Left Lower Abdominal Pain: Causes and Next Steps - Gastroenterology and Hepatology

Left lower abdominal distension and pain?

Left lower abdominal bloating and pain, unsure if it's related to the urethra or the ovaries, with some slight stabbing pain in the vagina.
After a few days, urination has become more difficult, requiring some effort to empty the bladder completely, and there is decreased sensitivity to the urge to urinate.
There is a constant feeling of heat in the stomach, and recent bowel movements have been loose and dark in color.
However, I am unsure if this is due to taking probiotics and bowel-regulating supplements, as I tend to experience constipation with large, hard stools when not taking them.
Last year, I had a similar issue and underwent a colonoscopy, which was normal with no polyps, but a diverticulum was found that had become inflamed due to stool impaction.
Can an ultrasound confirm whether I have diverticulitis? I have already had a pelvic ultrasound at the gynecologist, but the doctor did not provide much information and only prescribed anti-inflammatory and pain relief medication for three days, which seems to have provided only slight relief.
I'm unsure what to do next.

Wo, 40~49 year old female. Ask Date: 2022/10/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

Follow-up visits are recommended, and please monitor for any fever or worsening symptoms.
Diverticulitis is often diagnosed through colonoscopy or computed tomography (CT) and may be associated with fever.

Reply Date: 2022/10/31

More Info

Left lower abdominal pain can be a complex issue with various potential causes, especially when accompanied by urinary symptoms and changes in bowel habits. Based on your description, it seems that you are experiencing a combination of gastrointestinal and possibly urological symptoms, which can complicate the diagnosis.

Potential Causes
1. Gastrointestinal Issues: Given your history of diverticulosis (the presence of diverticula in the colon), it is possible that you may be experiencing diverticulitis, which is an inflammation of these diverticula. Symptoms can include localized pain, changes in bowel habits, and sometimes fever. The fact that you mentioned having a history of black stool could indicate bleeding or other gastrointestinal issues, which should be evaluated further.

2. Urinary Tract Issues: The symptoms you describe, such as difficulty urinating and a change in bladder sensitivity, could suggest a urinary tract infection (UTI) or possibly interstitial cystitis. UTIs can cause lower abdominal pain and discomfort, especially when urinating. The sensation of needing to push to urinate could indicate bladder irritation or inflammation.

3. Gynecological Concerns: Since you have also undergone a gynecological ultrasound, it is important to consider ovarian issues, such as ovarian cysts or other conditions that could cause referred pain to the lower abdomen. The sharp pain you mentioned could be related to these structures.

4. Musculoskeletal Factors: Sometimes, pain in the lower abdomen can be referred from musculoskeletal issues, especially if there has been any recent physical activity or strain.

Next Steps for Diagnosis
1. Further Imaging: An abdominal ultrasound can help visualize the organs in the lower abdomen, including the bladder, ovaries, and any potential diverticula. A CT scan of the abdomen and pelvis may provide more detailed information, especially if diverticulitis is suspected.

2. Urinalysis and Culture: A urinalysis can help identify any signs of infection, blood, or other abnormalities in the urine. If a UTI is suspected, a urine culture can confirm the diagnosis and identify the specific bacteria involved.

3. Gastroenterology Follow-Up: Since you have a history of diverticulosis, it would be prudent to follow up with a gastroenterologist. They may recommend a repeat colonoscopy or other imaging studies to assess for diverticulitis or other gastrointestinal issues.

4. Symptom Management: While you are awaiting further evaluation, it may be helpful to manage your symptoms with dietary changes, such as increasing fiber intake to help with bowel regularity. However, be cautious with fiber if you suspect diverticulitis, as it may exacerbate symptoms during an acute episode.

5. Pain Management: If the pain is significant, discuss with your healthcare provider about appropriate pain management strategies. While anti-inflammatory medications may provide some relief, it is essential to address the underlying cause of the pain.

Conclusion
Given the complexity of your symptoms, it is crucial to have a comprehensive evaluation by your healthcare provider. They can help coordinate the necessary tests and referrals to specialists, such as a gastroenterologist or urologist, to ensure that all potential causes of your left lower abdominal pain are thoroughly investigated. Early diagnosis and treatment are key to managing your symptoms effectively and improving your quality of life.

Similar Q&A

Understanding Severe Left Lower Abdominal Pain: Causes and Remedies

Today, on April 5th, shortly after finishing dinner, I started experiencing severe pain in my lower left abdomen. I took some gastrointestinal medication, but it didn't improve the pain. Afterward, I took some pain relievers, which helped a bit. On March 20th in the afternoo...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: A 17-year-old female presents with left lower abdominal pain after meals, possibly due to indigestion. It is advised to eat slowly and to monitor bowel movements for regularity. Other potential causes include gastroenteritis, urinary tract infection, and abdominal issues s...

Understanding Left Lower Abdominal Pain: Causes and When to Seek Help

Medical History: In late 2019, the patient was diagnosed with fulminant hepatitis and primary biliary cholangitis, and has been on medication since then. Early the following year, the patient underwent surgery for stage 1A endometrial cancer. Currently, the patient is experiencin...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Left lower abdominal pain should be considered in relation to intestinal adhesions, urinary tract issues, or reproductive system problems—such as pelvic inflammatory disease. Additionally, diverticulitis or enteritis of the colon are also possible causes. It is advisable t...

Understanding Left Lower Abdominal Pain: When to Seek Help

Hello Dr. Chen: In the past two days, I have experienced pain in the lower left abdomen when pressure is applied, but there are no other abnormalities when not under pressure.

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Left lower abdominal pain is usually related to intestinal issues, commonly associated with bloating or constipation. If the symptoms persist, please consult a gastroenterologist. Best regards, Dr. Chi-Feng Chen, Taoyuan Hospital, Department of Health.

Understanding Left Lower Abdominal Pain: Possible Causes and Insights

I have been experiencing pain in the lower left abdomen for the past three days. The pain does not occur while sitting, but becomes noticeable when I stand up and walk. I do not have any bad habits, do not smoke or drink, and my daily routine is normal. I also do not have any gas...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Left lower abdominal pain can be related to gastrointestinal issues, as well as gynecological or urological problems. Please consult a gastroenterologist for further differential diagnosis.