Dull pain in the left lower abdomen is a common clinical symptom, referring to mild pain below the navel and to the left of the midline. The causes of this pain are complex and varied, potentially related to digestive and urinary system disorders, gynecological conditions, trauma, and skin diseases. Dull pain in the left lower abdomen should not be ignored; seek medical attention promptly to avoid delays in treatment.
symptom
Typical manifestations
The typical presentation of dull pain in the left lower abdomen may vary depending on the cause and may be accompanied by different symptoms.
1. Digestive system diseases
Dull pain in the lower left abdomen may be caused by digestive system diseases such as Crohn’s disease, intestinal tuberculosis, colitis, colon polyps, colon cancer, etc. These diseases usually cause symptoms such as diarrhea, bloody stools, and abdominal pain.
2. Urinary system diseases
Left lower abdominal pain may also be caused by urinary system diseases, such as left ureteral stones, cystitis, etc. These diseases usually cause symptoms such as frequent urination, urgency, and pain when urinating.
3. Gynecological diseases
Dull pain in the lower left abdomen may also be caused by gynecological diseases, such as ovarian cysts, adnexitis, endometriosis, etc. These diseases may cause abdominal pain and may be accompanied by symptoms such as irregular menstruation and abnormal leucorrhea.
4. Trauma
If the left lower abdomen is hit or squeezed by external force, it may cause injury to the left lower abdomen and symptoms of dull pain in the left lower abdomen. This condition is usually accompanied by symptoms such as local tenderness, swelling, and congestion.
5. Skin diseases
Certain skin diseases, such as eczema and contact dermatitis, may also cause dull pain in the left lower abdomen. These diseases are usually accompanied by symptoms such as itching, redness and swelling of the skin.
complication
This symptom generally has no obvious complications.
reason
Overview
The causes of dull pain in the lower left abdomen are complex and varied, and may be related to digestive system diseases (such as Crohn’s disease), urinary system diseases (such as left ureteral stones), gynecological diseases (such as ovarian cysts), trauma, skin diseases (such as eczema), etc.
Cause of symptoms
1. Digestive system diseases
Such as Crohn’s disease, intestinal tuberculosis, colitis, colon polyps, colon cancer, etc., may manifest as dull pain in the lower left abdomen.
2. Urinary system diseases
Conditions such as left ureteral stones and cystitis may also manifest as dull pain in the left lower abdomen.
3. Gynecological diseases
Conditions such as ovarian cysts, adnexitis, and endometriosis may also cause dull pain in the lower left abdomen.
4. Trauma
If the lower left abdomen is hit or squeezed by external force, it may cause injury to the lower left abdomen and symptoms of dull pain in the lower left abdomen.
5. Skin diseases
Skin diseases such as eczema and contact dermatitis may also cause dull pain in the lower left abdomen.
Common diseases
Crohn’s disease, intestinal tuberculosis, colitis, colon polyps, colon cancer, left ureteral stones, cystitis, ovarian cysts, adnexitis, endometriosis, abdominal trauma, eczema, contact dermatitis
Seeking medical treatment
Emergency (120) indications
1. The dull pain in the left lower abdomen worsens and persists without relief, or is accompanied by other serious symptoms such as nausea, vomiting, fever, etc.
2. The patient has a history of abdominal trauma, such as impact, compression, contusion, etc.
3. Other life-threatening symptoms occur.
In all of the above cases, you must call the emergency number or go to the emergency room immediately.
Outpatient indications
1. Long-term dull pain in the left lower abdomen, repeated attacks of diarrhea or alternating with constipation, often due to fatigue, improper diet, overeating and mood changes as recurrence triggers, often consider chronic intestinal infection or dysfunction.
2. Recurrent dull pain in the left lower abdomen and the appearance of a mass, accompanied by fatigue, weight loss, anemia, night sweats and other systemic symptoms, should consider the possibility of intestinal tuberculosis.
3. Repeated dull pain in the lower left abdomen, accompanied by bowel sounds, bloody stools with mucus, fever, weight loss, anemia and other symptoms, should alert you to Crohn’s disease or intestinal tumors.
4. Other severe, persistent or progressive symptoms and signs occur.
All of the above require prompt medical consultation.
Treatment department
1. If the patient’s pain worsens, becomes unbearable, or is life-threatening, he or she should go to the emergency department immediately.
2. If you suspect intestinal lesions, you can go to the gastroenterology department or general surgery department for treatment.
