Abdominal Pain: When to See a Gastroenterologist - Gastroenterology and Hepatology

Q: Abdominal Pain: When to See a Gastroenterologist

Reply： Hello, <br>1. <br>This area may correspond to the terminal ileum, cecum, or appendix in males, as you mentioned. <br>Other possibilities include the sigmoid colon, ureters, and bladder (though less likely), which could be evaluated by either gastroenterology or colorectal

Which area is affected?

Hello, I have a few questions to ask:
1.
Below the navel (above the genitals), I can feel a bone, which should be the pelvic cavity.
Recently, I have occasionally felt a slight dull pain in the lower abdomen on the right side, near the upper right edge of that bone.
Which area might be problematic? (Rectum, cecum, or terminal ileum?) Should I consult a gastroenterologist or a colorectal surgeon?
2.
When I have a bowel movement, sometimes the stool is thick, sometimes thin, and sometimes it is not well-formed.
Could this indicate a problem with my intestines? If I want to undergo intestinal examination, should I see a gastroenterologist or a colorectal surgeon?
3.
I heard that a flexible sigmoidoscopy can be performed in the outpatient setting.
What should I do in terms of preparation or restrictions before making an appointment? How long does a colonoscopy take? Does it examine the entire colon and small intestine?
Thank you, doctor!

Hai Hai, 20~29 year old female. Ask Date: 2004/10/28

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Reply: Hello,
1.
This area may correspond to the terminal ileum, cecum, or appendix in males, as you mentioned.
Other possibilities include the sigmoid colon, ureters, and bladder (though less likely), which could be evaluated by either gastroenterology or colorectal surgery.

2.
It is essential to rule out any pathological changes in the intestinal organs.
Both specialties can arrange for the necessary examinations.

3.
Generally, fasting and bowel preparation are required.
Most patients are advised to take laxatives at home and schedule a time for the examination, unless it is absolutely necessary to perform it on the same day, in which case an enema may be administered first.
The duration of a colonoscopy varies from person to person (both patients and physicians) and can take anywhere from 10 minutes to half an hour to an hour.
A complete examination should reach at least the cecum, and if possible, extend to the terminal ileum.

Sincerely, Dr.
Chen Zhiping, Internal Medicine.

Reply Date: 2004/10/28

More Info

When it comes to understanding abdominal pain, especially in the context of your questions, it's essential to recognize that abdominal pain can arise from various sources, including gastrointestinal, gynecological, and even psychological factors. Given your specific inquiries, let's break down the issues systematically.

1. Location of Pain: You mentioned experiencing a dull pain in the lower right abdomen, just above the pelvic bone. This area is indeed close to several critical structures, including the appendix (which is part of the cecum), the terminal ileum (the last part of the small intestine), and potentially the reproductive organs if you are female. The dull pain could indicate issues related to the appendix (appendicitis), inflammation of the ileum (ileitis), or even conditions affecting the reproductive organs, such as ovarian cysts or ectopic pregnancy in females. Given this complexity, it would be prudent to consult a gastroenterologist first, as they can evaluate gastrointestinal causes and refer you to a colorectal surgeon if necessary.

2. Bowel Movement Changes: The variability in your stool consistency—sometimes formed, sometimes loose—can indeed indicate an underlying issue with your intestines. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even infections can cause such symptoms. If you are concerned about the health of your intestines, a gastroenterologist would be the appropriate specialist to consult. They can perform necessary evaluations, including stool tests and imaging studies, to determine if there is a significant underlying issue.

3. Colonoscopy Preparation: For a flexible sigmoidoscopy or colonoscopy, preparation is crucial for obtaining clear results. Generally, patients are advised to follow a low-fiber diet for a few days before the procedure and to take a prescribed laxative or enema the night before to clear the bowel. Specific instructions may vary depending on the healthcare provider, so it’s essential to follow the guidelines given by your doctor. The procedure itself typically lasts about 30 minutes to an hour, depending on the findings and whether any biopsies are taken. A colonoscopy primarily examines the large intestine (colon) and rectum, while a flexible sigmoidoscopy focuses on the lower part of the colon.

In summary, abdominal pain can be multifactorial, and the location of the pain can help narrow down potential causes. Given your symptoms, starting with a gastroenterologist is advisable, as they can assess your gastrointestinal health and guide you through the necessary diagnostic procedures. If gastrointestinal issues are ruled out, further evaluation by a colorectal surgeon or other specialists may be warranted. Always ensure to communicate all your symptoms clearly to your healthcare provider, as this will aid in accurate diagnosis and treatment.

Similar Q&A

Understanding Right Lower Abdominal Pain: When to See a Gastroenterologist

Hello, Dr. Chen... I have been experiencing sharp pain in my lower right abdomen for about 1-2 months. The pain usually occurs after 2 PM and is accompanied by a feeling of urgency and heaviness, but there is no bowel movement. Earlier this year, I had severe pain in my lower rig...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
It is recommended to first consult a gastroenterologist.

Understanding Abdominal Pain: When to See a Gastroenterologist or Proctologist

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 da...

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.

Understanding Abdominal and Back Pain: When to See a Gastroenterologist

Hello Doctor, I had a barbecue lunch the day before yesterday, and after taking a shower that evening, I suddenly felt abdominal pain along with discomfort in my lower back. Later that night, I had two episodes of diarrhea, but the pain in my stomach and lower back persisted. B...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Upper abdominal pain that radiates to the back may be indicative of pancreatitis, gastroesophageal reflux disease (GERD), or duodenal ulcers. It is recommended to consult a gastroenterologist to determine the cause. Changhua Hospital cares about your health. Dr. Tsai An-Sh...

Chronic Abdominal Pain: Finding the Right Specialist for Diagnosis

Hello Doctor, I am inquiring on behalf of a 30-year-old female friend. She has been experiencing abdominal pain for over two months. Initially, she underwent an upper gastrointestinal endoscopy in the gastroenterology department, which was normal. Later, she had a urinary tract i...

Dr. Chen Shidian reply Gastroenterology and Hepatology
In a major hospital's gastroenterology department, with careful follow-up appointments, adherence to medical orders, and dietary compliance, a reassuring answer should be attainable.