Persistent Lower Abdominal Pain: Should You Consider a Colonoscopy?

Q: Persistent Lower Abdominal Pain: Should You Consider a Colonoscopy?

Hello, sir： There is currently no need for further invasive examinations (the likelihood of a normal colonoscopy is quite high). <br>Just be patient and follow up regularly, using symptomatic treatment medications and maintaining a balanced diet to monitor any changes in weight.

Lower abdominal discomfort with tenderness upon palpation for an extended period?

Hello doctor, I have been experiencing a dull, pressing pain in my lower abdomen for a long time.
The color of my stool is normal, but the shape has changed to a tapered end, and sometimes it appears fluffy.
Additionally, it sinks in water.
I have undergone occult blood tests at two hospitals, both of which showed no abnormalities, and I also had an X-ray that indicated increased gas.
A urine test was performed as well, and everything was normal.
This has been going on for about two months, and today I noticed a weight loss of around one kilogram.
I would like to ask the doctor what could be the possible causes of this.
Is it necessary to undergo a colonoscopy? Thank you, doctor.

Jun, 10~19 year old female. Ask Date: 2015/11/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir: There is currently no need for further invasive examinations (the likelihood of a normal colonoscopy is quite high).
Just be patient and follow up regularly, using symptomatic treatment medications and maintaining a balanced diet to monitor any changes in weight.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2015/11/14

More Info

Persistent lower abdominal pain can be a challenging symptom to evaluate, especially when accompanied by changes in bowel habits, weight loss, and other gastrointestinal symptoms. In your case, the description of your pain as a dull, pressing sensation, along with the changes in stool shape and the presence of increased gas, raises several considerations.

Firstly, it is important to note that while your stool color and the results from the occult blood tests have returned normal, the changes in stool shape (becoming tapered or "pencil-like") and the sensation of increased gas can indicate potential underlying issues. These symptoms can sometimes suggest the presence of a mass or obstruction in the colon, which could be benign or malignant. The fact that you have experienced weight loss, even if it is only a kilogram, is also a significant factor that should not be overlooked, as unintentional weight loss can be a red flag for various gastrointestinal conditions.

Given that you have already undergone X-rays and urinalysis without significant findings, the next step in your evaluation could indeed be a colonoscopy. A colonoscopy is a valuable diagnostic tool that allows for direct visualization of the colon and rectum, and it can help identify conditions such as inflammatory bowel disease (IBD), diverticulitis, colorectal polyps, or even colorectal cancer. The presence of persistent symptoms, especially in the context of your family history of colorectal cancer, makes it prudent to consider this examination.

In addition to a colonoscopy, other diagnostic tests might be warranted based on your symptoms. For instance, a CT scan of the abdomen could provide more detailed information about the structures within your abdomen and help identify any abnormalities that might not be visible on X-ray. Blood tests to check for inflammatory markers, liver function, and other relevant parameters could also be beneficial.

It is also worth considering functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), which can cause symptoms like abdominal pain and changes in bowel habits without any identifiable structural abnormalities. However, the presence of weight loss and changes in stool shape makes it essential to rule out more serious conditions first.

In summary, while your initial tests have not indicated any alarming issues, the persistence of your symptoms, particularly the abdominal pain, changes in stool characteristics, and weight loss, suggest that further investigation is warranted. A colonoscopy would be a reasonable next step to ensure that any potential underlying conditions are identified and appropriately managed. It is crucial to discuss your symptoms and concerns with your healthcare provider, who can guide you through the decision-making process regarding further testing and management options.

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