Hello. Thank you for posting your query at DoctorSpring.com
Left lower quadrant pain can be attributed to a variety of different causes. It can be related to the digestive tract, the urinary tract, problems with the left kidney, reproductive tract, problems with the body wall (e.t.c )
Since it is not a severe pain, the serious causes such as rupture of an ovarian cyst, or PID can be ruled out. Even most of the infectious causes such as pyelonephritis can be ruled out in absence of fever. Is there any constipation? Sometimes even bowel obstruction can present with such an acute constant pain that you described.
The things that need to be ruled out in your case will be kidney stones, acute gastroenteritis, inflammatory bowel disease, urinary tract infection, and hernia which you're suspecting. Is there any burning micturition? How are your periods? Are they regular? Is there any menorrhagia?
In case of hernia, there will be a small protrusion on standing down, or coughing and can be felt as a projection in the skin. It will be associated with a dull dragging kind of a pain, but mostly the pain is not constant. Does anyone in the family have a history of hernia? The characteristic part of hernia swellings are that they disappear on laying down immediately and have a positive cough impulse as i mentioned.
It is better to get an ultrasound whole abdomen/ CT abdomen, to rule out the causes i mentioned.
Feel free to discuss further,
Regards.
Patient replied :
Nothing unusual GI-wise, at all. No constipation or diarrhea, no gas, no urge to defecate, no bloating/distention, no nausea, and no food sensitivity. No urinary abnormalities either (e.g., no burning micturition).
Periods are irregular, for the first time ever. I forgot to take my birth control for about a week, about three weeks ago. I haven't had a period in ~2 mos. My last period was light, as it has been since I've been on oral contraceptives.
In regards to hernia, there's no bulging, no physical abnormalities I or my friend can feel, and no tenderness with applied pressure. The pain does not get worse with coughing; it is worse with laughter and with hiccuping, however.
I'm away at veterinary school on St. Kitts for another three weeks, so unfortunately I cannot be an U/S or CT, as medical care on the island is very limited.
Hello. Thank you for the follow up.
In the absence of an ultrasound it is very difficult to make a diagnosis, however with your added history the more serious causes such as PID, or rupture of an ovarian cyst or UTI can be ruled out.
Are you sexually active? Is there any chances of pregnancy? Because sometimes this pain can be attributed to ectopic pregnancy where a women presents with such left lower abdominal pain. If this is ruled out too, then all the serious causes can be ruled out.
It can be a sign before your periods. You may be experiencing period in the next few days. Few other causes that need further investigations are endometriosis, ovarian cyst, and fibroids. It is very difficult to adiagnose these conditions without an ultrasound. I undertand you're away for work, but somehow if you can manage to get back early and get it done it will be helpful in initiating the right treatment.
Till then you can take an anti-inflammatory OTC to rule out some muscular spasm. Take Ibuprofen 400 mg twice daily after food, and see if it relieves the pain.
Feel free tp discuss further,
Regards.
Patient replied :
Nothing unusual GI-wise, at all. No constipation or diarrhea, no gas, no urge to defecate, no bloating/distention, no nausea, and no food sensitivity. No urinary abnormalities either (e.g., no burning micturition).
Periods are irregular, for the first time ever. I forgot to take my birth control for about a week, about three weeks ago. I haven't had a period in ~2 mos. My last period was light, as it has been since I've been on oral contraceptives.
In regards to hernia, there's no bulging, no physical abnormalities I or my friend can feel, and no tenderness with applied pressure. The pain does not get worse with coughing; it is worse with laughter and with hiccuping, however.
I'm away at veterinary school on St. Kitts for another three weeks, so unfortunately I cannot be an U/S or CT, as medical care on the island is very limited.
Hello.
The same follow up question has been put up twice.
Kindly edit the second question so that i can answer to your new query.
Regards.