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Q. What are the possible causes for pain and discomfort in the lower left abdominal area?

Answered by
Dr. Divakara P
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 03, 2017 and last reviewed on: Feb 25, 2021

Hello doctor,

My primary issue was blood in the stool. The stools used to be dark or red in color. It was difficult to pass unless I pushed extremely hard due to very dense or heavy stool. I had constipation almost daily for a few months leading up to seeing blood in the stool. Since I was very busy, I stupidly thought it was not a very big deal. I went to my local ER and answered all their questions to the best of my ability. I am 27 years old, nearly always tired even after a full night's sleep. I have body pain and the pain intensity is about 6 out of 10. The pain or discomfort is mostly in my lower left front side abdominal area, between the upper pelvis and bottom of the rib cage. It is extremely uncomfortable, but not really to the touch. I feel the organs inside are enlarged in the area of pain.

The ER checked for anal issues and they did not seem to find anything, but they were very vague. They ordered an abdominal CT scan with contrast. The ER doctor told me that the CT scan showed nothing and I was frankly astonished. The ER doctor seemed reluctant to go into any sort of detail and seemed to be focused on getting me discharged as quickly as she could. I work with people almost every day and because of this, I do my absolute best not be a nuisance or a problematic patient. The ER doctor told me that I need to see a gastro doctor. My BP was 155/101 mmHg at the time of release. I really could not believe what was happening at this stage. I had a very kind and friendly nurse who came to remove my IV. I asked her what she thought this could be since the ER doctor did not indicate any possible diagnosi. Based on my charts or intake, she thought it could possibly be Crohn's disease. I was given my discharge papers very quickly. I was prescribed no medicine and told that my blood and urine tests were fine. I was not given a copy of the CT scan. I got home around in the night and promptly went to bed. I woke up the following morning feeling about more than two times worse than the prior day and reviewed my discharge papers. They were incredibly vague, included no test results, and a two-sentence note from the ER doctor that said I need to see a gastro doctor to get an endoscopy and a colonoscopy as soon as possible.

Considering the vagueness of my discharge papers and how bad my experience in the ER was, I decided to see my GP. After telling my GP about my symptoms and my ER experience he was very concerned. I gave his assistant my release papers from the ER to try and help them figure out what was going on and they agreed that my ER experience was not satisfactory, to say the least. My GP was sent the CT scan copy from the ER. The GP told me that, it showed swollen lymph nodes throughout my intestines although he did not show me or release to me the imaging results. My GP was very reassuring and told me that the lymph nodes can get swollen one by one and it sets of a kind of chain reaction over time. They took blood and ordered a breath test for H. pylori and a test for Epstein-Barr. He asked what they prescribed me in the ER and when I told him nothing he was more shocked than I was and indicated that their conduct was unacceptable. The following day, I was told that the normal Epstein-Barr levels were 0-18 and mine was at 337. As of this moment, I am still waiting for the H. pylori test results.

I honestly feel dead. I cannot function, and my left side pain is increasing steadily. My GP told me that the endoscopy and colonoscopy are both basically unnecessary and that I needed to change my diet to five to six small meals per day along with lean proteins and carbohydrates. GP prescribed me a seven day dose of Valtrex 500 mg three times a day for one day. The previous day the GP prescribed a seven day dose of Cipro 500 mg twice a day and a three day dose of Flagyl 500 mg thrice a day. I was told that he would call me as soon as he got the H. pylori test results, but I still have not heard from him. At this point, I feel lost and I am practically on my knees begging for any sort of help. I am trying to stay positive and strong but this is worse than anything I have ever endured. I am hesitant to annoy my GP and am scarred from my last visit to the ER. This is the first time I have ever consulted anyone online, so I apologize if this is either too vague, or too in depth, but I am desperate for answers. I also take Diazepam 5 mg thrice a day for anxiety, 2 mg Suboxone maintenance once a day and Vyvanse 40 mg once a day for adult ADD. Any help will be truly and greatly appreciated. Should I call my GP? Or should I go to another ER? I do not know if I am being paranoid or if I should be as concerned as I am now. Please help me.

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Hi,

Welcome to icliniq.com.

I am very sorry to hear about your condition and your experience in ER (emergency room).

  • There are certain conditions that can explain your symptoms. I sincerely feel that you have not been evaluated thoroughly.
  • You might be having an infection of the gut (colitis), inflammation of the gut (inflammatory bowel disease, Crohn's disease or ulcerative colitis), problems in bowel movement either due to some partial mechanical obstruction to the gut, inflammation in the pancreas or infected hemorrhoids.
  • Looking at your condition, I feel you first need hospital admission so that you can be given IV fluids which shall restore your energy and give rest to your bowels.
  • You need to be personally examined per rectum. If that is normal then you need to undergo further blood tests like liver function tests, serum amylase and serum lipase. If all these come normal, then you have to get colonoscopy and or biopsy done.
  • I do not think it is Epstein-Barr virus or Helicobacter pylori. You may not like it, but I recommend you go to ER again and discuss the above with them.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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