Abdominal Pain and Symptoms: When to Seek Help

Abdominal discomfort?

On the first or second day of menstruation, I experience abdominal pain and diarrhea; especially on the second day, the flow is particularly heavy, with dark red blood clots being expelled, and my abdomen feels bloated.
However, by the third day, the flow is almost gone.
Is this abnormal? Sometimes (not during menstruation), when lying flat, I feel a bloated sensation and a bit of sharp pain in my left abdomen, while there is no discomfort on the right side.
Is this related to gastrointestinal issues or problems within the uterus? When I sleep on my stomach, I also feel a sensation as if my intestines are protruding on the left side.
Some people say this could be the cecum; is that true? My mother's abdomen is quite large, resembling someone who is 5 to 6 months pregnant, and it feels hard.
Can an ultrasound determine what it is? She has had an ultrasound (at a gastroenterology clinic), and the doctor said it was fat, but she is only overweight in her abdomen and not elsewhere.
Could it be a cyst or tumor? Or could there be something growing in her uterus? However, she does not feel any pain; how can this be explained?

amy, 20~29 year old female. Ask Date: 2000/12/14

Dr. Liang Yinpan reply Obstetrics and Gynecology

Hello Ms.
Amy,
In response to your questions, here are the answers:
1.
Menstrual periods typically last between 3 to 7 days, which is considered normal.
During the first couple of days or when the flow is heavy, it may stimulate abnormal contractions of the intestines, leading to symptoms such as bloating, abdominal pain, or diarrhea.
Additionally, when the flow is heavy, the menstrual blood may not dissolve quickly and can contain a significant amount of endometrial tissue, resulting in the expulsion of dark red clots.
If these symptoms are not severe enough to disrupt your daily life or are not progressively worsening, they are likely normal.
2.
The presence of formed stool in the colon can create a sensation of fullness in the abdomen.
If there is significant bloating or peristalsis, it may cause discomfort.
However, this phenomenon is usually temporary and the location of the discomfort is not fixed.
If the symptoms persist and are consistently located in the same area, it is advisable to seek medical evaluation to rule out the possibility of an abdominal tumor.
3.
Your mother's abdomen appears distended and firm, and has been diagnosed by a gastroenterologist as fatty tissue, which is likely due to obesity.
If there are concerns, it would be prudent to consult a gynecologist to rule out the possibility of pelvic tumors.
Best regards,
Liang Yin Pan

Reply Date: 2000/12/14

More Info

Understanding abdominal pain and its associated symptoms can be quite complex, especially when considering the various potential causes and the interplay of different bodily systems. In your case, the symptoms you describe—pain during menstruation, changes in bowel habits, and sensations of fullness or pressure in the abdomen—could indicate several underlying issues that warrant further investigation.

Firstly, it is not uncommon for women to experience abdominal pain and gastrointestinal symptoms during their menstrual cycle. This is often due to hormonal changes that can affect the gastrointestinal tract, leading to symptoms such as cramping, diarrhea, and bloating. The presence of dark red blood clots during menstruation can also be typical, especially on heavier flow days, but if this is accompanied by severe pain or if the pattern changes significantly, it may be worth discussing with a healthcare provider.

The sensation of fullness or a "pushing" feeling in the left abdomen, particularly when lying down, could suggest several possibilities. It might be related to gastrointestinal issues, such as gas or bloating, or it could be indicative of a more serious condition involving the organs in that area, such as the colon or the reproductive organs. The left side of the abdomen houses parts of the colon, as well as the left ovary and fallopian tube, so any abnormalities in these structures could lead to discomfort.

The mention of your mother's abdomen appearing distended and hard, resembling a pregnancy, is concerning. While the ultrasound indicated that the issue was related to fat distribution, it is essential to consider other possibilities, such as ascites (fluid accumulation in the abdominal cavity), tumors, or other masses. If the ultrasound did not reveal any concerning findings, but the symptoms persist or worsen, further imaging studies, such as a CT scan or MRI, may be warranted to provide a clearer picture of what is happening internally.

In terms of when to seek help, it is crucial to pay attention to the following signs:
1. Severe or Persistent Pain: If abdominal pain is severe, persistent, or worsening, it is essential to seek medical attention.

2. Changes in Bowel Habits: Significant changes in bowel habits, such as persistent diarrhea, constipation, or the presence of blood in the stool, should be evaluated.

3. Abdominal Distension: If the abdomen appears distended and hard, especially if accompanied by discomfort or pain, it is advisable to consult a healthcare provider.

4. Unexplained Weight Loss: If there is unexplained weight loss along with abdominal symptoms, this could indicate a more serious underlying condition.

5. Menstrual Irregularities: If menstrual cycles become irregular, or if there are significant changes in the flow or associated symptoms, it is important to discuss these changes with a gynecologist.

Given the complexity of your symptoms and your mother's condition, it would be prudent to consult with both a gynecologist and a gastroenterologist. The gynecologist can evaluate any potential issues related to the reproductive organs, while the gastroenterologist can assess the gastrointestinal tract for any abnormalities. Additionally, if there are concerns about potential masses or fluid accumulation, a referral to an oncologist or a specialist in abdominal imaging may be necessary.

In conclusion, while some abdominal symptoms can be benign and related to normal physiological processes, others may indicate more serious conditions that require prompt evaluation and treatment. It is always better to err on the side of caution and seek medical advice when experiencing concerning symptoms.

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