Brief Answer:
Lower left abdominal pain is large bowel related

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail. I meet many patients with problems that you are facing and in most cases it is treated with medications by a general surgeon. As you have mentioned the ultrasound scan is normal, in ultrasound scan we are able to evaluate the main organs in the abdomen including the liver, kidneys, pancreas, spleen, gall bladder and urinary bladder in complete details.

This means you do not have any problems in the above mentioned organs which may be responsible for your pain which is more in left lower abdomen. Keeping this in mind I would like to concentrate on the large bowel, an infection or inflammation of which can cause left lower abdominal pain, below and to the left side of umbilicus. It is important to know if you are having regular constipation. If you are having constipation then it is essential to eat fiber rich diet and avoid processed foods.

Somehow a problem in the large bowel is unlikely to be related to taking late lunches. Food related pain is usually in the left upper or middle portion of abdomen. This can be caused by gastritis or duodenal ulcers. In this condition, you must avoid taking spicy foods and try and have small amounts of food at regular intervals to avoid accumulation of acid in the stomach which can cause pain.

Both the above mentioned situations requires clinical examination by a general surgeon and dietary changes which you can start with right now. If you are having the left upper and middle abdominal pain more felt after taking delayed meals then you must take medications to decrease stomach acid formation, avoid spicy foods and alcohol. Similarly for the left lower pain you need to take fiber rich diet and drink adequate amount of water and fluids for smooth passage of stools.

The general surgeon may decide to do an endoscopy based on clinical examination and location of pain, if felt necessary before giving you medications for your exact problems.

Please feel free to correct any errors in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Most likely gastritis or stomach ulcer

Detailed Answer:
Hi XXXX
Thanks for writing back and clarifying your problem as a left upper abdomen mild irritating pain.

In my opinion, possibility of mild erosive gastritis or an ulcer in the stomach may be considered. The inner lining of stomach cannot be seen on ultrasound scan. To confirm any stomach conditions like erosive gastritis or ulcer, an upper gastrointestinal endoscopy has to be done. In this procedure a small tube is put into the stomach through the mouth and pictures are captured to look for any surface abnormalities within the stomach lumen. This procedure is done by a general surgeon or gastroenterologist.

If confirmed, you may have to take medicines like pantoprazole, ranitidine or omeprazole 30 minutes before food once or twice a day to decrease stomach acid formation. Subsequently please take food which is non spicy. Also you may add a regular serving of curds at lunch. In between lunch and dinner please have light snacks at about 5 pm in evening. Please remember never to skip lunch and avoid alcohol completely.

As for bowel movements i suppose it is not a concern at the moment.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---