Left Lower Abdominal Pain and Diarrhea: Is It IBS?

Left lower abdominal pain with diarrhea?

Hello Doctor, my symptoms started last year when I experienced a breakdown for a period of time due to certain reasons.
After that, I began to have diarrhea, although I still have normal bowel movements, the frequency of diarrhea has increased.
Subsequently, I started experiencing abdominal pain, with the left lower abdomen being the most frequent site of pain.
However, sometimes the pain manifests in the upper abdomen, right upper abdomen, and right lower abdomen, often presenting as cramping, sharp pain, or bloating.
Because my symptoms are similar to those of colorectal cancer, I became depressed for a while, which made my condition worse...
Could this possibly just be irritable bowel syndrome? However, I read online that irritable bowel syndrome only presents with left lower abdominal pain when constipation is involved, so I am still very worried...
P.S.
My health check last year did not reveal anemia, with hemoglobin levels around 13.

Tom, 10~19 year old female. Ask Date: 2023/08/13

Dr. Chen Bingze reply Surgery

Hello, I think this issue might be concerning for you.
I suggest you inform your family and arrange to have a colonoscopy under sedation at a hospital.
Basically, the risk of colorectal cancer at your age is very low.
Instead, it’s important to be aware of the possibility of inflammatory bowel disease.
Having a colonoscopy can help ensure that everything is fine, which may give you more peace of mind.

Reply Date: 2023/08/13

More Info

Understanding left lower abdominal pain and diarrhea can be quite complex, especially when symptoms overlap with conditions like Irritable Bowel Syndrome (IBS) or even more serious issues such as colorectal cancer. Based on your description, it seems that your symptoms began after a period of emotional distress, which can often trigger gastrointestinal issues. This is not uncommon, as stress and anxiety can significantly affect gut health.

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, including diarrhea and constipation. It is important to note that IBS can present with a variety of symptoms, and not all patients will experience the same pattern. While it is true that some individuals with IBS may primarily experience constipation, others can have predominant diarrhea or alternating patterns. Therefore, your experience of left lower abdominal pain along with diarrhea does not rule out IBS.

The left lower abdominal pain you are experiencing could be due to several factors. One possibility is that it is related to the colon, particularly if you have a history of IBS. The colon can become hypersensitive in IBS patients, leading to pain and discomfort, especially in the left lower quadrant where the sigmoid colon is located. Additionally, the pain can manifest as cramping, sharp, or even a dull ache, which can vary in intensity.

Another consideration is the possibility of other gastrointestinal conditions. For instance, diverticulitis, which is inflammation of diverticula in the colon, can cause similar symptoms, including localized pain and changes in bowel habits. However, this condition is typically accompanied by fever and more severe symptoms. Given your history of abdominal pain and diarrhea, it would be prudent to consider a thorough evaluation to rule out any structural issues or inflammatory conditions.

Your concern about colorectal cancer is understandable, especially given the nature of your symptoms. However, it is important to remember that the absence of anemia and normal hemoglobin levels from your recent health check are reassuring signs. Colorectal cancer often presents with additional symptoms such as significant weight loss, changes in stool caliber, or blood in the stool. Nevertheless, if you have a family history of colorectal cancer or other risk factors, it is advisable to discuss these concerns with your healthcare provider.

In terms of management, if your symptoms are indeed related to IBS, lifestyle modifications can be beneficial. These may include dietary changes, such as increasing fiber intake, staying hydrated, and possibly identifying and avoiding trigger foods. Stress management techniques, such as mindfulness, yoga, or cognitive behavioral therapy, can also play a significant role in alleviating symptoms.

It is crucial to maintain open communication with your healthcare provider. If your symptoms persist or worsen, further diagnostic tests, such as a colonoscopy or imaging studies, may be warranted to rule out other conditions. Keeping a symptom diary can also help your doctor understand the patterns of your symptoms and tailor a treatment plan that works for you.

In summary, while your symptoms may suggest IBS, it is essential to consider a comprehensive evaluation to rule out other potential causes. Your health and well-being are paramount, and seeking the right medical advice is the best course of action.

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