Left Lower Abdominal Pain: Possible Causes and Insights - Gastroenterology and Hepatology

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Understanding left lower abdominal pain can be quite complex, as it can arise from various underlying causes. Based on your description, it seems that the pain is associated with bowel movements, which suggests a potential gastrointestinal issue. Here are some possible causes and insights into your condition.

1. Irritable Bowel Syndrome (IBS): One of the most common gastrointestinal disorders, IBS can cause abdominal pain, bloating, and changes in bowel habits. The pain often improves after a bowel movement, which aligns with your experience. IBS is characterized by a functional disturbance rather than structural abnormalities, which means that standard imaging tests like a barium study may not reveal any issues.

2. Diverticulitis: This condition occurs when small pouches (diverticula) in the colon become inflamed or infected. The left lower abdomen is a common site for diverticulitis, and it can cause localized pain, especially during bowel movements. If you have a history of diverticulosis, this could be a possibility.

3. Muscle Strain or Ligament Issues: Sometimes, pain in the lower abdomen can be due to muscle strain or issues with the ligaments in the abdominal area. If you have engaged in any physical activity that may have strained your abdominal muscles, this could lead to localized pain that may feel worse when sitting or during bowel movements.

4. Hernia: An inguinal or femoral hernia can present as a bulge and cause discomfort or pain, particularly when straining or sitting. Although you mentioned not feeling anything when pressing on the area, hernias can sometimes be subtle and may not always be palpable.

5. Pelvic or Gynecological Issues: In females, left lower abdominal pain can sometimes be related to gynecological conditions such as ovarian cysts, endometriosis, or pelvic inflammatory disease. If you are female, it may be worth discussing these possibilities with your healthcare provider.

6. Colorectal Issues: Although you mentioned that a barium study did not reveal any polyps, other conditions such as colitis or other inflammatory bowel diseases could still be at play. If the pain persists, further evaluation, including a colonoscopy, may be warranted.

7. Referred Pain: Sometimes, pain in the lower abdomen can be referred from other areas, such as the kidneys or the spine. Given your history of back pain, it’s possible that there may be an interrelation between your back issues and abdominal pain.

Given that your pain is intermittent and associated with bowel movements, it is crucial to keep a detailed diary of your symptoms, including the timing, duration, and any associated activities or foods. This information can be invaluable for your healthcare provider in making a diagnosis.

If the pain persists or worsens, or if you experience additional symptoms such as fever, significant changes in bowel habits, or weight loss, it is essential to seek further medical evaluation. A gastroenterologist may be able to provide more specialized insight and recommend additional tests, such as a CT scan or MRI, to rule out any underlying conditions that may not have been previously identified.

In conclusion, while there are several potential causes for your left lower abdominal pain, a thorough evaluation by a healthcare professional is necessary to determine the exact nature of your condition. Keeping track of your symptoms and discussing them with your doctor will help in reaching a diagnosis and developing an appropriate treatment plan.