Is there a need for upper GI endoscopy for persistent abdominal pain and blood in stool?

Hello,

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I had gone through all the details that are posted. The causes for persistent pain in the left lower abdomen were not answered by PCP or your CT (computed tomography) abdomen. Normally if there is frank blood in stools we need to do proctoscopy or sigmoidoscopy or colonoscopy to look for lower gastrointestinal causes. If there are black colored stools then we suspect upper GI pathology (ulcer). So we go for upper GI endoscopy to look for the bleeding cause. Aspirin and Naprosyn may cause gastritis and ulceration which might be the cause they wanted to look for on upper GI endoscopy but it will not answer your blood in stools.

CT abdomen has shown multiple things. Mainly important are:

1) 8mm nodule in the right lung middle lobe which needs further characterization. 2) Multiple hepatic cysts were mentioned but characterization was not done. Is it a hydatic cyst or what kind of cyst needs mention?

3) Left non-obstructive renal calculus and a renal cyst. Again characterization of the renal cyst was not done whether benign or Bosnaik's grade?

This renal thing is the one that fits into the location of your persistent left lower abdominal pain. For gastric ulcer pain, you can take Esmoprazole or Pantoprazole. If you get UGIscopy we need to look for ulcer and take a biopsy from that and send for histopathology to look for H.Pylori in it. If it is positive treatment is for two weeks only, so do not use antibiotics for H.Pylori.

Avoid spicy foods, NSAIDs (nonsteroidal antiinflammatory drugs), and alcohol which will help to reduce acidity. Kindly consult a new PCP, discuss these issues with him and then decide on further evaluation and management. I hope this helps.