[43M] With severe lower left abdominal pain and constipation

Patient Description

A 43-year-old male has been experiencing severe pain in the lower left abdomen since this morning. The pain is rated 7 out of 10, hurts to the touch, and worsens with movement such as coughing. It gradually built up and is constant, but less noticeable when sitting still. The patient has not found any relief methods. He had a bowel movement last night around midnight and has noticed constipation but no blood in the stool. There are no accompanying symptoms such as nausea, vomiting, fever, chills, or changes in appetite. There have been no recent changes in diet, travel, injuries, or physical activities that might have strained the abdominal area. The patient has no history of similar abdominal pain, diverticulitis, or other gastrointestinal conditions. He is not currently taking any medications, including over-the-counter drugs or supplements, and does not use substances such as alcohol, tobacco, or recreational drugs. There is a family history of colon cancer but no recent diagnostic tests like a colonoscopy or abdominal imaging. The patient has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Diverticulitis: This condition occurs when small pouches (diverticula) in the digestive tract become inflamed or infected. It often causes pain in the lower left abdomen, which can be severe and tender to the touch. Constipation is also a common symptom.

    • Treatment: Treatment typically involves antibiotics to clear the infection and a liquid diet for a few days to allow your bowel to heal. In severe cases, hospitalization or surgery may be required.
  • Constipation: Chronic constipation can cause significant abdominal pain and discomfort, especially if stool becomes impacted.

    • Treatment: Increasing fiber intake, staying hydrated, and using over-the-counter laxatives can help relieve constipation. In some cases, a doctor may prescribe stronger medications.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause cramping, abdominal pain, bloating, gas, and constipation.

    • Treatment: Managing IBS often involves dietary changes, stress management, and medications to relieve symptoms.
  • Hernia: A hernia occurs when an organ or tissue pushes through a weak spot in the muscle or surrounding tissue. This can cause localized pain that worsens with movement.

    • Treatment: Treatment may involve lifestyle changes, wearing a supportive belt, or surgery to repair the hernia.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help manage your symptoms:

  1. Stay Hydrated: Drink plenty of water to help ease constipation and keep your digestive system functioning properly.
  2. Increase Fiber Intake: Incorporate more high-fiber foods into your diet, such as fruits, vegetables, and whole grains, to help relieve constipation.
  3. Avoid Straining: Try to avoid activities that strain your abdominal muscles, such as heavy lifting or intense physical activity.
  4. Use Over-the-Counter Remedies: Consider using over-the-counter laxatives or stool softeners to help with constipation, but consult a healthcare professional before starting any new medication.
  5. Rest and Monitor: Rest and avoid movements that exacerbate the pain. Keep track of your symptoms using the MDandMe journal to monitor any changes and share this information with your healthcare provider.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe or Worsening Pain: If the pain becomes more severe or does not improve with rest.
  • Fever or Chills: These could indicate an infection that requires prompt medical treatment.
  • Blood in Stool: This could be a sign of a more serious condition that needs immediate evaluation.
  • Inability to Pass Stool or Gas: This could indicate a bowel obstruction, which is a medical emergency.
  • Unexplained Weight Loss: This could be a sign of an underlying condition that needs further investigation.

Remember, while these suggestions can help manage your symptoms, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment. If you have any further questions or need to track your symptoms, consider using MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago


People Also Ask


What are the common symptoms of diverticulitis?

Common symptoms of diverticulitis include severe pain in the lower left abdomen, tenderness to touch, constipation, fever, and sometimes nausea or vomiting. The pain often worsens with movement.


How can constipation lead to abdominal pain?

Constipation can lead to abdominal pain because it causes stool to build up in the intestines, leading to bloating, discomfort, and sometimes severe pain if the stool becomes impacted.


What lifestyle changes can help manage IBS symptoms?

Lifestyle changes to manage IBS symptoms include increasing dietary fiber, staying hydrated, managing stress through techniques like yoga or meditation, and avoiding trigger foods such as caffeine, alcohol, and certain carbohydrates.


When should I seek medical attention for abdominal pain?

You should seek medical attention for abdominal pain if it becomes severe or worsens, if you experience fever or chills, if there is blood in your stool, if you cannot pass stool or gas, or if you experience unexplained weight loss.


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