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

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Left lower abdominal pain can be a perplexing symptom, especially when it is vague and intermittent. Given your description of the pain being present for several months, along with episodes of diarrhea and bloating, it is essential to consider a variety of potential causes.

Common Causes of Left Lower Abdominal Pain
1. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS), diverticulitis, or inflammatory bowel disease (IBD) can lead to left lower abdominal pain. IBS is particularly common and can cause symptoms like abdominal pain, bloating, and changes in bowel habits, including diarrhea. Diverticulitis occurs when small pouches in the colon become inflamed or infected, often leading to localized pain, typically in the lower left abdomen.

2. Musculoskeletal Pain: Sometimes, pain in the abdomen can be referred from the muscles or ligaments in the lower back or pelvis. This can happen due to strain or injury, especially if you have been physically active or have had a recent injury.

3. Gynecological Issues: In women, left lower abdominal pain can also be related to gynecological conditions such as ovarian cysts, endometriosis, or pelvic inflammatory disease. These conditions can cause pain that may be felt in the lower abdomen and can sometimes be associated with menstrual cycles.

4. Urinary Tract Issues: Conditions affecting the urinary tract, such as a urinary tract infection (UTI) or kidney stones, can also cause pain in the lower abdomen. Although you mentioned that you have seen a urologist, it is worth considering if any urinary symptoms were overlooked.

5. Cancer Concerns: While it is natural to worry about cancer, especially with symptoms like persistent pain and changes in bowel habits, it is important to note that many other benign conditions can cause similar symptoms. However, if you have risk factors for colorectal cancer (such as a family history or age over 50), or if your symptoms persist or worsen, further evaluation may be warranted.


When to Seek Help
Given your symptoms, it is advisable to consult a healthcare professional if:
- The pain persists or worsens.

- You experience significant changes in bowel habits (e.g., persistent diarrhea or constipation).

- You notice blood in your stool or experience unexplained weight loss.

- You have associated symptoms such as fever, vomiting, or severe abdominal tenderness.


Diagnostic Considerations
Since you have already undergone a fecal occult blood test, which was negative, and have had some imaging studies, the next step could be a colonoscopy, especially if your symptoms continue. A colonoscopy can help visualize the interior of the colon and identify any abnormalities such as polyps, inflammation, or other issues that might not be visible through other imaging techniques.


Conclusion
In summary, while left lower abdominal pain can be concerning, it is often related to benign gastrointestinal or musculoskeletal issues. However, given the duration and nature of your symptoms, further evaluation, including a possible colonoscopy, may be necessary to rule out more serious conditions. Always discuss your symptoms and concerns with your healthcare provider, who can guide you through the appropriate diagnostic steps and treatment options.