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Left Lower Quadrant PainAPPROACH

ABDOMINAL AND GASTROINTESTINAL · 19 SECTIONS

⚲

585 items

☷ Legend

⚲

Resuscitation and Universal Approaches9▾

Chest and Cardiovascular12▾

Respiratory11▾

Abdominal and Gastrointestinal24▾

Abdominal Distension Abdominal Pain, Undifferentiated Acute Abdominal Pain (general)Suspected Incarcerated Or Strangulated Hernia Pancreatitis Concern Biliary Colic And Cholecystitis Concern Appendicitis Concern Diverticulitis Concern Rectal Pain And Anorectal Complaints Dysphagia And Food Bolus Impaction Foreign Body Ingestion Refractory Vomiting And Recurrent Vomiting Syndromes Cannabis Associated Hyperemesis Upper Gastrointestinal Bleeding Symptoms (melena)Lower Gastrointestinal Bleeding And Hematochezia Constipation And Obstipation Diarrhea Acute Hepatitis And Jaundice Concern Right Upper Quadrant Pain Epigastric Pain Left Upper Quadrant Pain Right Lower Quadrant Pain Left Lower Quadrant Pain Suprapubic Pain

Renal and Urinary7▾

Neurologic11▾

Back and Neck8▾

Women's Health, Pregnancy, and GU11▾

Infectious Disease and Fever Syndromes11▾

Allergy and Dermatology7▾

Musculoskeletal and Extremities14▾

Trauma and Wounds14▾

ENT, Eye, Dental10▾

Endocrine, Metabolic, and Abnormal Labs9▾

Toxicology and Behavioral14▾

Pediatrics16▾

Environmental and Exposure4▾

01History/hx91

HPI

›Core features

›Location

›Onset and time course

›Pattern

›Progression

›Prior episodes

›Baseline bowel and urinary patterns

›OPQRST

›Onset

›Sudden

›Gradual

›Maximal at onset

›Provocation and palliation

›Worse with movement

›Worse with cough

›Worse with eating

›Worse with urination

›Worse with bowel movement

›Relief with defecation

›Quality

›Cramping

›Sharp

›Dull

›Colicky waves

›Region and radiation

›Suprapubic

›Flank

02Alarm Features/alarm37

Immediate threats

›Unstable physiology

›SBP < 90 mmHg

›HR > 120 per minute

›RR > 24 per minute

›SpO2 < 92 percent

›Temperature >= 38.5 C

›Peritonitis

›Involuntary guarding

›Rigidity

›Rebound tenderness

›Sepsis concern

›Altered mental status

›Lactate elevation

›Mottling

›Hemorrhage concern

›Syncope

›Pallor

›Ongoing hematochezia

›Vascular emergency concern

›Pulsatile abdominal mass

›Back pain

›Limb ischemia symptoms

High risk populations

›Pregnancy or postpartum

›Any abdominal pain with hypotension

›Any abdominal pain with vaginal bleeding

›Elderly

03Medications/meds23

Current and recent

›Medication list review

›Prescription medications

›OTC medications

›Supplements and herbals

›Recent changes

›New antibiotics

›New NSAIDs

›New anticoagulants

›High risk classes

›NSAIDs

›Anticoagulants

›Antiplatelets

›Steroids

›SGLT2 inhibitors

›Relevant adverse effects

›Constipation from opioids

›C difficile risk after antibiotics

Contraindications and interactions

›Analgesic cautions

›NSAIDs with CKD

›NSAIDs with GI bleeding risk

›Antibiotic cautions

›QT prolongation interactions

›Warfarin interactions

04Diet/diet13

Recent intake and triggers

›Intake pattern

›Poor oral intake

›Inability to tolerate fluids

›Hydration indicators

›Decreased urine output

›Orthostasis symptoms

›Potential triggers

›High fat meal association

›High fiber change

›Dairy exposure

›Substance exposures

›Alcohol recent use

›Caffeine or energy drinks

05Review of Systems/ros27

GI and GU

›GI

›Constipation

›Diarrhea

›Tenesmus

›Hematochezia

›Melena

›Bloating

›GU

›Dysuria

›Hematuria

›Frequency

›Urgency

›Gynecologic

›Vaginal bleeding

›Vaginal discharge

›Dyspareunia

Systemic and other

›Infectious and inflammatory

›Fever

›Chills

›Myalgias

›Cardiopulmonary

›Chest pain

›Dyspnea

›Palpitations

›Neurologic

›Syncope

06Collateral History and Family History/chafh13

Collateral and reliability

›Source and reliability

›Family or caregiver input

›EMS report

›Baseline function

›Baseline cognition

›Baseline mobility

Family history

›GI and vascular

›Colorectal cancer (C18 to C20)

