Left Lower Abdominal Mass: Is It Gallstones or Colon Cancer?

Hard mass in the left lower abdomen?

I recently felt a hard lump in my lower left abdomen.
Could it be a bowel stone? I experience pain after eating too much and also have diarrhea.
Could this be colon cancer or a bowel stone?

Liu, 20~29 year old female. Ask Date: 2015/05/14

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, the so-called intestinal stones, in the era when medical advancements were limited, sometimes occurred as a complication of gallstones leading to cholecystenteric fistulas, which could cause intestinal obstruction due to these stones.
This is now quite rare.
Additionally, there are cases where fecaliths form from remnants of certain foods.
As for colorectal tumors, once they grow large enough to be palpable, it is usually quite serious, and the symptoms related to the gastrointestinal tract will be very evident.
There is also a condition where constipation or bloating may lead to a palpable mass in the left lower abdomen; however, this so-called mass may sometimes be detectable and at other times may diminish.
Of course, other abdominal tumors are also possible, but they are less common.
Wishing you peace and good health.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/05/14

More Info

When it comes to the presence of a mass in the left lower abdomen, it is essential to consider various potential causes, including both gallstones and colon cancer, among other conditions. The symptoms you describe—feeling a hard mass, experiencing pain after eating, and having diarrhea—can be indicative of several gastrointestinal issues.

Firstly, gallstones typically form in the gallbladder and can cause pain in the upper right abdomen, but they can also lead to referred pain in the left lower abdomen if there are complications such as a gallbladder attack or if the stones migrate into the bile ducts. However, gallstones are less likely to present as a palpable mass in the left lower abdomen.

On the other hand, a palpable mass in the left lower abdomen can be more concerning for conditions related to the colon, such as diverticulitis, colon polyps, or even colon cancer. The presence of a hard mass that you can feel suggests that there may be a significant underlying issue. Colon cancer, in particular, can present with a mass that is palpable, especially if it has grown large enough to be felt through the abdominal wall. Other symptoms of colon cancer may include changes in bowel habits, blood in the stool, unexplained weight loss, and persistent abdominal discomfort.

Given your symptoms of pain after eating and diarrhea, it is crucial to seek medical evaluation. A healthcare provider may recommend imaging studies such as an abdominal ultrasound or a CT scan to assess the mass's characteristics and determine its nature. Additionally, a colonoscopy may be warranted to visualize the colon directly and obtain biopsies if necessary.
It is important to note that while the risk of colon cancer increases with age, it is not exclusive to older adults. Young adults can also develop colorectal cancer, especially if there are risk factors such as a family history of the disease or certain genetic syndromes. Therefore, even if you are younger, it is prudent to discuss your symptoms with a healthcare provider who can assess your risk and recommend appropriate screening.

In summary, while gallstones are a possibility, the symptoms you describe are more suggestive of a potential issue within the colon, such as a mass that could be benign or malignant. Prompt medical evaluation is essential to determine the cause of your symptoms and to initiate any necessary treatment. Early diagnosis and intervention can significantly improve outcomes, especially in cases of cancer. Please do not hesitate to reach out to a healthcare professional for a thorough assessment and appropriate management.

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