Abdominal X-rays and Stool Tests for Digestive Issues

Abdominal X-ray and stool examination?

Hello Dr.
Chen: After reading your advice, I feel concerned.
Today, I went to the hospital for an abdominal X-ray, which revealed a shadow in the lower right abdomen.
The doctor has requested a stool test, and I won't know the results until next week! What could this shadow in the lower right abdomen indicate? Could it be a tumor? What symptoms does the stool test aim to check for? Is it for occult blood or secretions? (Below is the previous response)
Hello Dr.
Chen: Recently, I have been experiencing a slight dull pain in the lower right abdomen (above the pelvic cavity), which usually resolves on its own within a day.
However, it recurs every four to five days or about a week later, following a similar cycle of dull pain for approximately 5 to 6 times.
After that, I also feel a slight dull pain near the left side of my navel, close to the waist, and at the junction of the left lower abdomen and thigh (descending colon?).
Sometimes, the pain is only in the left lower abdomen and the junction with the thigh, which also resolves in about a day, but it recurs after a few days, occurring 2 to 3 times.
Two days ago, I had pain in the lower right abdomen, and the next day it was gone, then it switched to the lower left abdomen, continuing this cycle.
The pains never occur on both sides simultaneously.
When I had pain in the lower right abdomen two days ago, I felt a kind of noise (borborygmi?) when I touched it, which was only felt once—similar in duration to passing gas.
Could you please tell me what these symptoms indicate? Additionally, during the episodes, I did not experience nausea or diarrhea, only the dull pain.
[Response] Consultant: Taoyuan Hospital / Hepatobiliary and Gastroenterology / Dr.
Chen Zhi-Ping replied: Hello, the pain in the lower right abdomen, and sometimes in the lower left abdomen, without diarrhea or blood in the stool, and with a mild level of pain, may indicate an issue with the colon, but it does not seem typical of colitis.
Is it related to bowel movements? If there is difficulty in passing stool, it may occur more frequently, and the symptoms may resolve after a bowel movement, which is more indicative of symptoms caused by feces.
In any case, please visit a gastroenterologist for an abdominal X-ray and a stool test, and if necessary, further evaluation of the colon.
Sincerely, Dr.
Chen Zhi-Ping.

Yuwen, 30~39 year old female. Ask Date: 2004/11/15

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello, the dark shadow on the X-ray usually indicates the presence of air, so a shadow in the lower right abdomen suggests localized bloating rather than a tumor.
The stool test primarily checks for occult blood and the presence of white blood cells or inflammatory cells.
I recommend that you wait for the doctor to complete the examination before discussing further.
For now, there is no need to be overly anxious.
Sincerely, Dr.
Chen Zhi-Ping, Internal Medicine.

Reply Date: 2004/11/15

More Info

Understanding abdominal X-rays and stool tests is crucial for diagnosing digestive issues, especially when symptoms like abdominal pain arise. In your case, the presence of a shadow in the right lower abdomen on the X-ray raises concerns that warrant further investigation.

Interpretation of Abdominal X-ray Findings
The shadow observed in the right lower abdomen could represent several conditions. It might indicate the presence of stool, which is often a benign finding, or it could suggest more serious issues such as an abscess, a mass, or even a tumor. The fact that you have experienced intermittent dull pain in the right lower abdomen, which resolves after a day, could suggest a functional issue, such as constipation or a mild obstruction, rather than a severe pathology. However, the variability in your symptoms and the location of the pain could also indicate conditions like appendicitis, diverticulitis, or even gynecological issues, depending on your gender and medical history.

Stool Tests: Purpose and What They Detect
The stool test your doctor has ordered is likely aimed at identifying any underlying gastrointestinal issues. Common reasons for stool tests include:
1. Occult Blood Testing: This checks for hidden blood in the stool, which can indicate bleeding in the gastrointestinal tract. This is particularly important if there is a suspicion of polyps or malignancy.

2. Infection: Stool tests can also identify pathogens that may be causing gastrointestinal symptoms, such as bacteria, viruses, or parasites.

3. Fat Malabsorption: If there are concerns about how well your body is absorbing nutrients, a stool test can help determine if there is an excess of fat in the stool.

4. Inflammatory Markers: Some tests can look for markers of inflammation, which can indicate conditions like inflammatory bowel disease (IBD).

Symptoms and Their Implications
Your description of the pain being intermittent and not accompanied by diarrhea or vomiting is noteworthy. This pattern may suggest that the pain is related to bowel function rather than an acute inflammatory process. If the pain resolves after a bowel movement, it could indicate that stool accumulation is contributing to your discomfort.

Next Steps and Recommendations
1. Follow-Up with Your Doctor: Once the stool test results are available, it is essential to discuss them with your healthcare provider. They will interpret the results in the context of your symptoms and medical history.

2. Consider Further Imaging or Procedures: Depending on the X-ray and stool test results, your doctor may recommend additional imaging studies, such as an abdominal ultrasound or CT scan, or even a colonoscopy to visualize the colon directly.

3. Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency, duration, and intensity of the pain, as well as any changes in bowel habits. This information can be invaluable for your healthcare provider in making an accurate diagnosis.

4. Dietary Considerations: If constipation is suspected, consider dietary changes to increase fiber intake and hydration, which can help regulate bowel movements.

Conclusion
In summary, while the shadow in your right lower abdomen and your symptoms warrant further investigation, it is essential to approach this systematically. The stool test will provide critical information that, combined with your clinical symptoms and imaging findings, will guide your healthcare provider in determining the underlying cause of your discomfort. Always communicate openly with your healthcare team about your concerns and any new symptoms that may arise.

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