Causes of Left Side Abdominal (Stomach) Pain

Finding the Cause of Abdominal Pain

Left side abdominal pain may arise from the internal organs of the gastrointestinal and urinary tract, chest, pelvic cavity, abdominal wall muscles, bones (ribs, spine, pelvis), vessels, nerves or skin. The presence of other signs and symptoms are an important indication of possible causes of left sided abdominal pain and factors that exacerbate or ease the pain are a vital clue to the underlying condition.

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If the pain is of a sudden onset, unbearable and associated with a high fever, dizziness, confusion or a loss of consciousness, immediate medical attention needs to be sought. Take note of whether the pain is related to eating, sleeping, bowel movements, flatulence (passing gas), movement or menstrual cycle in females.

The list of causes of  left side abdominal pain are listed below are arranged in order from the upper abdomen (above the navel) to lower abdomen (below the navel). It is intended to serve as a guide but ultimately a diagnosis by a medical professional is necessary so that the appropriate treatment can be commenced as soon as possible. An abdominal ultrasound, x-ray, CT scan or MRI are often necessary for a definitive diagnosis, along with specialized investigations like a flexible sigmoidoscopy, colonoscopy or double contrast barium enema for gastrointestinal conditions.

UPPER Left Abdominal Pain

Upper left abdominal pain is most often due to a condition afflicting one or more organs or structure in the LUQ (left upper quadrant) of the abdomen. It may also be due to conditions in the thoracic cavity or lower left abdominal area that either refers or radiates to the LUQ. Causes of upper left abdominal pain include:

LARGE INTESTINE

Also known as the large bowel, it is responsible for the final stages of water absorption which leads to the formation of a solid stool from liquid intestinal chyme from the small intestine. It houses a number of species of colonic bacteria which are necessary for normal functioning but can be pathological if there is an overgrowth or pathogenic bacteria replace it. The large intestine includes the cecum (junction between small and large intestine), colon, rectum and anus. Conditions of the large intestine that may cause left side abdominal pain includes :

  • Constipation
  • Volvulus – twisting of the transverse colon around its axis (rare)

ABDOMINAL MUSCLES

The abdominal muscles includes several types of muscles that make up the abdominal wall. It protects the abdominal organs which lacks a skeletal shield like the chest cavity and also plays various roles in movement of the legs and thorax. These muscle also stabilize the trunk during standing, walking and running and are prone to injury. Muscular conditions that may cause abdominal pain includes :

  • Muscle strain
  • Abdominal hernia
  • Strenuous exercise
  • Blow, blunt force trauma
  • Rectus sheath hematoma
  • Abscess in psoas muscle

PANCREAS

The pancreas is a large multipurpose gland which has exocrine functions that affects digestion and endocrine functions which control metabolism. It empties its digestive enzymes (exocrine component) into the duodenum, the first part of the small intestine, along with bile released by the gallbladder. Without these enzymes, the process of digestion is severely hampered. Pancreatic conditions that may cause left side abdominal pain include :

SPLEEN

The spleen is the largest lymph node in the body responsible for filtering blood and removing cellular debris and foreign microorganisms. Although the spleen can be removed without hampering life, it nevertheless plays several important roles in the body. Splenic conditions that may cause left side abdominal pain includes :

  • Splenic infarct
  • Ruptured spleen, often in car accidents
  • Enlarged spleen (splenomegaly) only in cases of massive splenomegaly.

KIDNEYS/URETER

The kidney is responsible for filtering the blood, removing wastes and passing it out in the urine while conserving essential electrolytes and water. It also plays other important roles in regulating several functions in the body that are not associated with urine, like stimulating the production of red blood cells. The kidney is located in the upper part of the abdomen and shielded by the ribcage. Urine from the kidney leads to the bladder via the ureter. Conditions affecting the kidney and/or ureter that may result in left side abdominal pain include :

  • Pyelonephritis – infection of the kidney
  • Glomerulonephritis (kidney inflammation), kidney cyst or tumor
  • Urinary stones

LEFT ADRENAL GLAND

The adrenal gland, also known as the suprarenal gland, is located on the top of the kidney. It has two distinct layers, the medulla and cortex, which secrete various hormones that play important roles in the body.

