Chronic Left Lower Abdominal Pain: Possible Causes and Solutions

Left lower abdominal pain?

Hello! I have been experiencing long-term pain in the lower left abdomen.
I have received intravenous antibiotic treatment at hospitals and clinics, but the pain recurs every 2-3 months.
Both the gynecology and gastroenterology departments have been unable to identify a clear cause for the pain.
Symptoms include localized sharp pain and a sensation of swelling in the same area, occasional nausea, headaches, lower back discomfort, and a general feeling of restlessness.
Occasionally, I notice a milky white discharge in my urine.
I am unsure if this is a gynecological issue or related to another urinary system problem.
Thank you!

Pangzi, 30~39 year old female. Ask Date: 2008/09/29

Dr. Chen Changfu reply Obstetrics and Gynecology

Lower abdominal pain has various causes, including gastrointestinal issues, urological problems related to the bladder and ureters, gynecological concerns involving the uterus, ovaries, and fallopian tubes, and even vascular issues within the circulatory system.
The symptoms of lower abdominal pain may vary at different times and could be attributed to different organ-related causes.
Therefore, it is essential to seek medical attention when symptoms arise, allowing the physician to make an accurate diagnosis based on the symptoms and various examinations.

Reply Date: 2008/09/29

More Info

Chronic left lower abdominal pain can be a complex issue, often requiring a thorough evaluation to determine the underlying cause. Based on the symptoms you've described—localized pain, nausea, headaches, lower back discomfort, and occasional white discharge in urine—there are several potential causes to consider.

1. Gastrointestinal Issues: Given your history of abdominal pain and previous treatments, conditions such as diverticulitis (inflammation of diverticula in the colon), irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD) could be contributing factors. Diverticulitis, in particular, can cause localized pain in the lower left abdomen and may present with symptoms like nausea and changes in bowel habits. If you have a history of diverticular disease, it would be prudent to monitor for any signs of inflammation or infection.

2. Gynecological Concerns: Since you mentioned the possibility of gynecological issues, conditions such as endometriosis or ovarian cysts could be relevant. Endometriosis can cause chronic pelvic pain, particularly during menstruation, and may also lead to gastrointestinal symptoms. Ovarian cysts can cause localized pain and discomfort, especially if they rupture. A pelvic ultrasound may help in identifying any abnormalities in the reproductive organs.

3. Urinary Tract Issues: The presence of white discharge in your urine raises the possibility of a urinary tract infection (UTI) or other urinary tract issues. Conditions such as interstitial cystitis or urethritis could also lead to chronic pelvic pain and discomfort. A urinalysis and urine culture can help determine if there is an infection or other abnormalities in the urinary system.

4. Musculoskeletal Factors: Chronic pain in the lower abdomen and back can also stem from musculoskeletal issues. Strain or injury to the muscles or ligaments in the abdominal or pelvic region can lead to persistent discomfort. Physical therapy may be beneficial in addressing any underlying musculoskeletal problems.

5. Psychological Factors: Chronic pain can often be exacerbated by psychological factors such as anxiety or stress. Your mention of feeling uncomfortable and restless may suggest that anxiety could be playing a role in your pain perception. Addressing mental health through counseling or stress management techniques can be an important part of a comprehensive treatment plan.

Given the complexity of your symptoms and the lack of a clear diagnosis from previous evaluations, it may be beneficial to seek a multidisciplinary approach. Consulting with a gastroenterologist, gynecologist, and possibly a pain specialist could provide a more comprehensive evaluation. Additionally, imaging studies such as a CT scan or MRI may help visualize any underlying issues that have not been identified through previous examinations.

In summary, chronic left lower abdominal pain can arise from various sources, including gastrointestinal, gynecological, urinary, musculoskeletal, and psychological factors. A thorough evaluation by healthcare professionals, including appropriate imaging and laboratory tests, is essential to pinpoint the exact cause of your symptoms and develop an effective treatment plan. It's important to communicate openly with your healthcare providers about your symptoms and any changes you experience, as this will aid in the diagnostic process and help tailor a treatment strategy that addresses all aspects of your health.

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