3. If you suspect a gynecological disease, you can go to a gynecologist for treatment.
4. If you suspect a urinary system disease, you can go to the urology department for treatment.
5. If you suspect a skin disease, you can go to a dermatologist for treatment.
Medical preparation
1. When visiting the doctor, patients should try to wear clothes that are easy to put on and take off to facilitate the doctor’s examination.
2. Patients should try to eat a light diet a few days before the examination, avoid spicy food, and avoid drinking alcohol, staying up late, etc.
3. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
4. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
5. If you have taken some medicine to relieve symptoms recently, you can bring the medicine box with you.
6. Family members can be arranged to accompany the patient to seek medical treatment.
7. Patients can prepare a list of questions they want to ask in advance.
What questions might a doctor ask a patient?
1. How long have your pain symptoms lasted? Has it gotten worse over time?
2. In addition to dull pain in the lower left abdomen, are there any other symptoms, such as nausea, vomiting, diarrhea, irregular menstruation, amenorrhea, vaginal bleeding, etc.?
3. Have you ever had dull pain in your left lower abdomen? What caused it?
4. Did you eat any unclean food before the pain started? Or did you eat too much or binge eat?
5. Have you ever had fallopian tube surgery? Do you have a history of fallopian tube inflammation, ectopic pregnancy, or intestinal tuberculosis?
6. Is your menstruation regular? Do you experience dysmenorrhea?
7. How many times have you been pregnant? How many children do you have?
What questions can patients ask their doctor?
1. Why do I have dull pain in my lower left abdomen? What is the most likely cause?
2. Are my symptoms serious? What tests do I need?
3. Do I need to be hospitalized?
4. What treatment methods do I need now? Is it curable?
5. Are there any risks for me from these treatments?
6. What are the next steps in my diagnosis and treatment?
7. I have other diseases. Will this affect my treatment?
8. What should I pay attention to after returning home?
9. If medication is required, what are the usage, dosage, and precautions?
10. Do I need follow-up examinations? How often?
examine
Scheduled inspection
Doctors usually perform a physical examination on the patient first to gain a preliminary understanding of the disease; they may then recommend a blood test, stool test, urine test, serum amylase test, liver and kidney function test, B-ultrasound, X-ray, CT, endoscopy, abdominal puncture, etc. to determine the cause of the disease.
Physical examination
1. Full body examination
Pay attention to the patient’s overall condition. In addition to routine measurements of body temperature, pulse, respiration, and blood pressure, pay attention to the patient’s expression, consciousness, body position, presence of swollen lymph nodes, and pay special attention to any special physical signs.
2. Abdominal examination
(1) Observe whether abdominal breathing is present, whether there are ecchymosis and surgical scars on the abdominal skin, whether there is abdominal distension, gastrointestinal type, and intestinal peristalsis or reverse peristalsis.
(2) The doctor uses palpation to determine whether there are peritoneal irritation signs such as muscle tension, tenderness and rebound pain in the abdominal wall, and pays attention to their range and degree.
(3) Abdominal percussion can reveal the presence of loss of liver sound and shifting dullness.
(4) Hyperactive, weakened or absent bowel sounds, and the presence or absence of special breathing sounds also have diagnostic value.
All patients with abdominal pain should undergo a routine bilateral inguinal examination and digital rectal examination. Female patients should undergo appropriate gynecological examinations as appropriate.
Laboratory tests
1. Blood routine test
Increased white blood cell counts and neutrophil counts indicate inflammatory lesions and are items that need to be checked for almost every patient with abdominal pain.
2. Urinalysis
The presence of a large number of red blood cells in the urine indicates urinary tract stones, tumors, or trauma. The presence of proteinuria and white blood cells indicates a urinary tract infection.
3. Routine bowel movements
It helps to determine whether the patient has bloody stools or occult blood in stool, and is helpful for the diagnosis of diseases such as ulcerative colitis and colon cancer.
4. Serum amylase assay
Elevated serum amylase indicates pancreatitis and is the most commonly used blood biochemistry test in the differential diagnosis of abdominal pain.
5. Liver and kidney function tests
Liver and kidney function and electrolyte tests are helpful in diagnosing the condition.
Imaging examinations
1. Ultrasound
Ultrasound examination is an important means of rapid screening for acute abdomen, so it is often used as the preferred examination method.
2. X-ray
Abdominal X-rays are the most commonly used to diagnose abdominal pain. Calcifications in the ureter may indicate ureteral stones, while blurred or absent psoas muscle shadows may indicate retroperitoneal inflammation or bleeding.
