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Gastroenterology (Expert Forum)
please help, left abdominal pain for a long time, very depressing..
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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please help, left abdominal pain for a long time, very depressing..
by silverstanger, Feb 09, 2003 12:00AM
I am a male age 27. I have a constant pain in my lower abdomen. It is on the left and at the waste line. It feels like a swollen, inflammed feeling, which increases in level throughout the day. Tenderness and more pain is felt when I press on the area in queston. The doctor at a charity hospital thinks it is diverticulitus and put me on tetracyline antibiotic and scheduled me for a barium enema. the BE is coming up in a few days.
No blood in stool, checked by me every time, and by the doctor with a finger/chemical??test
No constipation.
No fever or chills. No Nausea.
Stool seems normal "for me" except it is light light brown.
I have strained to defecate in the past, but not hard.
My Questions are:
EDIT: I have recently started taking Nexium to help with my newfound gastritis and hayetal hernia/acid reflux problem. Could it be the Nexium??
Q1- What could I have?
Q2- What is the proper procedure to diagnose me?
Q3- If it is diverticulitus, is a Barium Enema going to show anything while it is acting up?
Q4- Could it be painful diverticulosis instead?
Q5- Could it be cancer or something else?
Q6- After 3 days of antibiotics my symptoms have not improved, why could that be? Any other information to help me shed light on this would be helpful.
I can't take feeling like this EVERY day ALL day anymore. I want to know what it is and how to fix it. Please Please help me Please!! Mike
No blood in stool, checked by me every time, and by the doctor with a finger/chemical??test
No constipation.
No fever or chills. No Nausea.
Stool seems normal "for me" except it is light light brown.
I have strained to defecate in the past, but not hard.
My Questions are:
EDIT: I have recently started taking Nexium to help with my newfound gastritis and hayetal hernia/acid reflux problem. Could it be the Nexium??
Q1- What could I have?
Q2- What is the proper procedure to diagnose me?
Q3- If it is diverticulitus, is a Barium Enema going to show anything while it is acting up?
Q4- Could it be painful diverticulosis instead?
Q5- Could it be cancer or something else?
Q6- After 3 days of antibiotics my symptoms have not improved, why could that be? Any other information to help me shed light on this would be helpful.
I can't take feeling like this EVERY day ALL day anymore. I want to know what it is and how to fix it. Please Please help me Please!! Mike
Doctor's Answer
by Kevin Pho, MD, Feb 09, 2003 12:00AM
, Feb 09, 2003 12:00AM
Hello - thanks for asking your question.
I will briefly discuss left lower quadrant pain and diverticulitis. You have asked multiple questions - if I do not answer all your concerns, you can ask it again at the next opportunity.
1) What could I have?
Common causes of left lower quadrant pain include diverticulitis, inguinal hernia, gastroenteritis, irritable bowel, inflammatory bowel.
2) What is the proper procedure?
Routine abdominal and chest radiographs are commonly performed in the patient with acute abdominal pain, and are most useful in excluding other causes, such as intestinal obstruction, rather than in making the diagnosis of diverticulitis. Computer tomographic (CT) scanning has become the optimal method of investigation in patients suspected of having acute diverticulitis. Barium enema has the advantage of evaluating the lumen of the colon, is considerably less expensive than CT, and, in some hands, is the initial procedure of choice. One purported advantage of CT is that it is less invasive than contrast enema, but this advantage is lost if rectal contrast is employed. Also, high-resolution, graded, compression ultrasonography is a new method being used to evaluate diverticulitis.
3) If it is diverticulitus, is a Barium Enema going to show anything while it is acting up?
Yes, see above answer.
4) Could it be painful diverticulosis instead?
Diverticulosis by itself uncommonly causes pain. It is when it becomes perforated (i.e. diverticulitis) where it becomes painful.
5) Could it be something else?
Without examining you, it could definitely be something else. Follow-up with your personal physician is strongly encouraged.
6) After 3 days of antibiotics my symptoms have not improved, why could that be? Any other information to help me shed light on this would be helpful.