›Inflammatory bowel disease

›Abdominal aortic aneurysm

›Renal and stones

›Nephrolithiasis

›Polycystic kidney disease (Q61.2)

07Risk Factors/rf30

Infection and inflammation

›Diverticulitis risk

›Prior diverticulosis

›Prior diverticulitis episodes

›C difficile risk

›Antibiotics within 8 weeks

›Recent hospitalization

Vascular and bleeding

›Ischemic colitis risk

›Atherosclerotic disease

›Hypotension episodes

›Vasoconstrictive drugs

›AAA rupture risk

›Known AAA

›Smoking history

›Male sex

›Age > 65 years

›Bleeding risk

›Anticoagulant use

›Thrombocytopenia history

GU and gynecologic

›Nephrolithiasis risk

›Prior stones

›Dehydration

›Ectopic pregnancy risk

›Prior ectopic pregnancy

›Prior tubal surgery

›PID history

08Differential Diagnosis/ddx65

Life threatening

›AAA leak or rupture (I71.4)

›Sudden abdominal or back pain

›Hypotension or syncope

›Pulsatile mass sometimes absent

›Mesenteric ischemia

›Pain out of proportion

›Metabolic acidosis

›Elevated lactate late

›Ischemic colitis (K55.9)

›Crampy abdominal pain

›Hematochezia

›Older age and vascular risk

›Perforated viscus

›Peritonitis

›Free air on imaging

›Ectopic pregnancy (O00.9)

›Positive pregnancy test

›Vaginal bleeding

›Adnexal tenderness

›Ovarian torsion (N83.5)

›Sudden unilateral pelvic pain

›Nausea or vomiting

›Adnexal mass risk

›Strangulated hernia (K40.3 to K46.1)

›Irreducible groin mass

›Obstruction symptoms

›Obstructing ureteral stone with infection

09Past Medical History/pmh22

Relevant conditions

›GI and colorectal

›Diverticulosis

›Prior diverticulitis

›IBD

›Prior colorectal cancer

›Vascular

›Known AAA

›Atrial fibrillation

›Peripheral arterial disease (I73.9)

›Renal and metabolic

›CKD (N18.9)

›Nephrolithiasis

›Gynecologic

›Endometriosis (N80.9)

