Lower Left Abdomen Pain: Causes, Symptoms & When to See a Doctor

Question
It's been over three months now. I have a specific pain in my lower left abdomen, sharp but not excruciating. It does not intensify with touch or pressure, it does not move.  I have no problem urinating or moving my bowels.  No blood in stool.  There is a tightness that runs along my crotch to the left of my left testicle.  No swelling, no testicular pain, no outward sign of herniations.  It is most prevalent while stationary in a sitting position.  Nearly unnoticeable when exercising, running, or lifting weights. So far I've had blood,urine, and rectal tests, X-Ray, Cipro, Bentyl, CT Scan, another urine test, another blood test, ultrasound, another CT Scan.  They say they have ruled out the normal culprits - divirticulitus, kidney stone, hernia... I had a colonoscopy in 2005 for blood in my stool - no polyps, just hemaroids....The Doc said when he got the last CT Scan he would either refer me to a Urologist (if he confirmed a stone) or a GI if he did not -- no stone, but his assistant made me an appt at a urologist ?  I have to call him tomorrow to see if he changed his mind or made a mistake....   I am an active 47 year old.  I am on a high fiber diet, drink lots of water, and take vitamins and supplements.  Don't smoke, don't drink.  Rarely eat red meat.  What would you do if you were me?

Answer
Hi Eric,

There are many problems which can be present in your specific case. Your physician has ruled out many of the most common problems associated with left lower quadrant pain. The main concern is regarding an association of an indirect specific pain in your left lower quadrant and a "tightness" which occurs near your left inguinal and scrotal area.

The problems to rule out is whether you have an abdominal aneurysm, abdominal adhesion, ureteral colic from an inflammation of the bladder/prostate, a problem with the vascular flow causing thrombophlebitis, nerve compression, herniated discs causing pain, a flare up of rheumatoid arthritis if you have a history of RA, and very rare but has happened... referred pain from appendicitis, coronary heart disease, heartattack, or friction in the lung with increased fluids call pleurisy with effusion.

I would stop the high fiber diet for now and seek the advisory of your physician as the RDA of fiber. Too high of fiber intake can cause intestinal obstruction.

A referral to other physicians for second opinions doesn't hurt.

Regards,

John Thai, MD