Severe Lower Abdominal Pain During Colonoscopy: What to Do Next?

During the colonoscopy, I experienced significant pain below the navel?

I have a very sensitive gastrointestinal system, and I also tend to get anxious, which often leads to stomach pain.
Over the past two months, the stomach pain has become more frequent.
Initially, the doctor diagnosed me with irritable bowel syndrome, but one day I had bloody stools, with blood and a piece of clear mucus coming out.
That night, I experienced severe pain and couldn't sleep.
The doctor later said it was a bleeding ulcer in the digestive organs.
I took the medication prescribed for treating trichomoniasis or amoebic dysentery, and during the treatment, there were 1 to 2 days when my tongue had almost no coating, my stomach no longer hurt, and I had no symptoms of bloody stools.
I then underwent an upper endoscopy, and the doctor said my stomach was fine.
However, during the colonoscopy, I experienced excruciating pain "below the navel" (I'm not sure if it's the uterus or something else), and the pain was so intense that I couldn't complete the colonoscopy (so it was only done halfway).
The doctor mentioned that it could possibly be due to uterine displacement or something similar.
I'm unsure which specialty I should consult for this severe pain below the navel.

RuRu, 20~29 year old female. Ask Date: 2012/10/19

Dr. Chen Bozhang reply Family Medicine

If the physician suspects the possibility of endometriosis, a consultation with an obstetrician-gynecologist is recommended.

Reply Date: 2012/10/19

More Info

Severe lower abdominal pain during a colonoscopy can be concerning and may indicate several underlying issues. Given your history of gastrointestinal sensitivity and recent symptoms, it's essential to approach this situation with a comprehensive understanding of potential causes and next steps.

Firstly, the pain you experienced during the colonoscopy could be attributed to several factors. One possibility is the presence of underlying conditions such as irritable bowel syndrome (IBS), which you mentioned has been diagnosed previously. IBS can cause significant abdominal discomfort, especially during procedures that manipulate the intestines. Additionally, if there is any inflammation or irritation in the colon, the pressure from the colonoscope can exacerbate pain.

Another potential cause of your pain could be related to gynecological issues, particularly since the pain was localized below the navel. Conditions such as endometriosis, ovarian cysts, or uterine fibroids can cause significant discomfort and may be aggravated during a colonoscopy. If your doctor suggested the possibility of uterine displacement, it may be worthwhile to consult a gynecologist for further evaluation.

Given your recent symptoms of bloody stools and severe abdominal pain, it is crucial to follow up with your healthcare provider. They may recommend additional diagnostic tests to rule out conditions such as inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. These conditions can cause symptoms similar to what you are experiencing and may require specific treatments.

In terms of next steps, here are some recommendations:
1. Follow-Up Appointment: Schedule a follow-up appointment with your gastroenterologist to discuss the pain experienced during the colonoscopy. They can provide insights into whether this pain is related to the procedure or if it indicates a more significant issue.

2. Gynecological Evaluation: Since the pain is located in the lower abdomen, consider seeing a gynecologist to rule out any reproductive health issues. They may perform an ultrasound or other imaging studies to assess for conditions like endometriosis or ovarian cysts.

3. Further Testing: Depending on your symptoms and the findings from your colonoscopy, your doctor may recommend additional tests such as a CT scan of the abdomen or a repeat colonoscopy to ensure that no lesions or abnormalities were missed.

4. Symptom Management: In the meantime, managing your symptoms with dietary changes, stress reduction techniques, and possibly medications for IBS or other gastrointestinal issues may help alleviate some discomfort.

5. Monitoring Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any associated factors (like diet or stress levels). This information can be invaluable for your healthcare provider in diagnosing and treating your condition.

In conclusion, while the pain during your colonoscopy is concerning, it is essential to approach this issue holistically. By consulting with both your gastroenterologist and a gynecologist, you can ensure that all potential causes of your symptoms are thoroughly evaluated. Early intervention and appropriate management can significantly improve your quality of life and help address the underlying issues contributing to your abdominal pain.

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