Left Lower Abdominal Pain: Symptoms and Next Steps - Gastroenterology and Hepatology

Left lower abdominal pain?

Hello, doctor.
For the past few weeks, I've been experiencing intermittent pain in my lower left abdomen (near the navel), especially after falling asleep, although the pain is within tolerable limits.
It occurs about three to four times a day.
I have seen a doctor who mentioned that there is air in my intestines and some gastric inflammation, but there has been no improvement after taking medication.
I initially thought I had irritable bowel syndrome (IBS) because my bowel symptoms resemble IBS (several days without a bowel movement, followed by multiple bowel movements in one day).
Sometimes I experience diarrhea, other times only small pellets, and occasionally there is mucus present.
The stool can also be foul-smelling, yellow-brown with some black, and before bed, I sometimes experience palpitations and rapid breathing, which affects my sleep quality.
I have consulted a doctor, but the symptoms keep coming and going, leading me to suspect whether I might have symptoms of colorectal cancer.
Could you please explain the symptoms of colorectal cancer and what steps I should take next? Thank you! P.S.
I do not smoke or drink alcohol.

Ai De Hua, 30~39 year old female. Ask Date: 2006/08/10

Dr. Liu Nanshan reply Gastroenterology and Hepatology

Having irregular bowel movements, with periods of constipation followed by diarrhea, and symptoms that come and go, indeed resembles irritable bowel syndrome (IBS).
Another important characteristic of IBS is that abdominal discomfort or pain occurs before bowel movements and improves after defecation.
These symptoms mostly occur in young individuals and persist for more than three months in a year.
You may also experience palpitations, increased heart rate, and poor sleep quality, which could be related to a fast-paced lifestyle and heightened stress, characteristics common among those with IBS.
The likelihood of colorectal cancer is low; diagnostic methods include colonoscopy or imaging studies, which should be discussed with your primary care physician.

Reply Date: 2006/08/10

More Info

Understanding left lower abdominal pain can be quite complex, especially when accompanied by a variety of gastrointestinal symptoms. Based on your description, it seems that you have been experiencing intermittent pain in the left lower abdomen, particularly noticeable at night, along with changes in bowel habits and other gastrointestinal issues.
Firstly, it is important to recognize that left lower abdominal pain can arise from various causes, including gastrointestinal, gynecological, and urinary tract issues. Given your symptoms, it is understandable that you might be concerned about serious conditions such as colorectal cancer. However, it is crucial to approach this systematically.

Symptoms of Colorectal Cancer
Colorectal cancer can present with a range of symptoms, and while some of these may overlap with your current symptoms, it is essential to note that many benign conditions can cause similar presentations. Common symptoms of colorectal cancer include:
1. Changes in Bowel Habits: This can include diarrhea, constipation, or a change in the consistency of your stool. You mentioned experiencing both diarrhea and hard stools, which can be indicative of irritable bowel syndrome (IBS) rather than cancer.

2. Blood in Stool: This can appear as bright red blood or dark, tarry stools. You mentioned mucus and changes in stool color, which can be concerning but are not definitive indicators of cancer.

3. Abdominal Discomfort: Persistent abdominal pain or cramping, especially if it is new or different from your usual symptoms.

4. Unexplained Weight Loss: Significant weight loss without trying can be a red flag.

5. Fatigue: Feeling unusually tired or weak can also be a symptom.

Next Steps
Given your symptoms and the fact that you have already consulted with a physician, here are some recommended steps to take:
1. Follow-Up with Your Doctor: Since you have already been evaluated, it is important to maintain communication with your healthcare provider. Discuss your ongoing symptoms, especially the lack of improvement with medication.
2. Consider Further Testing: If your doctor has not yet performed a colonoscopy, this is a critical next step, especially given your concerns about colorectal cancer. A colonoscopy allows for direct visualization of the colon and can help identify any abnormalities, including polyps or tumors.

3. Evaluate for IBS: Since you suspect irritable bowel syndrome, it may be beneficial to discuss this diagnosis with your doctor. IBS can cause significant discomfort and is often managed through dietary changes, stress management, and sometimes medication.

4. Dietary Modifications: Keeping a food diary may help identify any triggers for your symptoms. Common triggers for IBS include high-fat foods, dairy, gluten, and certain carbohydrates (FODMAPs).

5. Manage Stress and Anxiety: Given that you mentioned experiencing palpitations and poor sleep quality, it may be beneficial to explore stress management techniques. Anxiety can exacerbate gastrointestinal symptoms, and addressing this may help improve your overall condition.

6. Seek a Second Opinion: If you feel your concerns are not being adequately addressed, seeking a second opinion from a gastroenterologist may provide further insights and options for management.

Conclusion
While your symptoms may be concerning, they can also be attributed to less serious conditions such as IBS or gastritis. It is essential to work closely with your healthcare provider to rule out serious conditions and find an effective management plan for your symptoms. Remember, early detection and intervention are key in managing any potential health issues effectively.

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