In the gynecology clinic, patients often complain of left lower abdominal pain, which accounts for about 5% to 10% of the outpatient population, with recurrent episodes and a long duration of more than 20 years. When they go to other hospitals, they are often diagnosed as having adnexitis, and thus are repeatedly treated with antibiotics and anti-inflammatory therapy. However, the efficacy is not satisfactory, and some patients seek herbal treatment, but the results are not satisfactory either. Chronic left lower abdominal pain plagues many female patients, and a friend of mine from school told me that this lower abdominal pain has almost always caused her to have psychosomatic problems.
All gynecological procedures in our hospital gynecology department are usually done under laparoscopy and hysteroscopy. During gynecologic laparoscopic surgery, we find many patients with sigmoid colon adhesions in the left lower abdomen, accounting for more than 30% of the total number of patients operated on. We usually use scissors to completely separate the sigmoid adhesions. Then, two days after the surgery, we ask these patients whether they had chronic lower abdominal pain and history of constipation before, and about 2/3 of them told us that they did have chronic left lower abdominal pain, especially those with serious adhesions, and almost every one of them had similar history. And about 70% of the patients had a history of constipation.
The sigmoid colon is located in the lower left abdomen, below which is connected to the rectum, where the body retains feces, and physiologically its lower side is connected to the posterior abdominal wall through the mesentery, while the other three sides are suspended. In people with a thin abdominal wall, they sometimes feel a long lump on the left side of the wall, with pressure pain, which is relieved after a bowel movement.
Therefore, when I encounter a patient with chronic lower left abdominal pain in the clinic, the first consideration is sigmoid adhesions. Many patients tell me that no doctor has ever told her this diagnosis before, and that they are usually diagnosed with adnexitis.
In fact, adnexitis is rarely isolated. Usually, when pelvic inflammatory disease progresses to adnexitis, the uterus is always infected first, which results in persistent pain in the lower abdomen proper, purulent leukorrhea and even fever. It makes no sense for the bacteria to cross the uterus indifferently and infect the adnexa directly.
So if you or your friend encounter pain in the lower left abdomen, you can check against it to see if it is sigmoid adhesions.