Abdominal Pain and Bowel Changes: When to Seek Medical Advice

Abdominal pain, bowel issues?

Hello doctor, this month, three days before my period, I drank Baojiumilk, about two bottles a day, with each bottle being 240ml (I used to have diarrhea when drinking milk, but after a while, it stopped, so I thought it might be lactose intolerance).
During this time, I started experiencing pain in my lower abdomen on both sides.
I have a bowel movement once a day, but the stool is hard at the front and soft at the back, somewhat like sweet potato puree.
The pain is located very low, about three finger widths above the junction of my thighs and torso, and I feel a dull pain on both sides.
After my period started, the pain persisted in the same areas, and my stool consistency remained the same, still once a day.
After my period ended, I felt pain in the upper left abdomen, around the lower ribs, which I believe is the stomach area.
At night, I sometimes feel an empty sensation in my stomach, and I'm not sure if it's hunger.
When I lie on my left side, I feel a slight pain, but when I switch to my right side, it goes away.
I usually skip breakfast and wake up close to noon, around 10:30 AM.
Before lunch, I sometimes feel a dull pain from hunger.
After eating, I start to feel pain in my lower left abdomen (not as low as before my period).
After standing for about 10 minutes, I feel the urge to go to the bathroom, which I didn't experience before after eating.
My stool has become soft like sweet potato puree, and there is no longer hard stool.
After a bowel movement, the pain in my lower left abdomen subsides, but sometimes I still feel a dull sensation in the upper left area.
After eating, this sensation can extend to the middle of my abdomen.
About an hour after eating, I sometimes feel that my stomach is empty again, but it’s not painful, just different from before.
Drinking warm water seems to help a bit.
This feeling has persisted for three days until today.
I thought I might be hungry since I hadn't eaten breakfast, so I started eating.
Before lunch, I felt pain again in my lower left abdomen and near my navel, prompting me to go to the bathroom.
After eating lunch, the same pain returned, and after using the bathroom, it went away.
At dinner, after eating (I had some tofu that seemed a bit spoiled and only ate two pieces), the pain returned, and I went to the bathroom again.
At midnight, I felt the same pain and went to the bathroom again.
Today, I went four times, and my stool has been in the shape of sweet potato puree.
The first three times, the stool floated in the water, but the fourth time it didn't.
I read online that changes in bowel habits could indicate colon cancer, and I would like to ask the doctor if my situation qualifies as a change in bowel habits.
Additionally, the pain is in different areas; previously, it was in the lower sides during my period, and now, after my period, I feel an empty sensation in my stomach at night, like hunger.
After eating, my stomach feels a bit uncomfortable, and a few minutes later, I start to feel pain in my lower left abdomen, which resolves after using the bathroom.
An hour after eating, I feel that my stomach is empty again.
I drink about 1000cc of warm water throughout the day.
I would like to ask the doctor what my symptoms might indicate and whether I need to see a doctor.
If my stool continues to be soft like sweet potato puree, should I see a doctor? I never used to feel pain after eating that prompted me to go to the bathroom, but now I do.
A few days ago, I was having a bowel movement once a day, but today I went four times.
Should I see a doctor due to this change? If I do need to see a doctor, how many days should I wait? However, if I return to having one bowel movement a day and still feel pain after eating, which resolves after using the bathroom, should I see a doctor in that case as well? Please help me with these questions, thank you.

Xunwenren, 20~29 year old female. Ask Date: 2022/06/12

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely irritable bowel syndrome, which involves some abnormal motility.
You can visit an outpatient clinic and prepare some medications for relief, to be used as necessary.

Reply Date: 2022/06/12

More Info

When it comes to abdominal pain and changes in bowel habits, it is essential to approach the situation with caution and awareness of potential underlying issues. Your symptoms, including abdominal pain, changes in stool consistency, and altered bowel habits, warrant a thorough evaluation by a healthcare professional.

Firstly, the abdominal pain you are experiencing, particularly on the left side and near the lower abdomen, could be indicative of several conditions. Given that you have a history of lactose intolerance, it is possible that the consumption of milk products, such as the "保久乳" (long-life milk), may have exacerbated your symptoms. Lactose intolerance can lead to gastrointestinal discomfort, including cramping and diarrhea, particularly if you consume large quantities of dairy.
The changes in your bowel movements, specifically the transition from hard stools to softer, "地瓜泥" (sweet potato-like) stools, are also significant. This change can be attributed to various factors, including dietary changes, hydration levels, and potential gastrointestinal issues. The fact that you are experiencing pain before and after bowel movements suggests that there may be an underlying issue with your gastrointestinal tract, such as irritable bowel syndrome (IBS), which is characterized by abdominal pain and altered bowel habits.

Moreover, the pain you describe in relation to your menstrual cycle could indicate a connection between your reproductive health and gastrointestinal symptoms. Conditions such as endometriosis can cause referred pain to the abdomen and may also affect bowel habits. It is crucial to consider this possibility, especially since your symptoms seem to fluctuate with your menstrual cycle.

Regarding your concerns about potential serious conditions, such as colorectal cancer, it is understandable to feel anxious, especially with changes in bowel habits. While it is true that changes in stool consistency and frequency can be alarming, they are not definitive indicators of cancer. However, any persistent changes in bowel habits, especially if accompanied by pain, should be evaluated by a healthcare provider.

In terms of when to seek medical advice, it is generally recommended to consult a physician if:
1. You experience persistent abdominal pain that does not improve with over-the-counter medications.

2. Your bowel habits continue to change significantly, especially if you notice blood in your stool or if your stools become consistently loose or watery.

3. You experience additional symptoms such as fever, unexplained weight loss, or severe fatigue.

Given your current symptoms and their duration, it would be prudent to schedule an appointment with a gastroenterologist. They can perform a comprehensive evaluation, which may include a physical examination, blood tests, and possibly imaging studies or endoscopic procedures to assess your gastrointestinal health.

In conclusion, while some of your symptoms may be related to dietary choices or menstrual cycles, the combination of abdominal pain and changes in bowel habits should not be ignored. Seeking medical advice sooner rather than later can help rule out serious conditions and provide you with the appropriate care and management strategies. It is always better to err on the side of caution when it comes to your health.

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