Persistent Lower Abdominal Pain: Symptoms and Next Steps

Lower abdominal issues?

Hello Doctor, I have been experiencing persistent dull pain in my abdomen for the past month.
I had some constipation recently, but it has improved; however, the dull pain in my abdomen continues.
I went to the hospital for a sigmoidoscopy, and the doctor said everything was fine, just some inflammation in the intestines, and prescribed medication for me, but there has been no improvement.
I also experience sharp pain in my abdomen.
I would like to ask the doctor what these symptoms could indicate.
Do I need to undergo a colonoscopy?

Hou An, 20~29 year old female. Ask Date: 2019/03/30

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Adjusting the diet and using medication can improve constipation and alleviate symptoms.

Reply Date: 2019/03/30

More Info

Persistent lower abdominal pain can be a complex issue, and understanding its underlying causes is crucial for effective management. Given your symptoms of continuous dull pain, previous constipation, and the recent diagnosis of colonic inflammation, there are several factors to consider.

Firstly, the inflammation in your intestines could be due to various conditions, such as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. These conditions can cause persistent abdominal pain, changes in bowel habits, and other gastrointestinal symptoms. It's important to note that even if a colonoscopy (colonoscopy) shows no significant abnormalities, inflammation can still be present and may require further investigation.

The stabbing pain you mentioned could be related to several factors, including muscle strain, nerve irritation, or even referred pain from other organs. For instance, conditions affecting the reproductive organs in women, such as ovarian cysts or endometriosis, can also present with lower abdominal pain. In men, issues related to the prostate or urinary tract may be considered.

Since you have already undergone a flexible sigmoidoscopy, which is a less extensive procedure than a full colonoscopy, it might be beneficial to discuss with your healthcare provider whether a full colonoscopy is warranted. This procedure allows for a more comprehensive examination of the entire colon and can help identify any potential abnormalities that may have been missed during the sigmoidoscopy.

Additionally, if your symptoms persist despite treatment, it may be worthwhile to explore other diagnostic options. Imaging studies, such as an abdominal ultrasound or CT scan, can provide valuable information about the organs in your abdomen and help identify any structural issues that may be contributing to your pain.

Anxiety and stress can also exacerbate gastrointestinal symptoms, leading to a cycle of discomfort. If you are experiencing anxiety, it may be beneficial to address this aspect of your health as well. Stress management techniques, such as mindfulness, cognitive-behavioral therapy, or relaxation exercises, can help alleviate some of the discomfort associated with anxiety and may improve your overall well-being.

In summary, persistent lower abdominal pain can stem from various causes, including inflammatory conditions, structural issues, or even psychological factors. Given your history and current symptoms, it is advisable to have a thorough discussion with your healthcare provider about the next steps, including the possibility of a full colonoscopy, further imaging studies, or referrals to specialists such as a gastroenterologist or a pain management specialist. Keeping a detailed symptom diary, noting when the pain occurs, its intensity, and any associated symptoms, can also be helpful for your healthcare provider in diagnosing and managing your condition effectively.

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