Abdominal Pain: When to See a Gastroenterologist or Proctologist

Abdominal pain

Hello, doctor.
I would like to ask you about a recent issue.
I often feel discomfort and pain in my left abdomen (under the left rib) after eating, and I need to rush to the bathroom to have a bowel movement.
My bowel habits have changed; I used to have three bowel movements a day, but now I need to resolve it immediately.
Sometimes, after drinking cold water, I also need to have a bowel movement.
Occasionally, the stool is formed, but most of the time it is unformed, and the pressure during elimination feels significant, similar to passing gas.
Two years ago, I had a colonoscopy, and the doctor diagnosed me with irritable bowel syndrome.
Should I see a proctologist or a gastroenterologist?

Tiāntiān, 30~39 year old female. Ask Date: 2004/02/29

Dr. Su Baojia reply Gastroenterology and Hepatology

There is a problem with the system.
Please respond again.
Your symptoms should be evaluated for the possibility of hepatitis.
You can consult a gastroenterologist for an examination and have blood tests done to check liver function for any abnormalities.

Reply Date: 2004/02/29

More Info

When dealing with persistent abdominal pain, especially when it is localized to the left side beneath the rib cage and accompanied by changes in bowel habits, it is essential to consider a variety of potential causes and the appropriate specialists to consult. Given your symptoms, which include discomfort after eating, frequent urges to defecate, and irregular stool consistency, it seems that your condition may be related to gastrointestinal issues, particularly irritable bowel syndrome (IBS), which you mentioned was diagnosed two years ago.

Irritable bowel syndrome is a common functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits, including diarrhea and constipation. Stress, dietary choices, and certain food intolerances can exacerbate these symptoms. Since you have experienced a change in your bowel habits, with a tendency to have loose stools and the feeling of urgency after meals, it is crucial to manage these symptoms effectively.

In your case, it would be advisable to consult a gastroenterologist. Gastroenterologists specialize in diagnosing and treating disorders of the gastrointestinal tract, including the esophagus, stomach, intestines, and colon. They can conduct further evaluations, such as stool tests, imaging studies, or even repeat colonoscopy if necessary, to rule out any underlying conditions that may be contributing to your symptoms. Given your history of IBS, the gastroenterologist can also help you develop a management plan that may include dietary modifications, stress management techniques, and possibly medications to alleviate your symptoms.

On the other hand, if your symptoms were more localized to the rectum or if you were experiencing significant pain during bowel movements, it might be appropriate to see a proctologist. Proctologists specialize in disorders of the rectum and anus, including hemorrhoids, anal fissures, and rectal pain. However, based on your description, it seems that your primary concern is more related to the overall gastrointestinal tract rather than specific rectal issues.

In addition to consulting with a gastroenterologist, it may be beneficial to keep a food diary to track what you eat and how it correlates with your symptoms. This can help identify any potential food triggers, such as dairy, gluten, or high-fat foods, which are known to exacerbate IBS symptoms. Additionally, consider incorporating stress-reducing activities into your routine, such as yoga, meditation, or regular exercise, as stress can significantly impact gastrointestinal health.

It is also important to stay hydrated and maintain a balanced diet rich in fiber, which can help regulate bowel movements. If you notice any alarming symptoms, such as significant weight loss, blood in your stool, or persistent vomiting, seek medical attention promptly, as these could indicate more serious conditions that require immediate evaluation.

In summary, based on your symptoms and history, I recommend seeing a gastroenterologist for a comprehensive evaluation and management plan tailored to your needs. They will be able to provide you with the best guidance on how to manage your abdominal pain and bowel irregularities effectively.

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