Left Lower Abdominal Pain: Causes and Diagnostic Procedures - Gastroenterology and Hepatology

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Left lower abdominal pain can be a complex symptom with a variety of potential causes, and understanding its origins is crucial for effective diagnosis and treatment. Given your situation, where the pain is more pronounced during standing and walking but less noticeable when lying down, it suggests that the discomfort may be related to musculoskeletal issues or gastrointestinal problems rather than purely gynecological concerns.


Potential Causes of Left Lower Abdominal Pain
1. Gastrointestinal Issues:
- Diverticulitis: This is an inflammation of diverticula, which are small pouches that can form in the walls of the colon. It often presents with localized pain, especially in the lower left abdomen, and can be accompanied by changes in bowel habits.

- Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder can cause abdominal pain, bloating, and changes in bowel habits. Stress and certain foods can exacerbate symptoms.

- Constipation or Gas: Even if you are having regular bowel movements, gas buildup or mild constipation can lead to discomfort, particularly if there is any underlying sensitivity in the intestines.

2. Musculoskeletal Issues:
- Muscle Strain: Activities that involve bending or lifting can strain abdominal muscles, leading to localized pain.

- Hernia: An inguinal or femoral hernia can cause pain in the lower abdomen, especially when standing or exerting pressure.

3. Gynecological Issues:
- While your gynecologist has ruled out gynecological causes, conditions such as ovarian cysts or endometriosis can sometimes present with similar symptoms. It’s essential to keep this in mind, especially if the pain fluctuates with your menstrual cycle.

4. Urinary Tract Issues:
- Conditions like a urinary tract infection (UTI) or kidney stones can also cause pain in the lower abdomen, although they often present with additional urinary symptoms.


Diagnostic Procedures
The decision to perform both an upper endoscopy (gastroscopy) and a colonoscopy is a standard approach when gastrointestinal issues are suspected. Here’s why these procedures are important:
- Gastroscopy: This procedure allows the doctor to visualize the upper gastrointestinal tract, including the esophagus, stomach, and duodenum. It can help identify conditions such as gastritis, ulcers, or tumors that might be causing your symptoms.

- Colonoscopy: This procedure examines the colon and rectum. It is crucial for diagnosing conditions like inflammatory bowel disease (IBD), polyps, or colorectal cancer. Given your symptoms and the need to rule out serious conditions, a colonoscopy is a prudent step.


What to Expect
While waiting for these procedures, it’s understandable to feel anxious. However, it’s important to remember that many causes of left lower abdominal pain are benign and manageable. The medications prescribed to prevent spasms can help alleviate some discomfort in the meantime.


Conclusion
In summary, left lower abdominal pain can arise from various sources, including gastrointestinal, musculoskeletal, and, less commonly, gynecological issues. The planned gastroscopy and colonoscopy are essential steps in ruling out serious conditions and identifying the underlying cause of your symptoms. If the pain persists or worsens, or if you experience additional symptoms such as fever, vomiting, or significant changes in bowel habits, it is crucial to seek immediate medical attention. Your healthcare provider will guide you through the diagnostic process and help you find relief from your symptoms.