Abdominal Discomfort: Possible Causes and Next Steps

Q: Abdominal Discomfort: Possible Causes and Next Steps

Hello： Based on the symptoms, gastrointestinal disorders and indigestion are the most likely conditions. <br>If you are concerned, you may consider undergoing a barium enema for an initial examination. <br>(PS： The so-called mass is likely an enlarged intestine. <br>Only the inte

Abdominal discomfort?

Hello: I have been experiencing a feeling of bloating and dull pain near my belly button (toward the right, close to the waist).
I often burp and pass gas, and occasionally have diarrhea.
I can feel a fairly large, firm mass (which seems elongated) when I press on the area to the right of my belly button (which should be the location of the colon).
It is movable when I apply pressure, but I can't feel it as much when lying down.
Is it possible that there is a growth? Should I undergo further examinations such as a colonoscopy? I have already had an abdominal ultrasound, which showed no issues.
Thank you.

La La, 20~29 year old female. Ask Date: 2011/11/15

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Based on the symptoms, gastrointestinal disorders and indigestion are the most likely conditions.
If you are concerned, you may consider undergoing a barium enema for an initial examination.
(PS: The so-called mass is likely an enlarged intestine.
Only the intestine can enlarge and then resolve.) Wishing you good health, Dr.
Chen Qifeng, Taoyuan Hospital, Department of Health.

Reply Date: 2011/11/15

More Info

Abdominal discomfort, particularly around the navel area, can be concerning and may arise from various underlying conditions. Given your symptoms—persistent bloating, dull pain, belching, gas, occasional diarrhea, and the presence of a palpable mass in the right lower quadrant—it's essential to consider a range of potential causes and the necessary next steps for evaluation.

Possible Causes
1. Gastrointestinal Issues: The symptoms you describe could be related to gastrointestinal disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even diverticulitis. IBS is characterized by abdominal pain and changes in bowel habits, while IBD includes conditions like Crohn's disease and ulcerative colitis, which can cause inflammation and other complications in the digestive tract.

2. Abdominal Mass: The palpable mass you mentioned could be a number of things, including an enlarged organ (like the liver or spleen), a hernia, or even a tumor. The fact that it is movable and less palpable when lying down could suggest a fatty deposit or a benign cyst, but it is crucial to have it evaluated further.

3. Gynecological Issues: In females, conditions such as ovarian cysts or fibroids can also present with abdominal discomfort and may be felt as a mass. These conditions can sometimes cause referred pain to the abdominal area.

4. Musculoskeletal Issues: Sometimes, abdominal pain can be related to musculoskeletal problems, such as muscle strain or issues with the spine, particularly if there is associated back pain.

5. Infections: Infections, such as appendicitis or diverticulitis, can also present with localized pain and discomfort. Appendicitis typically presents with sharp pain that starts around the navel and then moves to the right lower abdomen.

Next Steps
Given the complexity of your symptoms, it is advisable to pursue further diagnostic evaluations. Here are some recommended steps:
1. Consult a Gastroenterologist: Since you have already undergone an abdominal ultrasound, a gastroenterologist can provide a more specialized evaluation. They may recommend a colonoscopy to visualize the colon directly and assess for any abnormalities, such as polyps, inflammation, or masses.

2. Imaging Studies: If the colonoscopy is not conclusive, further imaging studies such as a CT scan of the abdomen may be warranted. This can provide a more detailed view of the abdominal organs and help identify any masses or structural abnormalities.

3. Blood Tests: Routine blood tests, including a complete blood count (CBC), liver function tests, and markers for inflammation (such as C-reactive protein), can help rule out infections or other systemic issues.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including their frequency, duration, and any associated factors (like food intake, stress levels, etc.). This information can be invaluable for your healthcare provider in determining the next steps.

5. Consider a Second Opinion: If you feel your concerns are not being adequately addressed, seeking a second opinion from another physician or specialist can provide additional insights.

Conclusion
While your abdominal discomfort may stem from a variety of causes, the presence of a palpable mass and the nature of your symptoms warrant further investigation. Early diagnosis and treatment are crucial in managing any potential underlying conditions effectively. Do not hesitate to reach out to your healthcare provider to discuss your symptoms and the best course of action. Your health is paramount, and addressing these concerns promptly can lead to better outcomes.

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