Left Abdominal Discomfort and Changes in Bowel Habits - Gastroenterology and Hepatology

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Dull pain in the left abdomen and passage of soft stools?


Hello Doctor! Previously, my bowel movements were mostly in the form of hard, pellet-like stools, and I would occasionally experience discomfort leading to diarrhea.
However, for about the past two years, I have been experiencing soft stools, with hard stools occurring only occasionally, which is the opposite of my previous condition.
After eating, I often feel bloated while sitting in a chair, and this discomfort lasts for a while.
Additionally, I notice that my stomach gurgles much more frequently than before.
I have a sensation of fullness or possibly swelling in the left abdominal area (not sure if it's near the spleen), and it feels tight.
Initially, I experienced less pain during diarrhea, but now I have more abdominal pain before needing to use the restroom.
Besides the tightness in my left abdomen and diarrhea, I also have a sensation of fullness, but there is no blood or other abnormal symptoms.
I'm unsure about how to treat this and what possible conditions it could be.
Thank you.

A Lu, 30~39 year old female. Ask Date: 2009/11/02

Dr. You Ligang reply Gastroenterology and Hepatology


Hello, the most common cause of chronic diarrhea is irritable bowel syndrome (IBS), while ulcerative colitis is frequently seen in Western countries.
The abdominal pain associated with IBS usually improves after a bowel movement.
It is advisable to perform a stool test to rule out any organic lesions in the colon.
Initial treatment typically involves avoiding irritants such as tobacco, alcohol, coffee, strong tea, chocolate, and fried foods.
It is also important to drink plenty of water and eat more fruits.
If these measures are ineffective, medication may be necessary.
Wishing you good health.
Sincerely, Dr.
You Li-Guang, Taoyuan Hospital, Department of Health.

Reply Date: 2009/11/02

More Info


Understanding left abdominal discomfort and changes in bowel habits can be quite complex, as various factors can contribute to these symptoms. Based on the information provided, it seems that the individual has experienced a significant change in bowel habits, transitioning from hard stools to predominantly soft stools over the past two years. This shift, along with the sensation of bloating and discomfort in the left abdomen, suggests a possible underlying gastrointestinal issue.

One potential diagnosis could be Irritable Bowel Syndrome (IBS), a common functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits. IBS can manifest in different ways, including diarrhea-predominant, constipation-predominant, or a mix of both. The fact that the individual has experienced a change in stool consistency and frequency, along with abdominal discomfort, aligns with this condition. Stress and dietary factors often exacerbate IBS symptoms, so it’s essential to consider lifestyle and emotional well-being as contributing factors.

Another possibility is the presence of diverticular disease, particularly diverticulitis, which can cause localized pain and changes in bowel habits. Diverticulitis occurs when diverticula (small pouches that can form in the colon wall) become inflamed or infected. Symptoms may include left-sided abdominal pain, changes in bowel habits, and sometimes fever or nausea. Given the history of diverticulosis (the presence of diverticula without inflammation), it would be prudent to monitor for any signs of diverticulitis, especially if the abdominal pain worsens or if new symptoms arise.

Additionally, the sensation of bloating and increased bowel sounds could indicate gastrointestinal dysmotility or an imbalance in gut flora, which can lead to symptoms of discomfort and altered bowel habits. Conditions such as small intestinal bacterial overgrowth (SIBO) or food intolerances (e.g., lactose intolerance, gluten sensitivity) may also contribute to these symptoms.

In terms of management, it is crucial to adopt a dietary approach that focuses on fiber intake, hydration, and avoiding trigger foods that may exacerbate symptoms. A diet rich in soluble fiber (found in fruits, vegetables, and whole grains) can help regulate bowel movements and improve overall gut health. Additionally, keeping a food diary may help identify specific foods that trigger discomfort or changes in bowel habits.

If symptoms persist or worsen, further evaluation by a gastroenterologist is recommended. This may include diagnostic tests such as a colonoscopy, stool studies, or imaging studies to rule out any structural abnormalities or inflammatory conditions. A healthcare provider may also consider prescribing medications to manage symptoms, such as antispasmodics for abdominal pain or medications to regulate bowel movements.

In conclusion, while the symptoms described may suggest conditions such as IBS or diverticular disease, a thorough evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate treatment plan. It is important to address both dietary and lifestyle factors, as well as to seek medical advice for persistent or concerning symptoms.

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