›Ovarian cysts

Surgeries and devices

›Prior surgery

›Appendectomy

›Hysterectomy

›Bowel resection

›Devices

›IUD

›Vascular graft

10Physical Exam/exam35

General and vitals

›General

›Toxic appearance

›Diaphoresis

›Pallor

›Vitals interpretation

›Fever pattern

›Hypotension

›Tachycardia

›Orthostatic changes

Abdominal and pelvic

›Abdomen

›Focal LLQ tenderness

›Guarding

›Rebound

›Distension

›Bowel sounds abnormal

›Peritoneal signs

›Rigidity

›Pain with percussion

›Hernia exam

›Inguinal mass

›Femoral mass

›Pelvic exam when indicated

›Cervical motion tenderness

›Uterine tenderness

›Adnexal tenderness

11Lab Studies/labs23

Core labs

›Initial set

›CBC

›Electrolytes and creatinine

›Liver enzymes

›Lipase when upper abdominal overlap

›Pregnancy testing

›Urine beta hCG

›Serum beta hCG if urine indeterminate or high suspicion

›Urine studies

›Urinalysis

›Urine culture when infection concern

›Inflammatory and perfusion markers when indicated

›Lactate

›CRP local protocol dependent

Interpretation pearls and limitations

›Diverticulitis

›Leukocytosis not required for diagnosis

›Normal labs do not exclude complicated disease

›Stone disease

›Hematuria may be absent

›Pyuria may reflect inflammation without infection

›Ischemia

›Lactate may be normal early

›Metabolic acidosis late finding

12Imaging/img33

Scoring Systems

›Severity and classification

›Hinchey classification for diverticulitis

›Complicated disease risk stratification

›CT based staging commonly used

›Local protocol dependent pathways

›Observation unit diverticulitis criteria

›Imaging first strategies

MRI

›Indications

›Pregnancy with persistent concern and nondiagnostic ultrasound

›Pelvic pathology characterization

›Limitations

›Limited availability in ED

›Motion artifact with severe pain

›CT abdomen pelvis with IV contrast

›Diverticulitis diagnosis and complications

›Abscess

›Perforation

›Fistula

›CT angiography abdomen pelvis

›Suspected AAA leak or rupture

›Suspected mesenteric ischemia

›Noncontrast CT for suspected stone

›When classic renal colic and pregnancy excluded

›Radiation considerations

13Special Tests/spec15

Bedside maneuvers and focused exams

›Abdominal wall source

›Carnett sign supportive

›Focal superficial tenderness

›Rectal exam when indicated

›Gross blood

›Fecal impaction

›Pelvic testing when indicated

›NAAT for gonorrhea and chlamydia

›Wet mount or vaginitis testing per local protocol

Procedural diagnostics

›Paracentesis when ascites and infection concern

›PMN count

›Culture

›Abscess evaluation

›Image guided drainage consultation triggers

›Blood cultures if sepsis

14ECG/ecg10

When relevant

›Indications

›Hypotension or syncope

›Significant tachycardia

›Chest pain

›High risk findings

›Ischemic changes

›New arrhythmia

›Serial strategy

›Repeat ECG if ongoing instability

›Troponin pathway local protocol dependent

15Assessment/ax30

Working problem list

›LLQ abdominal pain

›Most likely category

›Colonic inflammatory

›Urinary tract

›Gynecologic

›Vascular

›Complications to exclude

›Peritonitis

›Obstruction

›Sepsis

›Hemorrhage

›Diverticulitis suspected (K57.32)

›Uncomplicated features

›Localized tenderness

›Hemodynamic stability

›Complicated features

›Abscess concern

›Perforation concern

›Pregnancy related emergency excluded or pending

›Pregnancy test status

›Ultrasound findings

Risk stratification

›High risk

›Peritonitis

›Sepsis physiology

›Immunocompromised

›Unable to tolerate oral intake

16Plan/plan58

Differential Management

›!Diverticulitis→›!Ovarian torsion→›Ectopic pregnancy→

First 5 minutes

›Time critical workflow

›Monitor

›Cardiac monitoring if unstable

›SpO2 monitoring

›IV access

›Two large bore IVs if hypotension or bleeding concern

›One IV if stable

›Fluids

›Crystalloid bolus 10 to 20 mL per kg if hypotension

›Reassess after each bolus

›Analgesia early

›IV option if severe pain

›Oral option if mild pain

›Immediate consult triggers

›Surgery for peritonitis or perforation concern

›Vascular surgery for suspected AAA

›OB GYN for suspected ectopic or torsion

Symptom control

›Analgesia

›Acetaminophen PO 1000 mg once

›Ibuprofen PO 400 mg once

›Ketorolac IV 15 mg once

›Morphine IV 0.05 mg per kg once

17Disposition/dispo24

Admission and higher level care

›ICU level care

›Ongoing hypotension after fluids

›Vasopressor requirement

›Lactate rising with sepsis

›Inpatient admission

›Complicated diverticulitis

›Abscess

›Perforation

›Significant leukocytosis with systemic toxicity

›Immunocompromised

›Unable to tolerate oral intake

›Observation pathway local protocol dependent

›Moderate pain requiring repeated IV analgesia

›Borderline oral tolerance

Discharge criteria and follow up

›Discharge criteria

›Hemodynamic stability

›Pain controlled with oral medications

›Tolerating oral fluids

›No peritonitis

›Reliable follow up

›Follow up timing

›Primary care within 48 to 72 hours

›GI or surgery follow up if diverticulitis recurrence

›Colonoscopy timing post diverticulitis local protocol dependent

18Discharge Instructions/di29

Copy discharge instructions

›Summary

›Seen for left lower abdominal pain

›Most likely cause

›Serious causes were checked for today

›Medications

›Take pain medicine as prescribed

›Avoid NSAIDs if told you have kidney disease or stomach bleeding risk

›If antibiotics prescribed take as directed and finish the course

›Diet and fluids

›Drink fluids to keep urine light yellow

›Eat small meals as tolerated

›Activity

›Avoid heavy lifting until improving

›Rest as needed

›Follow up

›Follow up with your clinician within 2 to 3 days

›Return for reassessment if symptoms not improving within 24 to 48 hours

›Return to ED now for

›Fainting

›Trouble breathing

›New chest pain

›Worsening abdominal pain

›New severe back pain

›Fever

›Repeated vomiting

›Blood in stool

›Black stools

19References/r7

Guidelines and evidence

›Core references

›American College of Radiology Appropriateness Criteria Left Lower Quadrant Pain 2023

›World Society of Emergency Surgery guidelines for acute colonic diverticulitis 2020

›American Gastroenterological Association Clinical Practice Update on diverticulitis 2021

›Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines PID 2021

›Society for Vascular Surgery practice guidelines for abdominal aortic aneurysm management 2018

›Project instructions file

Evidence & Review

Reviewed by SymptomDx Medical Team · Last reviewed February 24, 2026

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.