3. CT
CT examination can better clarify the relationship between internal organs and has good diagnostic value for abdominal infection, tumors, obstruction, perforation, etc.
Other tests
1. Endoscopic examination
It can be used for the differential diagnosis of gastrointestinal diseases, which is often needed in patients with chronic abdominal pain.
2. Abdominal puncture fluid examination
If abdominal pain is not clearly diagnosed and peritoneal effusion is discovered, a paracentesis is essential. The fluid obtained should be sent for routine and biochemical examinations, and bacterial culture is performed if necessary. Visual inspection of the fluid after obtaining it can often assist in the diagnosis of intra-abdominal bleeding or infection.
diagnosis
Diagnostic principles
The doctor will first inquire about the patient’s medical history and perform a physical examination. The diagnosis is generally straightforward, combining results from routine blood tests, stool tests, urine tests, serum amylase assays, liver and kidney function tests, ultrasound, X-rays, CT scans, endoscopy, and abdominal paracentesis. During diagnosis, it is important to differentiate between common conditions that cause dull left lower abdominal pain, such as Crohn’s disease, intestinal tuberculosis, left ureteral stones, and endometriosis.
Differential diagnosis
1. Crohn’s disease
Crohn’s disease is an inflammatory intestinal disease that can present as dull pain in the left lower abdomen, chronic diarrhea, and weight loss. Symptoms typically begin in young adulthood and may be accompanied by complications such as intestinal obstruction, intestinal bleeding, and intestinal perforation. The diagnosis of Crohn’s disease requires a comprehensive evaluation based on clinical, endoscopic, and pathological examinations.
2. Intestinal tuberculosis
Intestinal tuberculosis is an intestinal infection caused by Mycobacterium tuberculosis. It can present as dull pain in the left lower abdomen, as well as diarrhea and constipation. While symptoms are often similar to those of Crohn’s disease, intestinal tuberculosis may be accompanied by systemic symptoms such as fever, night sweats, and weight loss. The diagnosis of intestinal tuberculosis requires a comprehensive evaluation based on clinical, laboratory, and pathological examinations.
3. Left ureteral stones
Left-sided ureteral stones typically present as left-sided flank pain that radiates to the left side of the abdomen. The pain may be accompanied by urinary irritation symptoms such as frequent urination, urgency, and pain. The diagnosis of left-sided ureteral stones requires a comprehensive evaluation based on clinical, laboratory, and imaging findings.
4. Endometriosis
Endometriosis refers to the presence of endometrial tissue outside the uterus. It can present as dull pain in the left lower abdomen, as well as dysmenorrhea and infertility. Symptoms may be related to sexual activity, reproductive system abnormalities, and other factors. The diagnosis of endometriosis requires a comprehensive assessment based on clinical, laboratory, and imaging tests.
treat
Expected treatment
The treatment of left lower abdominal pain depends on the specific disease and symptoms, but usually includes general treatment, drug therapy, and surgical treatment. After active treatment, the prognosis is usually good.
General treatment
1. Get enough rest and relaxation, avoid overwork and excessive stress, which will help relieve physical discomfort.
2. Avoid spicy, greasy, raw and cold foods, and choose light and easily digestible foods.
Drug treatment
1. Analgesics
Can have analgesic effect, such as ibuprofen, atropine, etc.
2. Anti-inflammatory drugs
It has an anti-inflammatory and bactericidal effect. For dull pain in the left lower abdomen caused by intra-abdominal inflammation, you can take penicillin or cephalosporin anti-inflammatory and bactericidal drugs, such as amoxicillin and ceftriaxone.
3. Anti-tuberculosis drugs
For dull pain in the left lower abdomen caused by intestinal tuberculosis, anti-tuberculosis drugs such as isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin can be used.
4. Glucocorticoids
For dull pain in the left lower abdomen caused by dermatitis, choose topical creams, ointments, or oral medications, depending on the situation. Commonly used medications include prednisone and hydrocortisone.
Related drugs
Ibuprofen, atropine, amoxicillin, ceftriaxone, isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin, prednisone, hydrocortisone
Surgical treatment
Crohn’s disease and left ureteral stones may require surgical treatment if they are difficult to resolve with conservative treatment. In addition, conditions such as colon polyps, colon cancer, ovarian cysts, and endometriosis, which are not effectively cured by medication, may also require surgical treatment.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, treatment timing, age and physical condition, and may vary from person to person.
Estimated treatment costs
There may be significant individual differences in treatment costs, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.