  • Adrenal adenoma (benign tumor)
  • Adrenal carcinoma also known as adrenocortical carcinoma. (malignant tumor)

LUNGS

The lungs are responsible for gas exchange between the air and blood stream. Although not often considered in abdominal pain, diseases affecting the base of the lung may affect the pleura lining around the lung) and diaphragm (main muscle of respiration) that can lead to pain. The lung itself cannot feel pain unless the surrounding structures are affected. Some conditions of the lung that may cause abdominal pain includes :

  • Pneumonia – usually bacterial or viral
  • Pleuritis – inflammation of the lung membrane
  • Pulmonary embolism – blood clots in the lungs

HEART

The heart is the muscular pump that circulates blood throughout the body. It is situated in the mediastinum, the centrally located cavity between the lungs and is in close proximity to the upper middle abdominal area. It often causes referred pain to the upper abdomen when diseased.

  • Heart attack
  • Angina pectoris – pain behind the breastbone in heart or coronary arteries disease
  • Pericarditis, mycocarditis or endocarditis

Heart diseases are often considered as medical emergencies as the condition can be life-threatening. It should always be suspected when accompanied by symptoms such as pain to the left jaw or arm with dizziness and/or fainting.

DIAPHRAGM

The diaphragm is the largest muscle of respiration and separates the chest cavity from the abdominal cavity. During inspiration it pushes the abdominal contents downwards as the chest cavity expands. On the left side, the most prominent feature is the diaphragmatic opening which allows the esophagus (gullet) to pass to connect with the stomach.

  • Abscess – collection of pus below diaphragm

STOMACH

The stomach is the hollow sac that lies between the end of the esophagus and the first part of the small intestine known as the duodenum. It is prone to various diseases often associated with the corrosive gastric acid that it produces and holds. Some conditions of the stomach that may be responsible for left sided abdominal pain includes :

  • Gastritis
  • Stomach ulcers
  • Hiatal hernia
  • Stomach cancer
  • Stomach polyps – pain is more likely in large masses.

OTHER

LOWER Left Abdominal Pain

Lower left abdominal pain may be due to the organs or structures located in the LLQ (lower left quadrant) of the abdomen. As with upper abdominal pain, the pain may be referred or radiated from other sites. Due to the continuity of the many structures, particularly the gastrointestinal tract, urinary tract and large blood vessels (aorta or inferior vena cava).  The pelvic structures, particularly the ovaries, fallopian tubes and uterus, are common causes of lower left abdominal pain in women.

COLON

The colon is the largest part of the left intestine as described above.

  • Constipation
  • Trapped gas in the colon is more likely to occur in the left part of the transverse colon (splenic flexure syndrome).
  • Irritable bowel syndrome (IBS) is functional disorder particularly of the large intestine characterized by disturbances in bowel habit and intestinal cramps, hence the alternative name spastic colon.
  • Diverticulitis – inflammation of the last part of the colon (sigmoid colon).
  • Diverticulosis – non-inflamed pouches in the colonic wall
  • Clostridium difficile infection after antibiotic treatment
  • Inflammatory bowel disease (IBD): Crohn’s disease or ulcerative colitis
  • Ischemic or microscopic colitis
  • Colorectal polyps, or cancer
  • Volvulus of sigmoid colon

APPENDIX

This is an outpouching of the large intestine which may become obstructed, infected and severely inflamed. Appendicitis usually causes right lower but sometimes left lower abdominal pain.

FEMALE REPRODUCTIVE ORGANS

Various gynecological disorders are a  common cause of lower left abdominal pain in women particularly when associated with ovulation and menstruation (periods). Pregnancy may also account for pain due to the expanding uterus and uterine contractions seen in an otherwise healthy pregnancy.