Left Lower Quadrant PainAPPROACH

ABDOMINAL AND GASTROINTESTINAL · 19 SECTIONS

⚲

585 items

☷ Legend

⚲

Resuscitation and Universal Approaches9▾

Chest and Cardiovascular12▾

Respiratory11▾

Abdominal and Gastrointestinal24▾

Renal and Urinary7▾

Neurologic11▾

Back and Neck8▾

Women's Health, Pregnancy, and GU11▾

Infectious Disease and Fever Syndromes11▾

Allergy and Dermatology7▾

Musculoskeletal and Extremities14▾

Trauma and Wounds14▾

ENT, Eye, Dental10▾

Endocrine, Metabolic, and Abnormal Labs9▾

Toxicology and Behavioral14▾

Pediatrics16▾

Environmental and Exposure4▾

01History/hx91

HPI

›Core features

›Location

›Onset and time course

›Pattern

›Progression

›Prior episodes

›Baseline bowel and urinary patterns

›OPQRST

›Onset

›Sudden

›Gradual

›Maximal at onset

›Provocation and palliation

›Worse with movement

›Worse with cough

›Worse with eating

›Worse with urination

›Worse with bowel movement

›Relief with defecation

›Quality

›Cramping

›Sharp

›Dull

›Colicky waves

›Region and radiation

›Suprapubic

›Flank

02Alarm Features/alarm37

Immediate threats

›Unstable physiology

›SBP < 90 mmHg

›HR > 120 per minute

›RR > 24 per minute

›SpO2 < 92 percent

›Temperature >= 38.5 C

›Peritonitis

›Involuntary guarding

›Rigidity

›Rebound tenderness

›Sepsis concern

›Altered mental status

›Lactate elevation

›Mottling

›Hemorrhage concern

›Syncope

›Pallor

›Ongoing hematochezia

›Vascular emergency concern

›Pulsatile abdominal mass

›Back pain

›Limb ischemia symptoms

High risk populations

›Pregnancy or postpartum

›Any abdominal pain with hypotension

›Any abdominal pain with vaginal bleeding

›Elderly

03Medications/meds23

Current and recent

›Medication list review

›Prescription medications

›OTC medications

›Supplements and herbals

›Recent changes

›New antibiotics

›New NSAIDs

›New anticoagulants

›High risk classes

›NSAIDs

›Anticoagulants

›Antiplatelets

›Steroids

›SGLT2 inhibitors

›Relevant adverse effects

›Constipation from opioids

›C difficile risk after antibiotics

Contraindications and interactions

›Analgesic cautions

›NSAIDs with CKD

›NSAIDs with GI bleeding risk

›Antibiotic cautions

›QT prolongation interactions

›Warfarin interactions

04Diet/diet13

Recent intake and triggers

›Intake pattern

›Poor oral intake

›Inability to tolerate fluids

›Hydration indicators

›Decreased urine output

›Orthostasis symptoms

›Potential triggers

›High fat meal association

›High fiber change

›Dairy exposure

›Substance exposures

›Alcohol recent use

›Caffeine or energy drinks

05Review of Systems/ros27

GI and GU

›GI

›Constipation

›Diarrhea

›Tenesmus

›Hematochezia

›Melena

›Bloating

›GU

›Dysuria

›Hematuria

›Frequency

›Urgency

›Gynecologic

›Vaginal bleeding

›Vaginal discharge

›Dyspareunia

Systemic and other

›Infectious and inflammatory

›Fever

›Chills

›Myalgias

›Cardiopulmonary

›Chest pain

›Dyspnea

›Palpitations

›Neurologic

›Syncope

06Collateral History and Family History/chafh13

Collateral and reliability

›Source and reliability

›Family or caregiver input

›EMS report

›Baseline function

›Baseline cognition

›Baseline mobility

Family history

›GI and vascular

›Colorectal cancer (C18 to C20)

›Inflammatory bowel disease

›Abdominal aortic aneurysm

›Renal and stones

›Nephrolithiasis

›Polycystic kidney disease (Q61.2)

