Left Lower Abdominal Pain: Possible Causes and Concerns

Dull, intermittent pain in the lower left abdomen?

Recently, I experienced dark stools again but didn’t seek medical attention, and then it disappeared.
After that, I had bloody stools, and there was fresh blood when wiping.
I also felt a sharp pain inside the anus, but I didn’t pay much attention to it, and now it has been 2-3 months.
I have a dull, stabbing pain in the lower left abdomen near the bladder, and my stools have been loose and sticky, without any constipation; I go to the bathroom once or twice a day.

A few months ago, I started to be cautious and visited a family doctor nearby, who suggested it might be gastritis.
The dark stools from a few months ago could also be related to eating duck blood or similar foods.
I would like the doctor to clarify my concerns.
Thank you.

Qiu, 30~39 year old female. Ask Date: 2018/10/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Please visit the gastroenterology outpatient clinic for an endoscopy at Changhua Hospital to take care of your health.
Best regards, Chen Shidian.

Reply Date: 2018/10/11

More Info

Understanding left lower abdominal pain can be quite complex, as it can stem from a variety of causes, some of which may be benign while others could indicate a more serious condition. Given your symptoms, including the presence of blood in your stool, changes in bowel habits, and ongoing discomfort in the left lower abdomen, it is crucial to approach this situation with caution and seek further medical evaluation.

Possible Causes of Left Lower Abdominal Pain
1. Gastrointestinal Issues: Conditions such as diverticulitis, inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS) can cause pain in the left lower abdomen. Diverticulitis, in particular, occurs when small pouches (diverticula) in the colon become inflamed or infected, leading to pain, fever, and changes in bowel habits.

2. Colorectal Concerns: The presence of blood in your stool, especially if it is bright red, could indicate issues such as hemorrhoids, anal fissures, or more serious conditions like colorectal polyps or cancer. The fact that you experienced black stools previously could suggest upper gastrointestinal bleeding, which may have resolved but still warrants investigation.

3. Urinary Tract Issues: Given the location of your pain near the bladder, urinary tract infections (UTIs) or bladder conditions could also be contributing factors. Symptoms might include pain during urination, increased frequency, or urgency.

4. Gynecological Issues: In females, conditions such as ovarian cysts or ectopic pregnancy can cause left-sided abdominal pain. While these may not apply to everyone, they are important considerations depending on your medical history.

5. Musculoskeletal Causes: Sometimes, pain can arise from muscle strain or issues related to the spine, especially if you have a history of injury or physical activity that may have led to strain.

The Role of Anxiety
Anxiety can exacerbate physical symptoms, including abdominal pain. It can lead to heightened awareness of bodily sensations and may contribute to gastrointestinal symptoms such as diarrhea or changes in bowel habits. However, it is essential to differentiate between anxiety-related symptoms and those caused by underlying medical conditions.

Recommended Actions
Given the complexity of your symptoms and the presence of blood in your stool, it is crucial to follow up with a healthcare provider. Here are some steps you should consider:
1. Consult a Gastroenterologist: A specialist can perform a thorough evaluation, which may include a colonoscopy to visualize the colon and identify any abnormalities. This is particularly important given your history of black stools and current symptoms.

2. Diagnostic Imaging: Depending on your doctor's assessment, imaging studies such as an abdominal ultrasound or CT scan may be warranted to evaluate the organs in your abdomen and pelvis.

3. Laboratory Tests: Blood tests can help assess for anemia (which may indicate bleeding), infection, or inflammation. Stool tests may also be performed to check for infections or other gastrointestinal issues.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency and characteristics of your bowel movements, any associated pain, and any other changes in your health. This information can be invaluable for your healthcare provider.

5. Lifestyle Modifications: While awaiting further evaluation, consider dietary changes that may help alleviate symptoms. Increasing fiber intake can improve bowel regularity, but be cautious if you have conditions like diverticulitis, where certain foods may exacerbate symptoms.

Conclusion
Your symptoms warrant a thorough investigation to rule out serious conditions, especially given the presence of blood in your stool and ongoing abdominal discomfort. While anxiety can play a role in physical symptoms, it is essential to address any potential underlying medical issues. Please prioritize seeking medical attention to ensure a comprehensive evaluation and appropriate management of your symptoms.

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