Lower Abdominal Pain and Gas: Possible Gastrointestinal Issues

Lower abdominal pain, anal spasms, and bloating in the lower abdomen?

Hello, doctor.
Recently, I have been experiencing symptoms of continuous flatulence (without odor) and noticeable bloating in my lower abdomen.
Upon waking up in the morning, I feel a sensation of fullness in my lower abdomen, followed by flatulence.
Occasionally, I experience sharp or stabbing pains around the anal area, but there is no pain during bowel movements.
My stools are mostly soft, and I have bowel movements 1 to 3 times a day.
Recently, I have also felt occasional pain in both sides of my lower abdomen, with the right side being more uncomfortable.
In the past two days, I have experienced sharp pains in my stomach after dinner, and I also have abdominal rumbling in the morning and after meals.
Last year, in the second half of the year, I sought medical attention due to persistent lower abdominal symptoms and gastric discomfort.
In September, I underwent a fecal occult blood test, which returned normal results.
I usually take probiotics, so I would like to ask the doctor what possible conditions these symptoms might indicate, what I should pay attention to, or any recommendations you may have.
Thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2023/03/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, the symptoms you described may be caused by gastrointestinal dysfunction.
The lower abdominal bloating and flatulence could be due to the accumulation of gas in the gastrointestinal tract.
It is recommended that, in addition to maintaining good dietary habits, you should avoid consuming excessive gas-producing foods and limit dairy and fatty foods.
You might also try to enhance intestinal motility through moderate exercise, avoiding prolonged sitting, and self-massage, which can help alleviate symptoms.
Regarding bowel movements, the frequency and consistency of your stools are within normal ranges; however, if you continue to experience pain after bowel movements, it is advisable to consult a general surgeon or gastroenterologist to rule out other potential conditions.
Lastly, if you find that dietary changes and probiotics do not improve your symptoms, further medical evaluation may be necessary.

Reply Date: 2023/03/09

More Info

Based on the symptoms you’ve described, it appears that you may be experiencing gastrointestinal issues that could be related to several factors, including diet, gut motility, and possibly stress. Your symptoms of lower abdominal pain, gas, and changes in bowel habits suggest a potential diagnosis of Irritable Bowel Syndrome (IBS) or functional gastrointestinal disorder. IBS is characterized by a combination of abdominal pain and altered bowel habits, which can include diarrhea, constipation, or both.

Understanding Your Symptoms
1. Gas and Bloating: The continuous passing of gas, especially if it is odorless, often indicates that there is an excess of gas in the intestines. This can be caused by several factors, including the consumption of certain foods that are difficult to digest, such as beans, lentils, dairy products (if lactose intolerant), and certain vegetables like broccoli and cabbage. Additionally, swallowing air while eating or drinking can contribute to gas buildup.

2. Lower Abdominal Pain: The pain you feel, particularly in the right lower abdomen, could be related to the intestines. Conditions like IBS can lead to cramping and discomfort due to abnormal contractions of the intestinal muscles. The pain may also be exacerbated by stress or anxiety, which can affect gut motility.

3. Bowel Movements: The fact that you have soft stools and a frequency of 1-3 times a day is generally within the normal range, but if you notice a significant change in your bowel habits or consistency, it’s worth monitoring. The presence of soft stools can sometimes indicate a diet high in fiber or the consumption of certain foods that may irritate the gut.

4. Gastric Discomfort: The stabbing pain in your stomach after meals could be a sign of dyspepsia or indigestion. This can occur due to overeating, eating too quickly, or consuming spicy or fatty foods. It’s also possible that your stomach is reacting to the stress of your gastrointestinal symptoms.

Recommendations
1. Dietary Adjustments: Keeping a food diary can help identify any specific foods that may trigger your symptoms. Consider reducing intake of high-FODMAP foods (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) which can exacerbate gas and bloating. Gradually reintroducing foods can help pinpoint triggers.

2. Hydration and Fiber: Ensure you are drinking enough water and consuming a balanced diet rich in fiber, which can help regulate bowel movements. However, if you increase fiber intake, do so gradually to avoid exacerbating gas and bloating.

3. Probiotics: Since you are already taking probiotics, continue to do so, as they can help maintain a healthy gut flora. However, it may take time to see significant benefits, and not all probiotics are the same. You might want to consult with a healthcare provider about which strains might be most beneficial for your symptoms.

4. Stress Management: Since stress can significantly impact gastrointestinal health, consider incorporating stress-reducing techniques such as mindfulness, yoga, or regular exercise into your routine.

5. Follow-Up with Healthcare Provider: Since you have already undergone a fecal occult blood test with normal results, it may be beneficial to discuss further testing with your healthcare provider if symptoms persist. This could include a colonoscopy or an upper endoscopy to rule out other gastrointestinal conditions.

6. Monitor Symptoms: Keep track of your symptoms, including any changes in pain intensity, bowel habits, and dietary intake. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, while your symptoms may suggest a functional gastrointestinal disorder like IBS, it is essential to work closely with your healthcare provider to rule out any serious conditions and develop a tailored management plan. Your proactive approach to understanding your symptoms and seeking advice is commendable and will aid in your journey toward better gastrointestinal health.

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