Chronic Abdominal Pain: Symptoms, Concerns, and Diagnosis

Chronic abdominal pain

Hello, doctor.
At the end of July, I experienced nighttime lower abdominal pain, followed by severe diarrhea the next day, which was watery.
After seeing a doctor, my symptoms improved, but in August, I started having intermittent cramping.
At the end of August, I visited the doctor again due to persistent abdominal pain, and they performed imaging on my liver, pancreas, and kidneys.
They suggested I might have mild heatstroke.
After taking medication, I felt better for a while, but by September, I had not improved, and in early October, I saw a doctor again.
They conducted an ultrasound and said my liver was fine and there were no obvious abnormalities in my lower abdomen (though I found information stating that ultrasounds are not very accurate).
The diagnosis was irritable bowel syndrome (IBS), and I was prescribed medication before going home.
However, during the National Day holiday, the medication seemed to cause persistent pain in my lower abdomen (last night, I felt pain when pressing on my lower right abdomen, but this morning there was no tenderness).
The pain is not severe, just a bloated feeling, or a tight sensation in my lower abdomen.
I haven't had constipation, but during the Mid-Autumn Festival, I had a bowel movement that was not very watery but floated and dispersed in the water.
I am now very worried about the possibility of colon cancer because I have felt a bit fatigued these past two days.
The medication for IBS mentions fatigue as a side effect.
My family says I am worrying too much, but I found information about people who were diagnosed and passed away shortly after.
My symptoms, including fatigue and bloating (we have a family history of anemia, so I am uncertain), are similar to those of colon cancer.
I am truly concerned, as I feel I still have many things I want to accomplish in life, and I am afraid it might really be colon cancer.
Please help me, doctor.
Thank you.

Niming, 10~19 year old female. Ask Date: 2021/10/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

The diagnosis should be irritable bowel syndrome.
Reduce oil and dairy intake, minimize stress, and continue to monitor the situation.
If necessary, a fecal occult blood test may be performed.

Reply Date: 2021/10/11

More Info

Chronic abdominal pain can be a complex and distressing condition, often leading to significant anxiety and concern about serious underlying health issues, such as colorectal cancer. Based on your description, it appears that you have been experiencing intermittent abdominal pain, particularly in the lower abdomen, along with episodes of diarrhea and feelings of bloating. You have undergone various diagnostic tests, including ultrasounds and evaluations for gastrointestinal issues, which have not revealed any alarming findings.

Firstly, it’s important to understand that chronic abdominal pain can arise from a multitude of causes, ranging from functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), to more serious conditions. IBS is characterized by symptoms like abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation), and it is often exacerbated by stress and dietary factors. Your symptoms of intermittent pain and bloating, along with the diagnosis of IBS, align with this condition.

Regarding your concerns about colorectal cancer, it is understandable to feel anxious, especially given your family history of anemia and your current symptoms. However, it is crucial to note that the majority of individuals with IBS do not develop colorectal cancer. The risk factors for colorectal cancer include age, family history of colorectal cancer, certain genetic conditions, and lifestyle factors such as diet and physical activity. Since you have undergone imaging studies that did not indicate any masses or abnormalities, this is a reassuring sign.

The fatigue you are experiencing could be related to several factors, including the stress and anxiety surrounding your health concerns, the side effects of medications, or even dietary changes. It is essential to maintain a balanced diet, stay hydrated, and engage in regular physical activity, as these can help alleviate some symptoms of IBS and improve overall well-being.

If your symptoms persist or worsen, it is advisable to follow up with your healthcare provider. They may consider additional diagnostic tests, such as a colonoscopy, especially if there are any changes in your bowel habits or if you develop new symptoms, such as significant weight loss, persistent abdominal pain, or blood in your stool. These could warrant further investigation to rule out any serious conditions.

In the meantime, managing anxiety is crucial. Techniques such as mindfulness, cognitive-behavioral therapy, and relaxation exercises can be beneficial in reducing stress and improving your quality of life. Additionally, discussing your concerns with a mental health professional may provide you with strategies to cope with your anxiety regarding your health.

In summary, while it is natural to worry about serious conditions like colorectal cancer, the absence of alarming findings in your tests and the nature of your symptoms suggest that IBS may be the underlying issue. Continuing to work with your healthcare provider to monitor your symptoms and manage your anxiety will be key in navigating this challenging situation. Remember, you are not alone in this, and there are resources and support available to help you through it.

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