What causes left lower abdominal pain and a feeling of rectal heaviness, and what should be done about it?
Nov 15, 2025
Source: Cainiu Health
Dr. Li Jingxiang
Introduction
In general, left lower abdominal pain accompanied by anal heaviness may be caused by menstrual pelvic congestion, constipation, ulcerative colitis, left ureteral stones, or pelvic abscess. Patients can choose appropriate management methods such as conservative treatment, medication, or surgical intervention based on their specific conditions. It is important to pay attention to signals from the body and avoid self-enduring symptoms or self-medicating when they occur.
Generally, left lower abdominal pain accompanied by a feeling of rectal heaviness may be caused by pelvic congestion during menstruation, constipation, ulcerative colitis, left ureteral stones, or pelvic abscess. Depending on the specific situation, patients can improve symptoms through general management, medication, or surgical treatment. Detailed analysis is as follows:
1. Pelvic Congestion During Menstruation
Hormonal changes during a woman's menstrual period can cause dilation and congestion of pelvic blood vessels, which may compress the rectum and lead to a sensation of anal heaviness. The vascular congestion can also stimulate the peritoneum, causing dull pain in the left lower abdomen. It is recommended to change sanitary products frequently, avoid prolonged sitting, take appropriate walks to promote blood circulation, and clean the external genital area with warm water for comfort.
2. Constipation
When stool remains in the colon too long, excessive water absorption causes dry, hardened feces to accumulate in the descending or sigmoid colon (located in the lower left abdomen), leading to abdominal pain due to intestinal wall pressure and a sensation of rectal fullness or heaviness. Increase dietary fiber intake by eating more celery, apples, and similar foods, drink sufficient amounts of warm water daily, and develop a regular bowel movement habit.
3. Ulcerative Colitis
Inflammation irritates the intestinal mucosa, causing congestion and erosion. When the colon lining in the left lower abdomen is damaged, it results in abdominal pain, while inflammatory secretions刺激 the rectum and cause a feeling of anal heaviness. This condition is often accompanied by mucus, pus, and bloody stools. Medications such as mesalazine enteric-coated tablets, sulfasalazine enteric-coated tablets, or olsalazine sodium capsules may be taken under medical supervision. Avoid spicy and irritating foods in the diet.
4. Left Ureteral Stones
Stones blocking the left ureter obstruct urine flow, causing ureteral spasms and radiating pain to the left lower abdomen. Irritation of the urinary tract mucosa by the stone may refer discomfort to the anal region. Under medical guidance, medications such as Shenshitong granules, Pashi granules, or diclofenac sodium sustained-release tablets may be used. Drinking plenty of water helps flush out stones; if necessary, ureteroscopic lithotripsy and stone removal may be performed.
5. Pelvic Abscess
An infection within the pelvis forms an abscess, and accumulated pus compresses surrounding tissues, causing persistent left lower abdominal pain. The abscess can also stimulate rectal and perianal nerves, resulting in a sensation of anal heaviness. Treatment includes antibiotics such as cefuroxime axetil tablets, levofloxacin tablets, or clindamycin capsules under medical supervision, along with surgical incision and drainage of the abscess. Wound hygiene should be maintained after surgery.
In daily life, pay attention to signals from your body—do not endure symptoms or self-medicate without consultation. Maintain a regular sleep schedule and avoid staying up late, which weakens immunity. Eat a light, easily digestible diet and reduce consumption of fried and spicy foods. Engage in moderate physical activity to enhance intestinal motility and overall health, and undergo regular check-ups related to the intestines and pelvic organs to ensure early detection and timely intervention.
