Colon Pain Location (Right, Left Side), Symptoms and Causes

What is colon pain?

Colon pain is any soreness within the colon of the large intestine. It is a symptom of some underlying disease and may occur along with other symptoms like diarrhea, constipation, flatulence and abdominal distention. In most instances it is difficult to attribute pain within the abdomen as arising from any specific organ especially if there are no other symptoms. Colon pain is one such instance and should therefore be investigated as abdominal pain as a whole, preferably localizing the pain to a specific abdominal quadrant or region.

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The colon is the longest portion of the large intestine which is located towards the end of the human gut. The large intestine is shorter but wider than the small intestine that precedes it. Most activities that occur within the large intestine like the reabsorption of excess water and storage of waste (feces) happens in the colon. The fluid contents of the small intestine pass into the cecum of the large intestine. From here it begins its transit through the different parts of the colon where it is transformed from a liquid mush into the solid yet soft feces that is eventually expelled into the environment. When the colon is diseased, passage of waste obstructed or cannot be emptied from the colon then pain may occur.

Colon Pain Location


Picture from Wikimedia Commons


The colon is located within the abdominal cavity. The abdomen can be broadly divided into four quadrants – (from top clockwise) right upper quadrant (RUQ), left upper quadrant (LUQ), left lower lower quadrant (LLQ) and right lower quadrant (RLQ). Different parts of the colon run through each of these quadrants. The course of the colon is as follows :

  • Ascending colon – where contents from the cecum enter the colon and travel upwards (RLQ and RUQ).
  • Transverse colon – where the colonic contents moves sideways from right to left (RUQ and LUQ).
  • Descending colon – where the colonic content moves downwards (LUQ and LLQ).
  • Sigmoid colon – where the colonic contents moves from left to right in a slightly downward orientation to empty into the rectum (LLQ).

Right Side

The ascending colon starts in the right lower quadrant and runs up to the right upper quadrant. It bends at the hepatic flexure to follow through to the transverse colon. Therefore the right side of the abdomen is occupied by the entire ascending colon and first part of the transverse colon.

Left Side

The left half of the transverse colon continues from the right upper quadrant to the left upper quadrant. It bends at the splenic flexure to become the descending colon and runs downwards to the left lower quadrant. Here it continues as the sigmoid colon and connects with the rectum.

Ascending Colon

Pain in the ascending colon occurs on the right side of the abdomen. There are various other causes of right side abdominal pain.

Transverse Colon

Pain in the transverse colon is felt across the upper abdomen. There are various other causes of upper abdominal pain.

Descending Colon

Pain in the descending colon occurs on the left side of the abdomen. There are various other causes of left side abdominal pain.

Sigmoid Colon

Pain in the sigmoid colon is felt on the lower left quadrant (LLQ) of the abdomen or left side of the pelvis. There are various other causes of lower left abdominal pain.

Other Symptoms

Colon pain is a symptom that may accompany :

  • Constipation or diarrhea
  • Excessive flatulence
  • Difficulty with or pain during defecation (dyschezia)
  • Rectal bleeding
  • Blood or mucus in the stool
  • Abnormal bowel sounds
  • Abdominal distention
  • Bloating
  • Nausea and sometimes vomiting

Causes of Colon Pain

There are a number of disorders that affect the colon which can lead to pain. These conditions may affect the entire length of the colon and even other parts of the gut or be isolated to specific segments of the colon. These causes can be further categorized according to the nature of the diseases – infectious, inflammatory, trauma, vascular and growths.

Infections

  • Infectious colitis is inflammation of the colon due to an infection usually caused with bacteria like E.coli (Escherichia coli), Salmonella, Shigella and Campylobacter species or parasites like Entamoeba histolytica (amoebiasis).
  • Pseudomembranous colitis is not actually an infection but arises with an overgrowth of a type of bacteria known as Clostridium difficile usually after the use of antibiotics. It is also commonly known as antibiotic-associated diarrhea (AAD). These bacteria secrete toxins that irritate the colon.
  • Diverticulitis is inflammation of the outpouchings (diverticula) that develop in the colon, particularly the lower parts of the colon. It may arise with an infection but can also occur for other non-infectious factors like ischemia (reduced blood supply to the outpouchings).

