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Left sided abdominal pain - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Women's Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2382 Questions
Doctor :   hi
Doctor :  
how can i help you?

Doctor :  
ok
User :   are you a male or female doctor?
Doctor :  
I am a lady doctor.
User :   ok, hi
User :   i have question regarding abdominal pain
Doctor :  
ok
Doctor :  
please proceed with your query
User :   it is now and then and to my left side
Doctor :  
ok
Doctor :  
does the pain come everyday?
User :   more or less, but unfortunately difficult to say, because it is not constant
Doctor :  
ok
Doctor :  
is the pain dull aching type or like cramps?
Doctor :  
do you have associated nausea, vomiting or loose stools?
User :   mostly dull, but sometimes more "intensive"
Doctor :  
may i ask your age, gender and location?
User :   female, 23
Doctor :  
when was your last menstrual period?
User :   about one week ago
Doctor :   ok
Doctor :  

do you have associated nausea, vomiting or loose stools along with the pain?
Doctor :  
where in the abdomen the pain is located? upper abdomen or lower ?
User :   nothing to your first questions
Doctor :  
ok
User :   lower, and to the left side
Doctor :  
ok
Doctor :  
i will guide you to come to the reason for your pain
Doctor :  
first you should know the structures that come on the left side of body which might cause you pain
Doctor :  
so the structures that come in the left side of body are-Left edge of the Liver, Spleen, Body and Tail of the Pancreas, The Stomach, Left half of the Transverse Colon or large intestine,
Doctor :   The Descending Colon, Sigmoid Colon, Left Adrenal gland, Left Kidney, Left Ureter, Left Ovary in women, Left Fallopian tube in women, Blood vessels on the left side of the abdomen including the aorta, Muscles of the wall of the left side of the abdomen, Nerves on the left side of the abdomen, Skin covering the left side of the abdomen.
Doctor :   these are the structures that are present inside left side of abdomen that can cause pain. apart from these there are other structures that are not in abdomen that can produce pain.
Doctor :  
these are: the lower part of the Left Lung, Left half of the diaphragm, The heart
Doctor :  
since your pain is in the left lower side of abdoment
Doctor :  
the probable causes could be due to diverticulitis, irritable bowel syndrome, left kidney stone,
Doctor :   left kidney infection, crohn's disease, ulcerative colitis,
Doctor :   left ectopic pregnancy, left ovarian disease,
Doctor :  
and infection of the left fallopian tube.
Doctor :   have you followed what i said uptill now?
User :   thank you very much for your detailed explanations, are you a general practitioner?
Doctor :   yes, I am a General Practitioner.
User :   i must admit that i am a little nervous seeing a doctor, is it possible that you describe what to expect?
Doctor :  
I believe I can help you within my expertise and If required I shall recommend a specialist.
Doctor :   ok
Doctor :  
now that you know what could be the possible reasons for the pain
Doctor :  
you need to undergo investigations to reach to a conclusion.
Doctor :  
an ultrasound of abdomen and pelvis will help to reveal the various causes.
User :   i am very grateful for all your help, i hope what we discuss is between you and myself?
Doctor :  
yes it will be confidential
Doctor :  
unless
Doctor :  
it requires a specialist opinion
User :   so you had start directly with an ultrasound, or first some kind of physical exam?
Doctor :  
it will be better to have a physical examination first to know what to expect
Doctor :  
then a scan to confirm
User :   and what will most probably a physical examination consist of in this case at a GP?
Doctor :  
it will consist of checking your vitals
Doctor :  
doing a general physical examination
Doctor :  
and then a examination of your abdomen
Doctor :  
to locate the pain
Doctor :  
and to do palpation to see if any mass or tenderness is associated
User :   i see, what is a "general" examination?
Doctor :  
it will be a general physical examination
User :   meaning?
Doctor :   meaning to do a head to toe examination
Doctor :   i will explain
User :   thank you doctor
User :   sorry for my questions, but i hope you understand how i feel
Doctor :  
yes
Doctor :  
it is fine
Doctor :  
you can ask
Doctor :  
i am there to help you
Doctor :  
so coming to general examination: Doctor :  
it will consist of a head to toe examination, they will see condition of hair
Doctor :  
hair if dull or dry, indicated poor nutrition, pointing towards gastritis
Doctor :  
or premature greying will suggest gastric reasons.
