Left Lower Abdominal Pain: Causes and Concerns - Internal Medicine

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Hello! Thank you for reaching out with your concerns regarding your left lower abdominal pain. Based on your description, it seems you have been experiencing a series of symptoms that have led to multiple consultations and tests, including evaluations for gastrointestinal and urinary issues.
Left lower abdominal pain can arise from various causes, and it is essential to consider both gastrointestinal and urological factors, especially given your recent diagnosis of hydronephrosis (water kidney). Hydronephrosis occurs when urine cannot drain from the kidney to the bladder due to a blockage, leading to swelling and potential damage to the kidney. This condition can cause pain, particularly in the lower abdomen and back, and may also lead to symptoms like nausea, vomiting, and changes in urination.

Your symptoms of pain, along with the presence of hydronephrosis, could indicate several possibilities:
1. Ureteral Obstruction: If there is a blockage in the ureter (the tube connecting the kidney to the bladder), it can lead to hydronephrosis and significant pain. This blockage could be due to kidney stones, strictures, or other anatomical issues.

2. Infection: An infection in the urinary tract or kidney (pyelonephritis) can also cause pain and may lead to fever and other systemic symptoms. Given that you experienced a fever, this is a possibility that should be ruled out.

3. Gastrointestinal Issues: Conditions such as diverticulitis, inflammatory bowel disease, or even appendicitis (though typically right-sided) can cause left lower abdominal pain. Your symptoms of bloating, belching, and nausea could suggest a gastrointestinal component.

4. Musculoskeletal Pain: As a transportation worker, you may also be at risk for musculoskeletal issues, especially if your job involves heavy lifting or prolonged sitting. Strains or injuries to the abdominal or pelvic muscles can manifest as pain in the lower abdomen.

Given your situation, it is crucial to follow up with your healthcare provider, particularly in the urology department, as they can perform further evaluations such as a CT scan or additional imaging studies to assess the kidneys and urinary tract more thoroughly. This will help determine if there is a blockage or other issues contributing to your hydronephrosis and pain.

In the meantime, here are some recommendations:
- Hydration: Ensure you are drinking plenty of fluids unless otherwise advised by your doctor, as this can help flush out the urinary system.

- Pain Management: Discuss with your doctor about appropriate pain management strategies. Over-the-counter pain relievers may help, but it’s essential to consult your physician before taking any medication.

- Monitor Symptoms: Keep track of any changes in your symptoms, including the intensity of pain, any new symptoms, or changes in urination. This information will be valuable for your healthcare provider.

Lastly, it’s understandable to feel anxious about your symptoms, especially when they are persistent and painful. If you find that anxiety is affecting your ability to cope, consider discussing this with your healthcare provider as well. They may suggest supportive measures or referrals to mental health professionals who can help you manage anxiety related to your health concerns.

In summary, your left lower abdominal pain, combined with hydronephrosis, warrants further investigation to identify the underlying cause. Please continue to work closely with your healthcare team to ensure you receive the appropriate care and treatment.