On appropriate therapy, improvement of diverticulitis should be noticed in 24-48 hours. An alternative diagnosis or complicated diverticulitis (ie, abscess, peritonitis, fistula, or obstruction) should be suspected in patients in whom there is no improvement. In such patients, a baseline or follow-up CT scan or contrast enema should be obtained.
Follow-up with your personal physician is strongly recommended.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
I will briefly discuss left lower quadrant pain and diverticulitis. You have asked multiple questions - if I do not answer all your concerns, you can ask it again at the next opportunity.
1) What could I have?
Common causes of left lower quadrant pain include diverticulitis, inguinal hernia, gastroenteritis, irritable bowel, inflammatory bowel.
2) What is the proper procedure?
Routine abdominal and chest radiographs are commonly performed in the patient with acute abdominal pain, and are most useful in excluding other causes, such as intestinal obstruction, rather than in making the diagnosis of diverticulitis. Computer tomographic (CT) scanning has become the optimal method of investigation in patients suspected of having acute diverticulitis. Barium enema has the advantage of evaluating the lumen of the colon, is considerably less expensive than CT, and, in some hands, is the initial procedure of choice. One purported advantage of CT is that it is less invasive than contrast enema, but this advantage is lost if rectal contrast is employed. Also, high-resolution, graded, compression ultrasonography is a new method being used to evaluate diverticulitis.
3) If it is diverticulitus, is a Barium Enema going to show anything while it is acting up?
Yes, see above answer.
4) Could it be painful diverticulosis instead?
Diverticulosis by itself uncommonly causes pain. It is when it becomes perforated (i.e. diverticulitis) where it becomes painful.
5) Could it be something else?
Without examining you, it could definitely be something else. Follow-up with your personal physician is strongly encouraged.
6) After 3 days of antibiotics my symptoms have not improved, why could that be? Any other information to help me shed light on this would be helpful.
On appropriate therapy, improvement of diverticulitis should be noticed in 24-48 hours. An alternative diagnosis or complicated diverticulitis (ie, abscess, peritonitis, fistula, or obstruction) should be suspected in patients in whom there is no improvement. In such patients, a baseline or follow-up CT scan or contrast enema should be obtained.
Follow-up with your personal physician is strongly recommended.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
i am new, and i posted the questions under 3 different categories
General, diverticulitus, diverticulosis..
i am so terribly sorry.. forum staff delete 2 of the 3 please, i dont want to take anyones questions away.
i have also noticed that my stool is skinny and smaller than normal the last 2 days - and in small pieces instead of a whole big piece. it may have been something i ate because it is also very soft, like after you have diareah and it starts hardening up again.
i haven't ate alot yesterday.. because i am not sure of what diet action to take for this.
it may also be my imagination but, i think some of the inflammed sore feeling that i felt, was relieved by the little bit of bowel that was released.
should i try a liquid diet, or soups with veggies or noodles??
just an observation.
all i know is this pain is affecting my happiness.. and life.
i don't want to go anywhere or eat anymore. when i move around or ride in a vehicle it hurts a whole lot more.
and i Don't like pain medicine because i want to be aware of the pain getting worse enough to go to the hospital.
i guess i am just very afraid it could be cancer or a major form of something.
I didn't want to add this but:
8 months ago after my leg surgery (the day I got out) I was constantly nauseated for weeks, my stool was dark green alot, and a pain in my lower left developed. I had colonoscopy, stomach scope, upper GI (where you drink barium), CT scans.. all negative except for hiyatel hernia, fatty liver, and hemmoroids.
During the stay in the hospital (around the water enema prep for the colonoscopy) my nausea went away without med.. and after i got out the hospital my little pain in my left did too.
I think the pain is in the same area, but the other symptoms are different. Back then the nausea bothered me the most.. now its the pain in my lower left bothering me now. It is between the belly button and my side.. maybe a little closer to my button, and at the waste line. It is also way more painfull than 8 mos. ago.
Thanks, sorry so long.
P.S. it is very sore now, like muscle sore but I think that is because I have been prodding it too much to feel where the pain is exactly. When I massage it, it seems to help for a second.