07Risk Factors/rf30

Infection and inflammation

›Diverticulitis risk

›Prior diverticulosis

›Prior diverticulitis episodes

›C difficile risk

›Antibiotics within 8 weeks

›Recent hospitalization

Vascular and bleeding

›Ischemic colitis risk

›Atherosclerotic disease

›Hypotension episodes

›Vasoconstrictive drugs

›AAA rupture risk

›Known AAA

›Smoking history

›Male sex

›Age > 65 years

›Bleeding risk

›Anticoagulant use

›Thrombocytopenia history

GU and gynecologic

›Nephrolithiasis risk

›Prior stones

›Dehydration

›Ectopic pregnancy risk

›Prior ectopic pregnancy

›Prior tubal surgery

›PID history

08Differential Diagnosis/ddx65

Life threatening

›AAA leak or rupture (I71.4)

›Sudden abdominal or back pain

›Hypotension or syncope

›Pulsatile mass sometimes absent

›Mesenteric ischemia

›Pain out of proportion

›Metabolic acidosis

›Elevated lactate late

›Ischemic colitis (K55.9)

›Crampy abdominal pain

›Hematochezia

›Older age and vascular risk

›Perforated viscus

›Peritonitis

›Free air on imaging

›Ectopic pregnancy (O00.9)

›Positive pregnancy test

›Vaginal bleeding

›Adnexal tenderness

›Ovarian torsion (N83.5)

›Sudden unilateral pelvic pain

›Nausea or vomiting

›Adnexal mass risk

›Strangulated hernia (K40.3 to K46.1)

›Irreducible groin mass

›Obstruction symptoms

›Obstructing ureteral stone with infection

09Past Medical History/pmh22

Relevant conditions

›GI and colorectal

›Diverticulosis

›Prior diverticulitis

›IBD

›Prior colorectal cancer

›Vascular

›Known AAA

›Atrial fibrillation

›Peripheral arterial disease (I73.9)

›Renal and metabolic

›CKD (N18.9)

›Nephrolithiasis

›Gynecologic

›Endometriosis (N80.9)

