Persistent Left Abdominal Pain: Possible Causes and When to Seek Help

Continuous intermittent pain in the left upper abdomen for eleven days?

Hello Doctor: Since Saturday morning two weeks ago, I experienced pain after eating spicy food the night before.
During the night, I woke up due to pain, which was localized on the left side of my lower back, about 5 to 10 centimeters above the lumbar region.
The pain lasted for about ten hours, and I took gastrointestinal medication, which seemed to help gradually.
I also paid attention to my diet.
However, less than a day later, the same area started hurting again.
I have not experienced fever, cold, or other symptoms, but sometimes the pain is so intense that I curl up and cannot do anything, although the cramping pain disappears suddenly for half a day and then recurs.
There has been no pain on the right side of my back or abdomen.
I feel like I cannot completely empty my bowels, accompanied by mild nausea, but I cannot induce vomiting.
Normally, I have bowel movements once or twice a day, but in the past eleven days, I think I have only had seven or eight bowel movements.
One of them had an unusually foul odor.
There was no blood in the stool, but the shapes were not complete; it did not feel like diarrhea, but rather like a muddy consistency (slowly passing, somewhat strange and warm).
After passing, the stool appeared relatively solid, and there was not always a watery consistency.
My urination has been completely normal.
However, it seems that there is not a direct correlation between bowel movements and the left lower abdominal pain; when I am not in pain, I can finish a bowel movement without it causing pain, but during cramping, finishing a bowel movement does not alleviate the pain.
I have never experienced this situation before.
My mother has a history of gastric issues, but I have never had any stomach discomfort until eleven days ago.
Could you please advise what symptoms I might be experiencing? Should I go to the hospital for observation? Thank you.

wulom, 20~29 year old female. Ask Date: 2007/04/02

Dr. Lin Minghui reply Gastroenterology and Hepatology

Abdominal pain accompanied by bowel irregularities, considering your age, common causes include gastroenteritis and irritable bowel syndrome.
It is recommended to pay attention to your diet, eat at regular intervals, chew food thoroughly, and avoid irritating foods, caffeine, carbonated beverages, and alcohol.
If symptoms persist or recur, it is advisable to seek medical attention.
When referring to pain in the left upper abdomen, does it mean pain in both the left upper and lower areas? Differential diagnosis should include the stomach, intestines, pancreas, and muscular or neurological issues.
Wishing you good health!

Reply Date: 2007/04/02

More Info

Persistent left abdominal pain can be a complex issue, especially when accompanied by symptoms such as changes in bowel habits, nausea, and significant discomfort. Based on your description, there are several potential causes for your symptoms, and it is crucial to approach this systematically.

Possible Causes
1. Gastrointestinal Issues: Given your recent consumption of spicy food and the onset of pain following that, it's possible that you may be experiencing gastritis or an exacerbation of a pre-existing condition such as irritable bowel syndrome (IBS). The fact that you have experienced changes in your bowel movements, including a decrease in frequency and the presence of unusual stool consistency, could indicate a gastrointestinal disturbance.
2. Diverticulitis: This condition occurs when small pouches (diverticula) in the colon become inflamed or infected. Symptoms often include localized pain, changes in bowel habits, and sometimes nausea. The left side of the abdomen is commonly affected due to the anatomy of the colon.

3. Kidney Issues: Although you mentioned that the pain is localized to the left side, kidney stones or infections can sometimes present with referred pain in the lower back or abdomen. Given the nature of your pain and its persistence, a renal issue should not be ruled out.

4. Musculoskeletal Pain: Sometimes, pain in the abdominal area can be related to muscle strain or issues with the spine, especially if you have been in positions that may have strained your back or abdominal muscles.

5. Pancreatic or Splenic Issues: Although less common, conditions affecting the pancreas or spleen can cause pain in the left upper quadrant. If there are any underlying issues with these organs, they could manifest as abdominal pain.

When to Seek Help
Given the persistence and severity of your symptoms, it is advisable to seek medical attention. Here are some indicators that you should consider:
- Duration of Symptoms: If your pain has lasted for more than a few days without improvement, it is essential to consult a healthcare provider.

- Severity of Pain: Pain that is severe enough to cause you to curl up or be unable to perform daily activities warrants immediate medical evaluation.

- Changes in Bowel Habits: Significant changes in bowel habits, especially if accompanied by nausea or vomiting, should be assessed by a physician.

- Associated Symptoms: If you develop additional symptoms such as fever, chills, or blood in your stool, you should seek emergency care.

Recommended Actions
1. Consult a Gastroenterologist: Given the gastrointestinal symptoms, a gastroenterologist can perform further evaluations, including imaging studies or endoscopy, to assess for conditions like gastritis, diverticulitis, or other gastrointestinal disorders.

2. Consider Imaging Studies: A CT scan or ultrasound may be necessary to visualize the organs in your abdomen and rule out any serious conditions such as appendicitis, diverticulitis, or kidney stones.

3. Dietary Modifications: While awaiting medical evaluation, consider avoiding spicy and irritating foods. Keeping a food diary may help identify any triggers for your symptoms.

4. Hydration and Rest: Ensure you are staying hydrated and getting adequate rest, as this can help your body manage the discomfort.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and nature of your pain, bowel habits, and any new symptoms that may arise.

In conclusion, while there are several potential causes for your persistent left abdominal pain, it is crucial to seek medical attention to obtain a proper diagnosis and treatment plan. Early intervention can lead to better outcomes and relief from your symptoms.

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