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Gastroenterology (Expert Forum)
Multitude of symptoms: Abdominal Pain in Lower Left Quadrant
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Multitude of symptoms: Abdominal Pain in Lower Left Quadrant
by bdusk, Dec 13, 2004 12:00AM
38 yr. old caucasion female. Early 20's diagnosed with IBS without any tests, just supposition. Health is currently fair/poor. Had 3 ruptured disks in lower spine 7 years ago which never healed completely. Still experience bouts of severe sciatica, left-sided hip and(centered)lower back pain.
Three weeks ago, I had an episode resulting in sciatica and hip pain. After a week of that, I felt improved but then my abdomen started swelling as though it contained 25 or so water balloons. This followed with pain directly beside and to the left of the top of my hip-bone (beside the Illiac Crest?). Pain was deep and clenching. Upon touch, the area was tight, hard, and swollen. The pain then radiated down towards my pubic area, and if I poked over my ovary, it would get much sharper. During this period, I alternated between constipation and extremely watery diarrhea. I was also severely nauseated (no vomiting) and very fatigued. Walking/standing seemed to make pain worse, as though a golf ball was inside and dragging me down. I suffered a week and a half, then it stopped, had a normal BM, and then it returned. During the next phase, if I was fortunate enough to pass anything, my stools were extremely soft, mustard yellow, and had a ribbon-like appearence; similar to shredded paper, long, FLAT and thin. I developed a significant fever, on and off, and had severe night sweats, fatigue and nausea. I also experienced some gas with no odor and intestinal spasms. This phase lasted 3-4 days. The pain eased again, but still had slight fever and still really tired. Been sleeping an avg. of 12-16 hrs a day! I was almost pain free (slight abdominal soreness)for just 2-3 days, and now the area next to my hip is tight and hurting again! I haven't had a normal-looking BM since that one time, and probably not for several months before that. I've always alternated between the two extremes, but these very FLAT, skinny, yellowish stools began about 3-4 months ago and after this recent bout of pain, I am somewhat alarmed. I should also mention that I did have a very small amount of bright red blood on my tissue, not in my stool. I've had that before but thought it was hemroids. This has been a very disturbing/miserable experience! Mother had one bout with diverticulitis; I've had a uterine hysterectomy due to cervical dysplasia after childbirth (I was 22). So my question is: Does this sound like a spastic intestine, diverticulitis or worse? As I'm still experiencing some discomfort and low grade fevers, I would greatly appreciate any insight or advise you could provide. Thanks so much!
Three weeks ago, I had an episode resulting in sciatica and hip pain. After a week of that, I felt improved but then my abdomen started swelling as though it contained 25 or so water balloons. This followed with pain directly beside and to the left of the top of my hip-bone (beside the Illiac Crest?). Pain was deep and clenching. Upon touch, the area was tight, hard, and swollen. The pain then radiated down towards my pubic area, and if I poked over my ovary, it would get much sharper. During this period, I alternated between constipation and extremely watery diarrhea. I was also severely nauseated (no vomiting) and very fatigued. Walking/standing seemed to make pain worse, as though a golf ball was inside and dragging me down. I suffered a week and a half, then it stopped, had a normal BM, and then it returned. During the next phase, if I was fortunate enough to pass anything, my stools were extremely soft, mustard yellow, and had a ribbon-like appearence; similar to shredded paper, long, FLAT and thin. I developed a significant fever, on and off, and had severe night sweats, fatigue and nausea. I also experienced some gas with no odor and intestinal spasms. This phase lasted 3-4 days. The pain eased again, but still had slight fever and still really tired. Been sleeping an avg. of 12-16 hrs a day! I was almost pain free (slight abdominal soreness)for just 2-3 days, and now the area next to my hip is tight and hurting again! I haven't had a normal-looking BM since that one time, and probably not for several months before that. I've always alternated between the two extremes, but these very FLAT, skinny, yellowish stools began about 3-4 months ago and after this recent bout of pain, I am somewhat alarmed. I should also mention that I did have a very small amount of bright red blood on my tissue, not in my stool. I've had that before but thought it was hemroids. This has been a very disturbing/miserable experience! Mother had one bout with diverticulitis; I've had a uterine hysterectomy due to cervical dysplasia after childbirth (I was 22). So my question is: Does this sound like a spastic intestine, diverticulitis or worse? As I'm still experiencing some discomfort and low grade fevers, I would greatly appreciate any insight or advise you could provide. Thanks so much!
Doctor's Answer
by Kevin Pho, MD, Dec 15, 2004 12:00AM
, Dec 15, 2004 12:00AM
There are several symptoms here - which may or may not be related. Regarding the blood in the stool as well as the change in caliber - any type of colon polyp or mass, as well as diverticulosis and inflammatory bowel can lead to these symptoms. Irritable bowel disease can also be present as well. A colonoscopy would be the best test for evaluation.
Regarding the abdominal swelling - you may want to be evaluated for ascities (i.e. fluid in the belly). Liver failure as well as ovarian cancer can present this way. An ultrasound would be a reasonable test to evaluate for this possibility.
You may want to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Regarding the abdominal swelling - you may want to be evaluated for ascities (i.e. fluid in the belly). Liver failure as well as ovarian cancer can present this way. An ultrasound would be a reasonable test to evaluate for this possibility.
You may want to discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
