Left Abdominal Pain and Swelling: Possible Causes and Solutions

Left-sided abdominal protrusion and abdominal pain?

Hello Dr.
Lin: My left side of the abdomen is more protruded than the right side, and I experience a dull pain constantly.
Sometimes the pain becomes severe enough that I lose my appetite.
There have been two or three instances where the pain was unbearable, and I had to be hospitalized, but the hospital only provided pain relief and IV fluids.
This condition has persisted for about three years.
I have undergone a colonoscopy, but the examination could not be completed due to inadequate preparation at the end of the colon.
Other examinations have indicated no significant issues, and I have been unable to determine the source of the problem, which has been very distressing.
I would appreciate your assistance in addressing this matter.
Thank you.

Lin Xiansheng, 50~59 year old female. Ask Date: 2020/08/04

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, the left side of my abdomen is protruding and often painful.
I have undergone a colonoscopy, but the bowel preparation was incomplete.
In addition to gastrointestinal issues, it is important to consider potential urinary tract problems.
I recommend follow-up at the outpatient clinic to arrange appropriate examinations.
Wishing you peace and health! Dr.
Lin Ming-Hui, Attending Physician, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/08/04

More Info

Left abdominal pain and swelling can be quite distressing, especially when it has persisted for an extended period, as you have described. Given your symptoms and the history of your condition, it is essential to consider several potential causes and solutions.

Possible Causes
1. Gastrointestinal Disorders: Conditions such as Irritable Bowel Syndrome (IBS), inflammatory bowel disease (IBD), or even functional dyspepsia can lead to chronic abdominal pain. IBS, in particular, is characterized by abdominal pain associated with changes in bowel habits, which could explain your discomfort.

2. Musculoskeletal Issues: Sometimes, pain in the abdominal area can stem from musculoskeletal problems, such as muscle strain or hernias. If the pain worsens with certain movements or positions, this could be a contributing factor.

3. Organ-related Issues: The left side of the abdomen houses several organs, including the spleen, left kidney, and parts of the colon. Conditions affecting these organs, such as splenic issues, kidney stones, or diverticulitis, could manifest as left-sided abdominal pain.

4. Referred Pain: Pain can sometimes be referred from other areas of the body. For example, issues with the spine or pelvis can lead to pain that feels like it originates in the abdomen.

5. Psychosomatic Factors: Chronic pain can also have a psychological component. Stress and anxiety can exacerbate physical symptoms, leading to a cycle of pain and discomfort.

Diagnostic Considerations
Since you have undergone a colonoscopy that was incomplete due to preparation issues, it may be worth considering a repeat procedure or alternative imaging studies, such as a CT scan or MRI, to get a clearer picture of what might be happening internally. Additionally, blood tests to check for inflammation markers, liver function, and kidney function could provide further insights.

Management Strategies
1. Dietary Adjustments: Keeping a food diary to identify any potential triggers can be beneficial. A diet low in fat, high in fiber, and avoiding known irritants (like caffeine, alcohol, and spicy foods) may help alleviate symptoms.

2. Medications: Depending on the underlying cause, medications may be necessary. For IBS, antispasmodics or medications that target specific symptoms may be prescribed. If inflammation is suspected, anti-inflammatory medications could be beneficial.

3. Physical Therapy: If musculoskeletal issues are suspected, physical therapy may help strengthen the abdominal muscles and improve posture, potentially alleviating pain.

4. Stress Management: Techniques such as mindfulness, yoga, or cognitive behavioral therapy can help manage the psychological aspects of chronic pain.

5. Regular Follow-ups: Given the chronic nature of your symptoms, regular follow-ups with a healthcare provider are crucial. This allows for ongoing assessment and adjustments to your treatment plan as needed.

Conclusion
Chronic left abdominal pain and swelling can arise from various causes, and it is essential to approach this issue holistically. A thorough evaluation, including repeat imaging and possibly a multidisciplinary approach involving gastroenterologists, pain specialists, and nutritionists, may be necessary to identify the root cause and develop an effective treatment plan. Remember, persistent symptoms warrant further investigation, and you should advocate for your health by seeking comprehensive care.

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