Lower Abdominal Pain: When to Seek Gastroenterology Help - Gastroenterology and Hepatology

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Understanding lower abdominal pain can be complex, especially when there is a history of gastrointestinal issues such as constipation and previous diagnoses like irritable bowel syndrome (IBS) and peptic ulcers. Given your symptoms and medical history, it is crucial to approach this situation with a comprehensive understanding of potential causes and the appropriate steps to take.

Firstly, your history of severe constipation and the fact that you have undergone both colonoscopy and gastroscopy, which revealed a clean colon but some gastric ulcers, suggests that your gastrointestinal tract has been under stress for a long time. The change in your bowel habits following the birth of your third child and the dietary changes you mentioned could be significant factors contributing to your current symptoms.
The symptoms you describe—persistent dull abdominal pain, changes in stool consistency, and the urgency to defecate after eating—could indicate several possibilities. One common issue could be functional gastrointestinal disorders, such as IBS, which can manifest as abdominal pain, altered bowel habits, and discomfort after meals. IBS is often exacerbated by stress, dietary changes, and hormonal fluctuations, especially in women post-pregnancy.

Additionally, the presence of inflammation noted in your uterine biopsy could also be a contributing factor. Conditions such as endometriosis or pelvic inflammatory disease can cause referred pain to the lower abdomen, which might be mistaken for gastrointestinal issues. It is essential to consider that gynecological conditions can sometimes present with gastrointestinal symptoms, particularly in women of childbearing age.

Your description of the stool being "sticky" and dark brown could also indicate a few things. While darker stool can sometimes be a sign of bleeding in the upper gastrointestinal tract, it can also result from dietary factors or dehydration. The fact that you feel an urge to defecate after eating but are unable to pass stool could suggest a functional issue, such as a rectal outlet obstruction or pelvic floor dysfunction, which can occur after childbirth.

Given your symptoms and history, it is advisable to consult with a gastroenterologist for a thorough evaluation. They may recommend further diagnostic tests, such as imaging studies or additional blood tests, to rule out any underlying conditions that may not have been previously identified. Additionally, a referral to a gynecologist may be warranted to address any potential pelvic or reproductive health issues that could be contributing to your abdominal pain.

In the meantime, consider keeping a symptom diary to track your pain, bowel habits, dietary intake, and any other relevant factors. This information can be invaluable for your healthcare provider in determining the best course of action. Dietary modifications, such as increasing fiber intake, staying hydrated, and possibly trying a low FODMAP diet, may help alleviate some of your symptoms, but these should be discussed with your healthcare provider.

In summary, while your symptoms may be related to functional gastrointestinal issues, it is essential to rule out any other potential causes, including gynecological conditions. Seeking help from both a gastroenterologist and a gynecologist will provide a comprehensive approach to your health concerns. Remember, timely intervention can lead to better management of your symptoms and overall well-being.