  • Ovulation (mid-cycle pain, Mittleschmerz)
  • Gonorrhea
  • Twisted or ruptured ovarian cyst
  • Ectopic pregnancy
  • Pelvic Inflammatory Disease (PID)
  • Endometriosis
  • Miscarriage
  • Polycystic ovarian syndrome – PCOS
  • Fibroids

MALE REPRODUCTIVE ORGANS

Pain rarely occurs solely in the left lower abdominal area without pain, swelling or visible lesions in the pelvic area or on the genitalia.

  • Spermatic cord disorders
  • Testes disorders
  • Gonorrhea

ABDOMINAL MEMBRANE (PERITONEUM)

The peritoneum is the membrane that surrounds various abdominal organs, particularly those of the gastrointestinal tract, and encloses it within its own peritoneal cavity in the abdomen. Peritoneal fluid helps to lubricate the organs that are in constant contact with each other.

  • Peritonitis
  • Ascites

ABDOMINAL BLOOD VESSELS

The abdominal blood vessels include the abdominal portion of two of the largest blood vessels in the body – aorta (artery) and inferior vena cava (vein) – that carries blood to and from the heart. It is prone to a number of disorders and diseases which may also include its various branches and tributaries.

  • Aneurysm of abdominal aorta
  • Atherosclerosis or embolism of mesenteric arteries
  • Hereditary angioedema
  • Henoch-Schönlein-purpura

BLOOD

  • Porphyria
  • Sickle Cell Disease

SKIN

Most skin diseases are associated with itching but pain can occur with the following conditions :

  • Herpes zoster (shingles)
  • Dermatitis exacerbated by an infection, abscess formation or tears in the skin.

OTHER

Read detailed articles with causes, symptoms and diagnosis of left upper abdominal pain and left lower abdominal pain.

About Jan Modric (249 Articles)
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  • Hi Sashh. There are so many possible causes of abdominal pain. Usually the cause of pain on its own with no other symptoms is not easy to identify. Further diagnostic investigation like an abdominal ultrasound may be necessary. You should speak to your family doctor. This pain may not be digestive in nature. The kidneys, ureter, bladder, ovaries or fallopian tubes (if you are female) ad so on can call cause lower left abdominal pain. Your doctor will advise you further.

  • Diann H Pounds

    My husband had those same symptoms and guess what it turned out to be his heart, yes that is right, heart, can cause a lot of your symptoms as well. Go get a full evaluation of your whole body don’t rule nothing out unless it has been thoroughly checked, also could be MS as well. They think that my husband has this and has been diagnosed with ulcerative colitis for years and for years they have been treating him for his stomach when the whole time it was his heart. So be very careful. Go be checked further.

  • Hi Diann. Thank you for your input. A diagnosis of ulcerative colitis is not loosely made. It involves investigations like a colonoscopy where specific lesions characteristic of UC are seen and may further be confirmed with histological examination of a sample biopsied at the time of the scope. You are correct that cardiac conditions cause many similar symptoms (although not the diarrhea). Usually a cardiac condition progressively worsens over short periods of time – years, months and sometimes weeks.

    On the other hand UC can cause relatively constant symptoms over long periods of time – years and even decades. What is more likely in your husbands case is that the stomach condition (assuming gastritis or peptic ulcers, and maybe even reflux) is what has closely resembled the heart condition. This is a common error and therefore investigations like an EKG or upper GI endoscope should be done to differentiate between heart and gastroesophageal (food pipe and stomach) conditions. Going with the symptoms alone for the diagnosis is not reliable.

  • David

    Been having severe Pain in lower back area. The pain in unbearable, I have D.D.D. In the same area. My urnine is coming out yellow. Stool is hard and soft at times. I am on morphine have been 14 years. I can barley move without it hurting. Not sure if the pain is from my spine are the area of Kidneys. I can’t afford to go the doctor. What can I do?