Doctor :  
coming to eyes, to see for any pallor which will suggest anemia, or any icterus, or yeelowness that will suggest jaundice and thereby affection of liver.
Doctor :  
have you followed what i have said?
User :   yes, i follow, thank you once again, i feel more relaxed to know what to expect and why you will check this or that
Doctor :  
ok
Doctor :  
so next will be to check your tongue, to see for pallor and yellowness again for the same reasons.
Doctor :  
next will be examination of lymph nodes to rule out any chronic infection
User :   lymph nodes on the throat?
Doctor :  
normal vitals will be checked which will include heart rate and rhythm (pulse), respiration, and blood pressure.
Doctor :  
both
Doctor :  
lymph nodes for chronic infection, and throat to see for thyroid enlargement
Doctor :  
nails will be checked to see for any infection, chronic changes, anemia related changes.
Doctor :  
coming to the various causes for the left sided pain
Doctor :  
here is what you could expect
Doctor :  
diffuse left sided pain slowly or abruptly increasing could be due to abdominal aortic aneurysms.
Doctor :  
but this generally presents with acute features
Doctor :  
causing rupture and bleed and collapse of the patient
Doctor :  
since you do not have any collapse history, this is ruled out
Doctor :  
2. next could be due to cancer affecting the left side of the bowel could cause left side abdominal pain.
Doctor :   for this there should be a significant history of bowel cancer in the family
User :   as i know, nothing
Doctor :   and the symptoms will include weight loss, change in bowel habit, tending towards more constipation, poor appetite, and feeling generally weak.
Doctor :   These symptoms may continue over months.
Doctor :  
however there are other diseases which could have similar symptoms
Doctor :  
they are
Doctor :  
Crohn's disease, ulcerative colitis, chronic constipation, celiac disease, irritable bowel syndrome to name a few.
Doctor :  
3.Next will be bowel obstruction and the symptoms will would include abdominal pain griping or cramping, feeling like vomiting, or actually vomiting, with distension of the abdomen. Also, the bowel may be making loud intermittent noises
Doctor :   4. next common cause will be constipation, manifesting as inability to pass faces as usual, feeling bloated, without weight loss,
Doctor :   5. Diverticulitis will generally present after 60 years of age, so again it is ruled out in your case.
Doctor :  
have you followed what i have said uptill now?
User :   yes, thank you
Doctor :  
ok
Doctor :  
6. next cause could be ectopic pregnancy if you are sexually active.
Doctor :  
and you will have lower right or left sided abdominal pain, plus or minus dizziness, plus or minus vaginal bleed.
Doctor :  
and in this case you should report immediately to a ER, as things could turn serious.
Doctor :  
7. Next cause could be endometriosis
Doctor :  
affecting the left side
Doctor :  
this is a condition where the uterine lining tissue is present outside the uterus
Doctor :  
and it causes pain
Doctor :   it could cause lower left abdominal pain, if it is on the left tube, ovary, or first part of the large bowel
Doctor :  
during examination, there will be severe pain on the affected side in this case
User :   do you think the doctor will listen to the abdomen?
Doctor :  
8. other than these food poisoning also might cause left sided abdomen pain. but in this case you will also have nausea vomiting and loose stools
Doctor :  
yes
Doctor :  
the doctor might listen to abdomen sounds
Doctor :  
9. next coming to kidney stones
Doctor :  
here, the pain presents as sudden onset severe pain, usually waking the sufferer up from sleep in the early hours of the morning or indeed any time,
Doctor :  
and often it is described as the most severe pain ever, comes in waves, spreads down to the thigh lower abdomen and thigh
Doctor :  
it will also be associated with nausea at times
Doctor :  
10. next will be kidney infection with similar symptoms as kidney stones, but with fever
Doctor :  
this can be diagnosed with urine test
User :   so, first this more general checkup, and then a more detailed abdominal part?
Doctor :  
11. next cause could be due to ovarian cause which might include cysts, this can be picked in ultrasound
Doctor :  
and sometimes during abdomen palpation if cyst is big
Doctor :  
yes
User :   what do you think is necessary to disrobe for this examination?
