Abdominal Discomfort: Is It Digestive or Muscular? - Gastroenterology and Hepatology

Colorectal issues

Hello, Director Chen.
Last February, I experienced abdominal bloating and pain.
In April, I underwent a colonoscopy, which revealed a single hyperplastic polyp approximately 0.2 cm in size that was removed.
It was also noted that there was mild inflammation in the colon, but the biopsy results indicated no significant issues.
This year, due to increased stress, I have started to feel occasional discomfort in my lower abdomen, primarily on the left side, which lasts for a few seconds.
However, I do not experience diarrhea or any other symptoms.
The discomfort occurs suddenly when I change positions, such as sitting up straight or slouching, which seems to pull or compress the lower abdomen.
Sometimes, when I lean forward while standing and support my abdomen, I also feel this discomfort while walking.
The left lower abdomen occasionally feels uncomfortable for a few seconds, and it's hard to describe (it’s not the sharp pain associated with diarrhea).
Sometimes, I don’t feel it at all.
Recently, my bowel movements have decreased in frequency, likely due to stress, and I have been eating less.
The stool shape varies; sometimes it’s thinner, and other times it resembles flat pieces, but it remains a normal yellow color.
I was concerned about potential issues with my bladder or urinary system, so I underwent an IVP (intravenous pyelogram), which came back normal.

1.
How can I determine whether this is an intestinal issue or a muscle strain? I don’t experience pain every time I perform these movements.
To my understanding, muscle strains typically cause discomfort with repeated actions.

2.
Could this be related to psychological stress?
3.
When I returned to see the doctor, they couldn’t identify a specific cause since the pain is not severe but rather occasional, which makes it more distressing.
They advised me to relax and not to stress, and prescribed me with Anban (a medication) to take before bed.

nan, 30~39 year old female. Ask Date: 2022/06/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

There may be some muscle strains; it is advisable to avoid excessive weight-bearing and to pay attention to posture.

Reply Date: 2022/06/08

More Info

Understanding abdominal discomfort can be quite complex, especially when differentiating between digestive issues and muscular problems. Based on your description, it seems you are experiencing intermittent discomfort in your lower abdomen, primarily on the left side, which is exacerbated by certain movements or postures. You have a history of gastrointestinal issues, including a previously identified polyp and mild inflammation, but recent imaging of your urinary system returned normal results.

1. Differentiating Between Digestive and Muscular Issues:
The nature of your pain is crucial in determining its origin. Digestive pain often presents with accompanying symptoms like changes in bowel habits, diarrhea, or significant cramping. In contrast, muscular pain typically arises from specific movements or positions, often described as a pulling or sharp sensation that can be localized to the muscle. Given that your discomfort occurs with certain movements and does not consistently present with gastrointestinal symptoms, it may suggest a muscular origin, possibly related to strain or tension in the abdominal muscles. However, since you have a history of gastrointestinal issues, it is essential to remain vigilant for any changes in your symptoms.

2. Psychological Stress and Its Impact:
Psychological factors, including stress and anxiety, can significantly influence physical health. Stress can lead to muscle tension, which may manifest as discomfort or pain in various body parts, including the abdomen. Additionally, stress can affect gastrointestinal function, potentially leading to symptoms like changes in bowel habits or abdominal discomfort. Your report of increased stress and changes in appetite could indeed correlate with your symptoms. It is not uncommon for individuals under stress to experience somatic symptoms, where psychological distress manifests physically.

3. Consulting Healthcare Professionals:
It is understandable that the lack of a definitive diagnosis can be frustrating. When symptoms are vague and not accompanied by severe pain or alarming signs, healthcare providers may recommend a conservative approach, focusing on lifestyle modifications and stress management. The prescription of a medication like Anxiolytic (安邦錠) suggests that your physician is considering the psychological component of your symptoms. It might be beneficial to follow up with your doctor if the discomfort persists or worsens, or if new symptoms arise. Keeping a symptom diary, noting when the pain occurs, its intensity, and any associated activities or stressors, can provide valuable information for your healthcare provider.

In conclusion, while your symptoms may suggest a muscular issue exacerbated by stress, it is essential to monitor your condition closely. If the discomfort continues or if you experience any new symptoms, such as significant changes in bowel habits, persistent pain, or urinary issues, seeking further evaluation is advisable. Additionally, addressing stress through relaxation techniques, counseling, or physical therapy may also help alleviate your symptoms. Remember, your health is a priority, and open communication with your healthcare provider is key to finding the right approach for your situation.

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