  • Marlboro Mann

    In early September, concurrent with my wife’s cancer surgery, I started to feel a sharp pain near my appendix. The pain soon disappeared and reappeared on my left side where it has stayed. Bowl movements were not a problem until I squeezed too hard and the left pain was intense. It soon subsided, but never goes away. Sometimes, it moves to the left kidney area. The last few days I was constipated and could not pass gas which concerned me. Today however I had the runs throughout the day and especially after breakfast and lunch. Anyone have a clue of what is happening to me. Just want to feel normal again. I am 61.

  • lissi

    Hello,
    I had a ruptured appendix back in 10/2012 and became pregnant immediately (thank you antibiotics:) which led to a planned caesarian in July. Now I have had, understandably so, a lot of pain in my lower abdomen, it feels like it never healed right , cause it probably didn’t. I didn’t have a maid of nanny or money to take off work . I also got a hernia from my navel laparoscopy cut. Which hurt like an itch when I was pregnant for sure.
    Anyhow, what has been odd is that following the appendectomy, my upper left side (literally side) right below my ribcage started hurting, even more so with gas ( which I rarely had before the appendectomy) which had become frequent or when I needed to have a bowel movement evacuation :). It still hurts and rumbles pretty much only there and has gotten worse and more swollen as of late. I never did get the hernia removed, another surgery I don’t have time for . But is this a common pain with appendectomies? Cause I haven’t really found someone with this exact type of pain with either appendectomy or hernia. And since I have Medicaid the surgeon , and many other doctors , act like jerks and insinuate that I’m a backwoods idiot (I’m from the frontwoods, darnit ;). People in my family get weird diseases and have died from them cause of misdiagnosis. I would appreciate your opinion and take it to my doctor, if I should push for it or not. Thanks so super much! Have a great day:)

  • Betty

    Hi, I have had some pain in my left side between rib cage and ovary for about two years now. It seems to bother me more after I eat. If I twist or jerk back suddenly it feels like a pulling or tearing pain. I am usually constipated, and after I eat I have a lot of bloating, so much that I will look like I’m six months pregnant. I had a ultrasound on my organs because my doctor wanted to check my pancreas, everything came back normal on my organs and the pancreatic blood work. I don’t know if this is related to any of it, but I have extremely bad reflux, it doesn’t matter if I eat or I don’t. If anyone has any idea what this could be, I would be so grateful to find out. Thank you, Betty

  • Irfan Aziz

    Dear Sufferer,
    I too have the same story like yours to tell. Exactly in the same pattern. Now it has been last 8 months since the first episode. Doctors say its IBS and Dyspesia. But i got it worse after Upper endoscopy. Now its constant for last six months. I went to a number of doctors but they had no solution for this except prescribing anti depression drugs. But what i believe is that it happened and increased in strength due to upper endoscopy. Number two the drugs that the doctors have been trying on us may have disturbed our natural functioning of stomach or intestines. If doctors say that every test( CT abdomen, USG abdomen, endoscopy etc in my case) is normal then why to experiment on us by prescribing ineffective drugs. Some dacks back i went to other GE he advised me to go through coloncopy but i am afraid to go through that procedure. Out of 6 GEs only one advised for colonoscopy. Rest say that there is no need of this procedure. Now what i conclude is that to manage with this and not to consult any more doctors. Rest is in the hands of Almighty God. May God cure us and keep us away from all unknown and kniwn agonies.

  • Laura

    Other causes of kidney pain: cysts (polycystic kidney) and hydronephrosis (as in obstructive pubic junction)

  • AndreaP.

    I am a 44 year old female in otherwise good health but have had constant pain on my left side abdomen sometimes under my left rib sometimes to the left of my belly button and now also near my left groin. Sometimes it’s cramps sometimes it’s bad pain. It’s literally been every day for 2 years. It started about 3 weeks before the onset of shingles (on my left torso and left arm) and has never gone away. Does seem to be affected by food and bowel movements. Definite bloating only on left side. Bloating is constant and never goes away. Like I can’t suck in my stomach in that side. No tenderness. Bloating there even when bowels empty. Had a colonoscopy and CT scan with contrast which both were clear. Doc says IBS but pain Every day? Starting to wonder if I have some sort of nerve damage on the inside? Is that possible? I assume if it were my pancreas it would show up on the CT? Or possibly is it an ulcer? Help!

