Discomfort in the Lower Left Abdomen: When to Seek Help

Dull discomfort in the lower left abdomen?

Hello Doctor: About a month ago, I started feeling a strange sensation in my lower left abdomen (just above the bladder).
Although it hasn't reached the level of pain, it feels quite unusual.
Approximately four weeks ago, I visited Chung Shan Hospital and had a urine test and X-ray, both of which showed no issues.
The family medicine doctor suggested that I see a gastroenterologist.
Later, I went to a small clinic where the gastroenterologist mentioned that the discomfort could be due to three possibilities: the first being gastrointestinal inflammation, the second being a urinary system issue, and the third being colorectal cancer.
Since I had already undergone urine tests and X-rays, the urinary system issue was ruled out.
The doctor then recommended a colonoscopy and referred me back to Chung Shan Hospital for the procedure.
I had the colonoscopy done before the Lunar New Year, and the doctor reported that there were only two small spots (which need to be monitored), and everything else looked fine, so I was advised to go home and rest.
However, I still feel something is off, so I would like to ask the doctor which specialty I should consult for further examination.

Nathan, 30~39 year old female. Ask Date: 2018/02/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, you only need to continue monitoring your condition.
If there is no improvement, please discuss it with your physician.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/02/25

More Info

It sounds like you are experiencing persistent discomfort in your lower left abdomen, which has not yet escalated to pain but is concerning enough for you to seek medical advice. Given the thorough evaluations you've already undergone, including urine tests, X-rays, and a colonoscopy, it's understandable that you want to get to the bottom of this issue.

Firstly, it's important to recognize that abdominal discomfort can stem from a variety of causes, and the differential diagnosis can be quite broad. Since you've already ruled out urinary tract issues and had a colonoscopy that showed only minor findings, it may be beneficial to consider other potential causes of your symptoms.

1. Gastrointestinal Issues: Since you were advised to see a gastroenterologist, it would be prudent to continue following up with this specialty. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even functional gastrointestinal disorders could be contributing to your discomfort. These conditions can sometimes present with vague symptoms that are not easily identifiable through standard imaging or tests.

2. Musculoskeletal Factors: Sometimes, abdominal discomfort can be related to musculoskeletal issues, such as muscle strain or referred pain from the back or pelvis. A physical examination by a physician who specializes in musculoskeletal disorders or a physical therapist may help identify if this is a contributing factor.

3. Neurological Causes: In some cases, nerve-related issues, such as neuropathy or entrapment syndromes, can cause discomfort in the abdominal area. A neurologist may be able to assess if there are any underlying nerve issues that could be contributing to your symptoms.

4. Follow-Up with a Specialist: Given that your symptoms persist despite previous evaluations, it may be beneficial to seek a second opinion from a gastroenterologist, especially one who specializes in functional gastrointestinal disorders. They may recommend further testing, such as a CT scan or MRI, to rule out any structural abnormalities that were not visible on previous imaging.

5. Lifestyle and Dietary Considerations: Since you mentioned that your symptoms may be exacerbated by dietary habits, it might be helpful to keep a food diary to track what you eat and how it correlates with your symptoms. Consulting with a dietitian could provide insights into any dietary changes that might alleviate your discomfort.

6. Psychological Factors: Stress and anxiety can also manifest as physical symptoms, including abdominal discomfort. If you feel that stress may be a contributing factor, speaking with a mental health professional could be beneficial.

In summary, I recommend that you consider following up with a gastroenterologist for further evaluation, especially given your ongoing symptoms. If gastrointestinal causes are ruled out, exploring musculoskeletal or neurological evaluations may provide additional insights. Keeping a detailed record of your symptoms and any potential triggers can also be helpful for your healthcare providers in diagnosing and treating your condition effectively. Remember, persistent symptoms warrant thorough investigation, and it’s important to advocate for your health until you find the answers you need.

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