›Ovarian cysts

Surgeries and devices

›Prior surgery

›Appendectomy

›Hysterectomy

›Bowel resection

›Devices

›IUD

›Vascular graft

10Physical Exam/exam35

General and vitals

›General

›Toxic appearance

›Diaphoresis

›Pallor

›Vitals interpretation

›Fever pattern

›Hypotension

›Tachycardia

›Orthostatic changes

Abdominal and pelvic

›Abdomen

›Focal LLQ tenderness

›Guarding

›Rebound

›Distension

›Bowel sounds abnormal

›Peritoneal signs

›Rigidity

›Pain with percussion

›Hernia exam

›Inguinal mass

›Femoral mass

›Pelvic exam when indicated

›Cervical motion tenderness

›Uterine tenderness

›Adnexal tenderness

11Lab Studies/labs23

Core labs

›Initial set

›CBC

›Electrolytes and creatinine

›Liver enzymes

›Lipase when upper abdominal overlap

›Pregnancy testing

›Urine beta hCG

›Serum beta hCG if urine indeterminate or high suspicion

›Urine studies

›Urinalysis

›Urine culture when infection concern

›Inflammatory and perfusion markers when indicated

›Lactate

›CRP local protocol dependent

Interpretation pearls and limitations

›Diverticulitis

›Leukocytosis not required for diagnosis

›Normal labs do not exclude complicated disease

›Stone disease

›Hematuria may be absent

›Pyuria may reflect inflammation without infection

›Ischemia

›Lactate may be normal early

›Metabolic acidosis late finding

12Imaging/img33

Scoring Systems

›Severity and classification

›Hinchey classification for diverticulitis

›Complicated disease risk stratification

›CT based staging commonly used

›Local protocol dependent pathways

›Observation unit diverticulitis criteria

›Imaging first strategies

MRI

›Indications

›Pregnancy with persistent concern and nondiagnostic ultrasound

›Pelvic pathology characterization

›Limitations

›Limited availability in ED

›Motion artifact with severe pain

›CT abdomen pelvis with IV contrast

›Diverticulitis diagnosis and complications

›Abscess

›Perforation

›Fistula

›CT angiography abdomen pelvis

›Suspected AAA leak or rupture

›Suspected mesenteric ischemia

›Noncontrast CT for suspected stone

›When classic renal colic and pregnancy excluded

›Radiation considerations

13Special Tests/spec15

Bedside maneuvers and focused exams

›Abdominal wall source

›Carnett sign supportive

›Focal superficial tenderness

›Rectal exam when indicated

›Gross blood

›Fecal impaction

›Pelvic testing when indicated

›NAAT for gonorrhea and chlamydia

›Wet mount or vaginitis testing per local protocol

Procedural diagnostics

›Paracentesis when ascites and infection concern

›PMN count

›Culture

›Abscess evaluation

›Image guided drainage consultation triggers

›Blood cultures if sepsis

14ECG/ecg10

When relevant

›Indications

›Hypotension or syncope

›Significant tachycardia

›Chest pain

›High risk findings

›Ischemic changes

›New arrhythmia

›Serial strategy

›Repeat ECG if ongoing instability

›Troponin pathway local protocol dependent

15Assessment/ax30

Working problem list

›LLQ abdominal pain

›Most likely category

›Colonic inflammatory

›Urinary tract

›Gynecologic

›Vascular

›Complications to exclude

›Peritonitis

›Obstruction

›Sepsis

›Hemorrhage

›Diverticulitis suspected (K57.32)

›Uncomplicated features

›Localized tenderness

›Hemodynamic stability

›Complicated features

›Abscess concern

›Perforation concern

›Pregnancy related emergency excluded or pending

›Pregnancy test status

›Ultrasound findings

Risk stratification

›High risk

›Peritonitis

›Sepsis physiology

›Immunocompromised

›Unable to tolerate oral intake

16Plan/plan58

Differential Management

›!Diverticulitis→›!Ovarian torsion→›Ectopic pregnancy→

First 5 minutes

›Time critical workflow

›Monitor

›Cardiac monitoring if unstable

›SpO2 monitoring

›IV access

›Two large bore IVs if hypotension or bleeding concern

›One IV if stable

›Fluids

›Crystalloid bolus 10 to 20 mL per kg if hypotension

›Reassess after each bolus

›Analgesia early

›IV option if severe pain

›Oral option if mild pain

›Immediate consult triggers

›Surgery for peritonitis or perforation concern

›Vascular surgery for suspected AAA

›OB GYN for suspected ectopic or torsion

Symptom control

›Analgesia

›Acetaminophen PO 1000 mg once

›Ibuprofen PO 400 mg once

›Ketorolac IV 15 mg once

›Morphine IV 0.05 mg per kg once

17Disposition/dispo24

Admission and higher level care

›ICU level care

›Ongoing hypotension after fluids

›Vasopressor requirement

›Lactate rising with sepsis

›Inpatient admission

›Complicated diverticulitis

›Abscess

›Perforation

›Significant leukocytosis with systemic toxicity

›Immunocompromised

›Unable to tolerate oral intake

›Observation pathway local protocol dependent

›Moderate pain requiring repeated IV analgesia

›Borderline oral tolerance

Discharge criteria and follow up

›Discharge criteria

›Hemodynamic stability

›Pain controlled with oral medications

›Tolerating oral fluids

›No peritonitis

›Reliable follow up

›Follow up timing

›Primary care within 48 to 72 hours

›GI or surgery follow up if diverticulitis recurrence

›Colonoscopy timing post diverticulitis local protocol dependent

18Discharge Instructions/di29

Copy discharge instructions

›Summary

›Seen for left lower abdominal pain

›Most likely cause

›Serious causes were checked for today

›Medications

›Take pain medicine as prescribed

›Avoid NSAIDs if told you have kidney disease or stomach bleeding risk

›If antibiotics prescribed take as directed and finish the course

›Diet and fluids

›Drink fluids to keep urine light yellow

›Eat small meals as tolerated

›Activity

›Avoid heavy lifting until improving

›Rest as needed

›Follow up

›Follow up with your clinician within 2 to 3 days

›Return for reassessment if symptoms not improving within 24 to 48 hours

›Return to ED now for

›Fainting

›Trouble breathing

›New chest pain

›Worsening abdominal pain

›New severe back pain

›Fever

›Repeated vomiting

›Blood in stool

›Black stools

19References/r7

Guidelines and evidence

›Core references

›American College of Radiology Appropriateness Criteria Left Lower Quadrant Pain 2023

›World Society of Emergency Surgery guidelines for acute colonic diverticulitis 2020

›American Gastroenterological Association Clinical Practice Update on diverticulitis 2021

›Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines PID 2021

›Society for Vascular Surgery practice guidelines for abdominal aortic aneurysm management 2018

›Project instructions file

Evidence & Review

Reviewed by SymptomDx Medical Team · Last reviewed February 24, 2026

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