Pain in lower left abdomen

[Frankie68]

I am a 38 year old female. For the last few months I've been noticing some strange stomach and bowel symptoms. I've had internal and external hemmorhoids for some time now and was last seen in February for them. Doctor did a digital rectal exam and a Fecal Occult Blood test. The Fecal was negative and the rectal exam led him to diagnose internal hems again.  About 2 weeks ago I had two cases of diarrhea within a week.  The second case showed what looked like blood mixed in.  Both times I had pretty severe abdominal cramping that would come and go and was worse when I ate or drank.  Between the epidsodes I had a Leep proceedure to remove severe dysplasia from my cervix.  The day after the surgery my tongue was sore and I attributed it to being put to sleep and having my tongue held out of the way during surgery.  For the last two days I've had pretty severe pain in my lower left abdomen with pain throughout most of my lower abdomen.  When it started it felt similar to menstral cramping but as it went on it became more of a stomach pain. Using a flashlight I could see what I'm assuming was blood in the stool (mixed in) and on one occasion it looked like blood on the outside of the stool. Occasionally it feels like I still need to go--kind of like a pressure feeling. No diarrhea. I also feel like the anal area is irritated, most likely the hemmorhoids. But there is also an area on the skin between the anus and vaginal opening that is sometimes sensitive to the touch and looks like a raised scratch right next to an old hemmorhoid. My doctor's office can't see me until next week. I'm uneasy about the anal symptoms because I know the HPV infection that caused the cervical dysplasia can also lead to anal dysplasia.  I'm curious what you think about all of the symptoms combined and the chances of colon cancer.

[Kevin Pho, MD]

I would comprehensively look at the lower GI tract.  Inflammatory bowel disease, masses, colitis or infection can lead to the discomfort.  

A colonoscopy or flexible sigmoidoscopy can be considered as a reasonable initial evaluation.  Sending off the stool can also be considered to evaluate for infection.  Of course, colon cancer can also be ruled out with these tests.

If there are upper GI or stomach discomfort, an upper endoscopy or upper GI series can be considered.

These options should be discussed with your personal physician or in conjunction with a GI 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.
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