OpenHealth Q&A

Creative Insights on Potential Causes of Lower Left Abdominal Discomfort

I'm a 28-year-old woman experiencing unexpected discomfort in my lower left abdomen for the past fortnight. After consulting with three different emergency department doctors, we haven’t pinpointed the underlying cause. I figured I would reach out for your input on possible reasons that I could discuss with my physician. If you have any thoughts at all, please share them in the comments—this has been quite perplexing! ### Patient Background - Slightly overweight - Works in an office; doesn’t engage in heavy lifting - Currently taking Luvox, Nexium, and has an Implanon implant - Has not experienced a menstrual period in about three years (details are a bit hazy) - Sexually active (not at the moment due to pain; what a disappointment!) - Diagnosed with a hypermobility condition, experiences frequent sprains and muscle pulls, with physiotherapy noting a “skeleton-less muscle system.” ### Description of the Pain - Pain is primarily localized in the lower left abdomen, beneath the navel, and can radiate towards the uterus occasionally. - The intensity varies; during strict bed rest, it hovers around a 1 or 2, but with any movement, it can escalate to a 7. Some episodes are triggered by activity while others emerge spontaneously. - Prolonged sitting or standing is difficult. - During these episodes, I experience cramping, heat sensation, swelling, a dull ache, and a need to curl into a fetal position to find relief, often feeling clammy and sweaty. - When not in an episode, the pain is consistently dull, sensitive to pressure, and mildly aggravated when touched, but not overly painful when left alone. - The discomfort also radiates slightly into the lower back, although the focal point is definitely in the front. ### Additional Symptoms - Experiencing constipation, possibly linked to pain medication. - Analyses reveal a minimal presence of white blood cells in urine, too few to confirm a urinary tract infection. ### Investigations Conducted - Blood tests returned normal except for low levels of vitamin B12 and vitamin D. - Urinalysis showed few white blood cells but was otherwise clear. - An ultrasound of the upper abdomen (including spleen, liver, kidneys, gallbladder, and pancreas) yielded normal results. - A cervical STI swab produced negative results. - A CT scan identified a unicornate uterus with a rudimentary left horn, a hiatal hernia, and a benign issue with my right lung (a mild inflation problem; not sure of the precise terminology). Everything else appeared normal. - Awaiting results from a transvaginal ultrasound; the technician didn’t identify any alarming concerns during the procedure, but we’re still uncertain about whether my uterus may be contributing to the issue. ### Pain Relief Strategies - The most effective relief has come from strict bed rest, though the discomfort inevitably returns even after an extended period of lying down. - Codeine and paracetamol provided some relief but not enough to alleviate the pain entirely. - Utilizing muscle gels, ibuprofen, and magnesium has been somewhat better, yet not sufficient for me to resume daily activities. I would greatly appreciate any unconventional suggestions! I remember a time before this pain took over, and I am eager to reclaim some semblance of normalcy in my life.

Answers (1)

8/28/2025, 12:44:18 AM

OpenHealth AI

It sounds like you are experiencing significant abdominal discomfort that has persisted for two weeks, and it’s completely understandable to feel perplexed given the complexity of your situation. Numerous factors could contribute to your symptoms, especially considering your medical history and the recent investigations you've undergone.

Possible Causes

Based on your description, several potential causes could be considered for your lower left abdominal discomfort:

1. Musculoskeletal Issues: Given your hypermobility condition and history of sprains, the pain may be related to muscle strain or dysfunction in the abdominal or pelvic region. Muscles or ligaments around the abdomen can cause pain that mimics organ pain.

2. Uterine Anomalies: Your presence of a unicornate uterus with a rudimentary left horn may lead to complications such as pain during the menstrual cycle or even during ovulation if any endometrial tissue is present in the rudimentary horn.

3. Gastrointestinal Factors: Chronic constipation or issues with gut motility might contribute to discomfort. The connection between gastrointestinal function and pain can sometimes be overlooked.

4. Nerve Compression or Irritation: Sometimes, nerve issues in the lower back can manifest as abdominal pain, especially with movement or prolonged activity.

5. Intra-abdominal Processes: Rarely, issues like an ectopic configuration of the rudimentary horn or other intra-abdominal conditions could lead to referred pain, though current imaging has not indicated significant abnormalities.

Next Steps

To address your situation, prioritize the following:

1. Symptom Diary: Keep a detailed log of your symptoms, noting when they occur, their intensity, and any activities that seem to trigger or alleviate the pain. Share this with your healthcare provider to aid in diagnosis.

2. Pain Management Strategies:

   • Continue your current medication regimen as prescribed, but follow up with your physician about adjusting dosages or types.
   • Discuss the timing of your pain in relation to your activity levels or any dietary contributions (like fiber intake).

3. Gentle Movement: While bed rest can provide temporary relief, consider gentle stretching or physiotherapy tailored to your hypermobility and abdominal muscles. Experience shows that low-impact exercises can sometimes help alleviate chronic pain by improving muscle strength and flexibility.

4. Follow Up on Test Results: Monitor the results from your transvaginal ultrasound closely, especially concerning any findings about the rudimentary horn of your uterus.

5. Nutrition and Supplements: Consider dietary adjustments to help with constipation, such as increasing fiber, staying well-hydrated, and reviewing the impact of any pain medications on your digestive system.

6. Alternative Therapies: Explore complementary pain management options such as acupuncture or mindfulness practices which may assist in managing chronic pain.

Seeking a collaborative approach with your healthcare provider where you can discuss these potential underlying causes and next steps may help guide your journey toward relief. It’s understandable to miss feeling like your usual self, so pursuing these actionable steps should be constructive. Please feel free to reach out if you have any more questions or need further clarity on any of these suggestions.