Doctor :  
so depending on the general findings and the abdomen examination we could narrow down to few causes for your pain
Doctor :  
no
Doctor :  
not completely disrobe
Doctor :  
only expose your abdomen from blow your breasts to your pantyline
Doctor :  
you need not completely disrobe for the examination
User :   ok, sounds good, sorry for the question, but of course a bit nervous about this
Doctor :  
and moreover there should be a female nurse along with you in the examination room
User :   i have a male gp, do you think he is used to this?
Doctor :  
yes he should be.
Doctor :  
and if he is examining you
Doctor :  
either a female nurse or your husband or mother should be present with you
Doctor :  
so that you feel better
User :   ok, thanks for the tip
Doctor :  
and also it is medical ethics
User :   but as i understand there is not need to take off trousers?
Doctor :  
not to examine a female patient without a female nurse present
Doctor :  
no not needed unless a gynaec cause is made out
Doctor :  
and for this he should refer you to a gynac
User :   ok, so in case of ovarian/fallopian tube, he is not doing a first assessment?
Doctor :  
no not usually.he should ask your permission before examining per vaginum.
Doctor :  
he will suggest a gynec examination
Doctor :  
to rule out ovarian/fallopian tube problems
User :   is this when you feel inside and at the same time feel with the other hand on the abdomen?
Doctor :  
yes
Doctor :  
is there anything else i can help you with?
User :   to feel enlargement or tenderness?
Doctor :  
yes
Doctor :  
it can be made out with palpation
User :   so this is something that he might want to perform?
Doctor :  
not if you are not having any ovarian or fallopian tube related causes.
User :   to be honest, i think it is related to this, because the pain is "in this area"
Doctor :  
if you are having the pain due to other structures, the per vaginum examination is not required
Doctor :  
ok
User :   so that why i asked
Doctor :  
ok
User :   of course a little embarrassing, but quite quickly performed? or?
Doctor :  
so is your pain crampy and severe and travelling down the legs on occassions?
Doctor :  
it depends
Doctor :  
if it is a gynaec doing it it migt take somewhere between 1 min to 5 mins
Doctor :  
I am not sure of GP
Doctor :  
so if you are sure that the cause for your pain is left ovaery or tubes or endometriosis
Doctor :  
then it is better that you see a gynecologist in the first place
Doctor :  
and more so
Doctor :  
get a ultrasound abdomen with pelvis done
User :   i understand, but the problem is that i am not sure, and often it is quite difficult to get gynappointment
Doctor :  
to know the possible causes for the pain whether it is arising due to abdominal structures or pelvis structures.
User :   do you as a GP perform such kind of palpation from time to time?
Doctor :  
then what you can do is apprach your GP
Doctor :  
and request for a
Doctor :  
prescription for ultrasound abdomen with pelvis
Doctor :  
once you have the report
Doctor :  
it will already show a possible cause
Doctor :  
and then you can decide with whom to follow up depending on the diagnosis based on the ultrasound report
Doctor :  
it will also help to decide the course of treatment needed for you
Doctor :  
Is there any thing else I can help you with?
User :   do you as a GP perform such kind of palpation from time to time?
Doctor :   yes i do, I have over three years experience in obstetrics and gynecology. so i am used to perform vaginal examination depending on the need.
User :   i see, could this be performed on a normal exam table?
Doctor :  
yes sometimes.but if a deep vaginal palpation is needed then a gyne examination table is required
User :   ok, but a first assessment could be performed on a normal table, is the patient lying flat then?
Doctor :  
yes
User :   is it ok to only put trousers down to the knees?
Doctor :  
no you will not need to put down your trousers, only if in the abdominal examination there is a need felt to do a per vaginum examination, then you will need to put down your trousers
User :   ok, i feel much more relaxed and know what to expect
User :   once again thank you very much
User :   i really appreciate it
User :   and grateful
Doctor :  
thank you
Doctor :  
Is there any thing else I can help you with?
User :   sorry if i was to nervous and asked to much
Doctor :   no it is fine. we are there to help you 24/7.
User :   thank you and have a nice day!
User :   hope this will be confidential
User :   will the chat be kept?
Doctor :  
yes
Doctor :  
it will be kept confidential
Doctor :  
unless
Doctor :  
your problem requires experts opinion
Doctor :  
or a specialist poinion
Doctor :  
on request by you.
User :   ok, thank you very much, take care and bye
Doctor :  
Please fill the feedback form say done when done.
Doctor :   Have you filled the feedback form?
User :   yes
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
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