Lower abdominal pain syndrome

The lower abdominal syndrome can be divided:


 * Painful right lower abdomen syndrome.
 * Lower left abdominal pain syndrom

The pain in the lower left abdomen can have several causes. It depends on the body structures that project into this area.

1. Left-sided renal colic
Renal colic

2. Bowel obstruction, ileus

 * Often caused by rectosigma cancer, which is found in elderly patients with a long history of digestive problems (constipation, alternation of constipation with diarrhea, enterorrhea).
 * Clinical picture: sudden pain in the left lower abdomen with bloating, lack of flatulence and bowel movement, vomiting missing or late, palpable tumor may be present
 * Dg.: X-ray native standing (ileose image), event. short colonoscopy after barium enema.

3. Ulcerative colitis

 * The disease is often known from a personal history, also IBD(Inflammatory Bowel Disease) in the family history.
 * Pain occurs during exacerbation of inflammation and perforation of ulcers (with subsequent limited or diffuse peritonitis).
 * Clinical picture: acute pain in the left lower abdomen with diarrhea with blood and mucus

4. Diverticular Disease (diverticulitis)

 * Clinical picture:
 * Typical are colic-like pains in the left lower abdomen, caused by spasms of the colon muscle or actual obstruction, or perforation of an inflamed diverticulum with peritonitis.
 * There are bloody diarrhea with mucus, fever and high CRP. Diagnosis: colonoscopy, but up to 6-8 weeks after inflammation has subsided.


 * Therapy:
 * uncomplicated diverticulitis is treated with a diet (residue-free diet), i.v. administration of antibiotics (e.g. Amoxiclav i.v. + Entizol supp.)
 * complications are solved surgically (diverticulum perforation, ileus)

5. Other causes

 * Left-sided appendicitis
 * Adnexitis
 * Ectopic pregnancy

Related articles

 * Syndrome of the Epigastrium
 * Painful right lower abdomen syndrome.