Left Abdominal Pain: When to Seek Medical Advice - Obstetrics and Gynecology

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Understanding left abdominal pain can be quite complex, as it can stem from various causes, ranging from benign to serious conditions. Your symptoms of dull pain above the pubic bone and the sensation of gas can be indicative of several underlying issues. Given your history and the fact that you are already taking probiotics, it is essential to approach this situation methodically.

Firstly, it's important to recognize that abdominal pain can arise from multiple sources, including gastrointestinal, urinary, and even gynecological systems. In your case, the location of the pain—specifically in the left lower quadrant—could suggest issues related to the intestines, such as diverticulitis, irritable bowel syndrome (IBS), or even constipation. The sensation of gas and the timing of your symptoms—worsening during the day and alleviating at night—could further support the idea of a gastrointestinal issue.

Since you mentioned that you previously had a colonoscopy appointment but chose to cancel it, it might be worth reconsidering this option. A colonoscopy is a valuable diagnostic tool that can help identify any abnormalities in the colon, such as polyps, inflammation, or other conditions that could be causing your symptoms. If your gastroenterologist, Dr. Song, has recommended this procedure, it is likely because he believes it could provide crucial insights into your condition.

In addition to gastrointestinal causes, it’s also important to consider urinary tract issues, especially if you experience any changes in urination, such as increased frequency or discomfort. Conditions like urinary tract infections (UTIs) can sometimes present with abdominal pain and may require a different treatment approach.

Moreover, if you are a woman, gynecological issues should also be considered. Conditions such as ovarian cysts or endometriosis can cause left-sided abdominal pain and may require evaluation by a gynecologist.

Given your ongoing symptoms, here are some steps you might consider:
1. Monitor Your Symptoms: Keep a detailed diary of your symptoms, noting when they occur, their intensity, and any associated factors (like food intake, stress levels, or physical activity). This information can be invaluable for your healthcare provider.

2. Consult Your Doctor: If your symptoms persist or worsen, it is advisable to consult your primary care physician or a gastroenterologist. They can reassess your situation and determine whether further diagnostic testing, such as a colonoscopy or imaging studies, is necessary.

3. Consider Dietary Changes: Since you are already taking probiotics, you might also want to evaluate your diet. Keeping a food diary can help identify any potential food intolerances or triggers that could be contributing to your symptoms.

4. Follow Up on Previous Recommendations: If Dr. Song has suggested a colonoscopy, it may be beneficial to follow through with that recommendation. Early detection of any gastrointestinal issues can lead to more effective treatment.

5. Stay Hydrated and Active: Ensure you are drinking enough water and engaging in regular physical activity, as these can help alleviate some gastrointestinal symptoms.

In conclusion, while it is understandable to feel hesitant about undergoing further testing, it is crucial to prioritize your health. Persistent abdominal pain warrants a thorough evaluation to rule out any serious conditions. By taking proactive steps and maintaining open communication with your healthcare provider, you can work towards finding the underlying cause of your symptoms and receiving appropriate treatment.