Left Lower Abdominal Pain: IBS or Something More Serious?

Q: Left Lower Abdominal Pain: IBS or Something More Serious?

Hello： Symptoms that may indicate irritable bowel syndrome (IBS) include abdominal pain, diarrhea, urgency, and bloating. <br>Whether to perform another colonoscopy or other examinations should be evaluated by a clinical physician. <br>Adjusting medication may help improve the co

There is a dull pain in the lower left abdomen, accompanied by a persistent urge to have a bowel movement, and at times there is a feeling of needing to pass gas but being unable to do so?

Hello Doctor, since last year, I have occasionally experienced dull pain in my lower left abdomen, and over the past few days, the pain has become daily.
I also have a persistent urge to have a bowel movement, even after I have already gone.
Additionally, a couple of days ago, I had the sensation of needing to pass gas but was unable to do so.
I underwent a colonoscopy around May of last year, which showed no polyps, but I was diagnosed with irritable bowel syndrome (IBS).
I would like to ask if IBS can cause the symptoms mentioned above.
If not, what other conditions could be responsible, such as tumors, colorectal cancer, or ulcers? Would it be necessary to have another colonoscopy for further evaluation, or are there other methods of examination that could be considered? I apologize for the many questions, and I appreciate your time in answering them.

Mr. Lin, 30~39 year old female. Ask Date: 2020/02/21

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Symptoms that may indicate irritable bowel syndrome (IBS) include abdominal pain, diarrhea, urgency, and bloating.
Whether to perform another colonoscopy or other examinations should be evaluated by a clinical physician.
Adjusting medication may help improve the condition.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2020/02/21

More Info

Left lower abdominal pain can be a complex issue, and your symptoms raise several important considerations. Based on your description, it seems you are experiencing persistent discomfort in the left lower abdomen, along with a sensation of needing to have a bowel movement even after you have already gone. Additionally, you mentioned difficulty passing gas. These symptoms can indeed be associated with Irritable Bowel Syndrome (IBS), which is a common gastrointestinal disorder characterized by a combination of abdominal pain and altered bowel habits.

IBS can manifest in various ways, including cramping, bloating, and changes in bowel movements, such as diarrhea or constipation. The sensation of incomplete evacuation, where you feel the need to pass stool even after doing so, is a common complaint among those with IBS. The fact that you have already been diagnosed with IBS suggests that your current symptoms could very well be an exacerbation of this condition.

However, it is also crucial to consider other potential causes for your symptoms, especially since you are experiencing daily pain and discomfort. While IBS is a functional disorder and does not lead to serious complications, other conditions could present with similar symptoms and warrant further investigation. These include:
1. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause abdominal pain, diarrhea, and other gastrointestinal symptoms. Unlike IBS, IBD is characterized by inflammation of the gastrointestinal tract and can lead to more serious complications.

2. Colorectal Cancer: Although less common, especially in younger individuals, persistent abdominal pain, changes in bowel habits, and the sensation of incomplete evacuation can be concerning for colorectal cancer. A history of normal colonoscopy does reduce this risk, but it does not completely eliminate it.

3. Diverticulitis: This condition occurs when diverticula (small pouches that can form in the colon) become inflamed or infected, leading to abdominal pain, fever, and changes in bowel habits.

4. Functional Dyspepsia: This condition can cause discomfort in the upper abdomen, but it can sometimes be mistaken for lower abdominal issues, particularly if there is bloating or gas.

Given your history of a normal colonoscopy and the diagnosis of IBS, it may be reasonable to initially manage your symptoms conservatively. This could include dietary modifications, such as increasing fiber intake, staying hydrated, and possibly trying medications that target IBS symptoms, like antispasmodics or laxatives if constipation is an issue.

However, if your symptoms persist or worsen, or if you develop new symptoms such as significant weight loss, blood in your stool, or severe pain, it would be prudent to consult your healthcare provider for further evaluation. A repeat colonoscopy may be considered, especially if there are any red flags or if your symptoms do not align with typical IBS presentations.

In summary, while your symptoms could be consistent with IBS, it is essential to remain vigilant for other potential gastrointestinal issues. Regular follow-ups with your healthcare provider and open communication about your symptoms will be key in managing your condition effectively.

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