  • David James

    I have had left sided upper pain for the last 4 months. The pain is down the left side of my body between the bottom 2 ribs and down the front left under my left breast under the rib cage. The pain is fairly constant, it can be sharp or dull. I’ve had an ultrasound, chest x Ray, bloods, urine test, stool sample test, ECG all have came back fine. We tired an upper Endoscopy under sedation but I couldn’t get the pipe down without gagging so currently awaiting an Endoscopy under a general. I have no other symptoms apart from this pain, no nausea, no toilets problems. What could this be?

  • Hamza

    I got a pain I had this stomach infection took pills course but still the same or worst I got even acid reflux so my throat it’s a mess and I smoke since I’m 12 I’m 28 now my I’m 1.70cm tall and 50kgs ate a sandwich like ok went in on the halal salami and I do abuse of mayonnaise I feel like I ate a whole chicken no I’m lying I had a whole chicken before and I felt just about the same if not less bloated as I’m feeling now I constantly feel the need to burp and like if I had something about to come up and everytime I eat I end up in the toilet trying to cough out like if something was stake there even a grain of rice in my throat feels like a big bean, I’m so scared because that bacteria can lid to cancer, I look like those people that Starves and end up with a big belly only difference is that I got definition not like flat arms and even if I pull my belly in you can see I got six pack I can’t even train because I feel like I’m gonna puke my stomach out even if I eat I’m really upset because I used to play football and now I don’t think I will be able because even when I run or jerck my body it really hurts sometime feels like I just got stabbed there the bigging of my stomach that soft space in your ribs it’s a 20 out 10 pain I never felt such pain anywhere I broken my tooth I blown a vain in my uncle before I dropped side way in concrete stand hit my rib cage dropped of a wardrobe when was a kid hit the bottom rib on the conner of the wardrobe and still none of that was worst than this two pains and I’m used to pain I got back pain since I remember head ache 10/10 as well I couldn’t open my eyes but thank God only happened three or two times there’s is just mild head ache

  • shannon

    Andrea,
    this is exactly what I have. I had shingles 3 years ago on my back left side. I have had pain under my left ribs and down my left side ever since. I have had tests done…nothing. I keep telling the doctor it has something to do with my shingles but looks at me like I am crazy. I have become very depressed over this and feel like I am dying some type of slow death. Have you found out any more answers to your symptoms?

  • David112358

    I have been having a sharp occasional (yet several times a day) pain just left of my Belly button and the pain doesn’t get worse with any type of food or drink. However because of the pain I was worried since it didn’t go away after a week,and the left area of My abdominal muscles are tighter. I had a sonogram done and the test were all clear. They told me it could be stress could someone explain how this would be the case?

  • Hi David. That is a good question. The exact way stress could cause such an isolated area of pain and abdominal tightness is not clear. We assume they meant psycological stress. Some people do experience abdominal pain with stress though just as headaches are common with stress.

    However, it is important to remember that there are flat sheets of muscle on the abdominal wall. An area of this muscle could go into spasm, as would a muscle anywhere on the body. On the surface it would feel tight or like a tiny lump and it would be painful. This could be caused by physical exertion. May be a good idea to follow up with your doctor if it persists.

  • Hi Bella. Your medical history is complex and a number of conditions could be contributing to the bowel symptoms that you are experiencing. IBS should only be diagnosed once all other possible causes have been excluded. For this reason it is always advisable to follow up with a gastroenterologist if your symptoms are persisting and the current treatment (or lack thereof in your case) is not providing any relief. Fortunately you are following up with the other surgeons in the coming weeks and it would be highly advisable that you disclose your possible IBS symptoms to them. They may be able to shed more light on the matter given that they are familiar with your medical history.