Lower Abdominal Pain: Is It Irritable Bowel Syndrome?

Lower abdominal pain

Hello Doctor, I have been experiencing gastrointestinal issues lately, with pain in my lower abdomen on both sides.
The pain feels tight when it occurs.
Could this be due to poor colonic motility? I have to strain during bowel movements, but my stools are not hard; sometimes they resemble tempura and other times they are soft and mushy like mud.
The color varies, sometimes deep green, sometimes yellow, and sometimes brown, depending on what I ate the previous day.
I have at least two bowel movements a day, and I often feel a sense of incomplete evacuation after finishing.
Sometimes, I feel the urge to have a bowel movement again in the evening or before bed, but not in the morning or at noon.
In August of this year, I had a fecal occult blood test done in Taiwan, which was weakly positive.
The doctor said not to worry and prescribed Delibs for me, but I didn't take it because I was concerned about the potential side effect of constipation, which I really want to avoid.
Doctor, could this be irritable bowel syndrome (IBS)? If it is IBS, is it classified as the constipation type or the diarrhea type? Would eating yogurt help improve my condition? I am currently abroad and only have access to yogurt, not buttermilk.
Are there any dietary considerations I should be aware of? Can these symptoms be improved through diet? Thank you, Doctor; I really appreciate your help!

Alice, 30~39 year old female. Ask Date: 2010/09/22

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, it is possible that they are due to incomplete recovery of gastrointestinal function following a bout of gastroenteritis, which can also lead to irritable bowel syndrome (IBS) symptoms.
It is recommended to adjust your diet by reducing fatty foods, limiting milk intake, and opting for a light diet.
If there is no improvement, consider using digestive enzymes.
As for yogurt or probiotic drinks, it varies from person to person.
If symptoms persist, medical attention should be sought.
Wishing you good health.
Dr.
Chen Qifeng, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2010/09/22

More Info

Lower abdominal pain can be a complex issue, often involving multiple systems in the body. Based on your description, it seems you are experiencing symptoms that could be consistent with Irritable Bowel Syndrome (IBS), particularly the mixed type, which includes both diarrhea and constipation. IBS is a functional gastrointestinal disorder characterized by a combination of abdominal pain and altered bowel habits, which can include diarrhea, constipation, or alternating between the two.

Symptoms and Diagnosis
Your symptoms of abdominal pain, the feeling of tightness, and the variability in stool consistency and color suggest that your gastrointestinal system is not functioning optimally. The fact that you experience a feeling of incomplete evacuation (the sensation of residual stool) is also common in IBS. The presence of weakly positive fecal occult blood can be concerning, but since your doctor has advised you not to worry, it may indicate a benign condition, especially if further testing has ruled out serious pathology.

Possible Causes
1. Dietary Factors: Certain foods can trigger IBS symptoms. Common culprits include high-fat foods, dairy products, gluten, and certain carbohydrates known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Keeping a food diary may help identify specific triggers.

2. Stress and Anxiety: Psychological factors can significantly impact gastrointestinal function. Stress can exacerbate IBS symptoms, leading to increased abdominal pain and altered bowel habits.

3. Gut Microbiome: The balance of bacteria in your gut plays a crucial role in digestion and overall gut health. Probiotics, such as those found in yogurt, can help restore this balance and may alleviate some IBS symptoms.

Management Strategies
1. Dietary Adjustments: Since you mentioned yogurt, incorporating it into your diet could be beneficial. Yogurt contains probiotics that can help improve gut health. However, if you are lactose intolerant, you may want to choose lactose-free options. Additionally, consider a low-FODMAP diet, which has been shown to help many individuals with IBS. This involves reducing foods that are high in fermentable carbohydrates.

2. Hydration: Ensure you are drinking enough water, especially if you are experiencing diarrhea. Staying hydrated is crucial for overall health and can help with bowel regularity.

3. Regular Exercise: Physical activity can help stimulate bowel function and reduce stress, which may alleviate some of your symptoms.

4. Stress Management: Techniques such as mindfulness, yoga, or cognitive-behavioral therapy can be effective in managing stress and anxiety, which may, in turn, help with your gastrointestinal symptoms.

5. Medication: If dietary changes and lifestyle modifications do not provide relief, you may want to discuss medication options with your healthcare provider. Medications for IBS can include antispasmodics for pain relief, laxatives for constipation, or anti-diarrheal medications.

Conclusion
While your symptoms may align with IBS, it is essential to continue working with your healthcare provider to monitor your condition. If your symptoms persist or worsen, further investigation may be warranted to rule out other gastrointestinal disorders. Keeping a detailed record of your symptoms, dietary intake, and any stressors can provide valuable information for your healthcare provider to tailor a management plan that works for you. Remember, managing IBS often requires a multifaceted approach, including dietary changes, stress management, and possibly medication.

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