Left Upper Abdominal Pain and Anal Itching: Symptoms and Solutions

Left upper abdominal pain for over a month?

Hello Doctor: I have been experiencing sharp pain in my upper left abdomen frequently, occurring daily for about a month.
The pain is located just below the left rib cage, towards the middle (above the navel on the left side, but in the upper abdomen).
The pain usually comes suddenly, lasts for a few seconds, and then subsides.
I feel this pain about 2 to 3 times a day, and it feels like a sharp pain, somewhat like cramping, and also resembles the discomfort one might feel from running right after eating, which could be related to gastric distension.
What symptoms do you think this resembles? Do I need to seek medical attention?
Additionally, I often feel itching around the anal area.
I have a habit of wiping excessively after a bowel movement, which sometimes leads to small abrasions.
I notice a little bit of blood on the toilet paper.
The itching usually starts about 1 to 2 hours after I wipe.
Sometimes, I feel so uncomfortable that I go back to the bathroom to wipe again, and I find that it seems I haven't cleaned thoroughly.
After wiping properly, the itching seems to subside.
Could this be caused by excessive wiping after a bowel movement? This is quite bothersome, and I would appreciate your clarification.
Thank you, Doctor!

Xiao Danxin, 30~39 year old female. Ask Date: 2018/01/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Essentially, there are no significant organs in the upper left abdomen, and you can continue to monitor the situation.
If discomfort persists, you may visit a gastroenterology clinic for an examination.
Additionally, there is a mild inflammation of normal internal hemorrhoids, which may cause itching.
You can treat this with ointment, and it is recommended to wash with water after using the restroom.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/01/11

More Info

Left upper abdominal pain can be a perplexing symptom, and your description of the pain being sharp and occurring intermittently raises several possibilities. The pain you are experiencing, located just below the left rib cage and above the navel, could be attributed to various gastrointestinal or musculoskeletal issues. Given that the pain is sudden and lasts for a few seconds, it may suggest a muscular origin, such as muscle spasms or strain, especially if it is exacerbated by certain movements or positions.
However, it is essential to consider other potential causes of left upper abdominal pain, including:
1. Gastric Issues: Conditions such as gastritis, peptic ulcers, or even gastroesophageal reflux disease (GERD) can lead to pain in this area. If the pain occurs after eating, it may be related to food intake or digestive processes.

2. Pancreatitis: Inflammation of the pancreas can cause severe pain in the upper abdomen, which may radiate to the back. This condition often requires immediate medical attention.

3. Splenic Problems: The spleen is located in the left upper quadrant, and conditions such as splenomegaly (enlarged spleen) or splenic infarction can cause pain in this area.

4. Musculoskeletal Pain: As mentioned, muscle strain or inflammation of the intercostal muscles (the muscles between the ribs) can lead to sharp, localized pain that may mimic visceral pain.

5. Referred Pain: Sometimes, pain in the left upper abdomen can be referred from other areas, such as the heart or lungs, especially if there are underlying conditions.

Regarding the anal itching and the associated symptoms you described, it is not uncommon for excessive wiping after a bowel movement to lead to irritation or even minor abrasions around the anal area. This can cause discomfort and itching, particularly if the skin becomes inflamed or if there is a small amount of bleeding. Here are some considerations:
1. Hygiene Practices: While maintaining cleanliness is important, excessive wiping can lead to skin irritation. It may be beneficial to use moist wipes or a bidet to clean the area more gently.

2. Hemorrhoids: Itching and minor bleeding can also be indicative of hemorrhoids, which are swollen veins in the rectal area. They can cause discomfort, especially after bowel movements.

3. Skin Conditions: Conditions such as dermatitis or fungal infections can also lead to itching around the anal area.

4. Dietary Factors: Sometimes, certain foods can irritate the digestive tract and lead to symptoms such as itching or discomfort.

Given the persistence of your symptoms, it is advisable to consult a healthcare professional for a thorough evaluation. They may recommend diagnostic tests such as blood work, imaging studies, or endoscopy to rule out any serious conditions. Additionally, a referral to a gastroenterologist may be warranted to address your abdominal pain and any gastrointestinal concerns.

In summary, while your symptoms may be benign and related to lifestyle factors, it is crucial to seek medical advice to ensure that any underlying conditions are identified and appropriately managed. Early intervention can lead to better outcomes and relief from discomfort.

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