a dull, bloated sensation below the navel, particularly when sitting, and the recent onset of mild diarrhea, it is important to consider a few potential causes. While your gynecological examination ruled out any issues related to the uterus, there are several other factors to consider.

1. Gastrointestinal Issues: Your symptoms could be related to gastrointestinal conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional dyspepsia. IBS is characterized by abdominal discomfort and changes in bowel habits, which could explain your symptoms. Given that you have a history of a normal colonoscopy four years ago, it is less likely that you have a significant structural issue like a tumor, but it is not impossible.

2. Dietary Factors: Sometimes, changes in diet or the introduction of new foods can lead to gastrointestinal discomfort and diarrhea. Consider whether you've changed your eating habits recently or if you've consumed anything that could irritate your digestive system.

3. Infections: Gastrointestinal infections, whether viral or bacterial, can lead to symptoms like bloating and diarrhea. If you have been exposed to anyone with gastrointestinal illness or have traveled recently, this could be a possibility.

4. Functional Disorders: Conditions like functional dyspepsia can cause bloating and discomfort without any identifiable structural cause. These conditions can often be exacerbated by stress or anxiety, which can also lead to changes in bowel habits.

5. Further Evaluation: Given your family history of colorectal cancer, it is prudent to remain vigilant. While your previous colonoscopy was normal, if your symptoms persist or worsen, it may be worth discussing with your healthcare provider the possibility of further evaluation. This could include a repeat colonoscopy or imaging studies such as an abdominal ultrasound or CT scan to rule out any underlying issues.

6. When to Seek Help: You should seek further evaluation if you experience any of the following:
- Significant changes in bowel habits (e.g., persistent diarrhea or constipation)
- Blood in your stool or dark, tarry stools
- Unexplained weight loss
- Severe abdominal pain
- Persistent nausea or vomiting
In conclusion, while your symptoms may not immediately indicate a serious condition, it is essential to monitor them closely, especially considering your family history. If your discomfort continues or worsens, do not hesitate to consult your healthcare provider for further evaluation. They may recommend additional tests or referrals to specialists to ensure that any potential issues are addressed promptly. Maintaining open communication with your healthcare team is key to managing your health effectively.

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