Inflammatory

  • Inflammatory bowel disease is among the most common, non-infectious inflammatory conditions of the colon. Ulcerative colitis only affects the colon and rectum but Crohn’s disease may affect any part of the gut including the colon. It is believed to be due to an autoimmune mechanism.
  • Microscopic colitis is an inflammation of the colon wall associated with thickening of the connective tissue (collagenous colitis) or a higher concentration of white blood cells in the colon (lymphocytic colitis). It may be a result of an infection or autoimmune disorder but the exact cause is unclear.

Trauma

  • Injury to the colon may arise with abdominal trauma either due to blunt-force or sharp-force trauma.
  • Surgery to the colon or neighboring structures may lead to colon pain. This should be short term until the area heals.
  • Colonoscopy or biopsy are diagnostic procedures that may cause pain after the procedure although this is short lived lasting a few days at most.
  • Radiation exposure to the abdomen in the treatment of cancer of the colon or other abdominal structures may injure the colon.

Growths

  • Colon polyps are small growths that form in the wall of the colon. Most are benign tumors and harmless but some have the potential to become cancerous. Polyps are usually asymptomatic till the later stages where it obstructs the colon.
  • Colon cancer is a malignant tumor in the colon. It may arise from tissue in the colon wall (primary) or spread to the colon from cancer at a distant site (metastasis).

Vascular

  • Ischemic colitis is inflammation of the colon caused by an interruption of the blood supply to the colon. The low oxygen supply to the colon leads to ischemia which can occur over long periods of time.
  • Bowel infarction is death of a portion of the colon wall usually following interruption of its blood supply (ischemic colitis) or sometimes with a bacterial infection. The tissue decomposes and is known as gangrene.

Obstruction

  • Volvulus is a twisting of the intestines causing an obstruction of the bowel and may also interrupt the blood supply to the bowel wall. In the large intestine, it is more likely to occur in the cecum or sigmoid colon.
  • Adhesions are bands of scar tissue that may constriction of the colon. It tends to follow inflammation or may arise after abdominal surgery particularly with repeat procedures.
  • Fecal impaction is an accumulation of stool in the sigmoid colon or rectum which turns into a hard, dry mass. It is a complication of severe constipation.
  • Other causes of obstruction of the colon includes colon polyps, colon cancer and diverticulitis which have been discussed above.

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  • Clara Allen

    I have pain in my left side, under my rib cage toward the center of my stomach.Sever years ago it was noted that I had a calcified aneurysm near my spleen, but nothing ever came of it.Could this pain be connected to that?

  • Hi Clara. It’s difficult to say for sure. It is possible but then it could be another condition altogether. The only way to know for sure is to see your doctor. You would probably need further medical investigations. It is best that you don’t leave it unattended for too long as complications could arise which may at times be life threatening due to the delay. Speak to your doctor.

  • crystal

    hi I have had colon and recual pain for around 10 months now and I cant even sit on my butt and its becoming annoying as Ive been for colonscopy and nothing got shown. please help

  • Hi Crystal. It is important to differentiate between buttock pain that may be arising from the skin, subcutaneous fat, muscles, joints and bones or pain from internal organs like the rectum, anus, bladder and so on. If the colonscopy has shown no abnormality, and there are no other bowel-related symptoms then it is possible that the pain is not from the bowels. You should follow up with the gastroenterologist who did the colonoscopy and you may require a referral to another specialist, like an orthopedist.

  • bellyfull

    I have a pain for months now that comes and goes, but pretty steady the last 2 weeks. It’s on my upper right, above my hip. I have no symptoms other than mild pain. I’m overweight, and have been skipping breakfast and lunch to ease the pain, but that’s not really helping.

  • Don Ivo

    Hey I have been walking with severe pain in the left pelvic area for 5 months now I have constipation sometime hard to pass water and when I touch or press down on that left side pelvic area I get severe burning pain down my left leg and have short moment of air hunger they did a MRI and found that I had a slipped disc that also contributes to the pain. Just wish it was over by now.

  • Teresa mizell

    I had a cat scan done a few days ago dr said he was going to do a colonoscopy on me Thursday that my colon was swollen and my stomach looks like I’m 8 months pregnant I have the worst pain ever at the right top of stomach can someone tell me

  • Disqus-sion

    I have pain on the low lower left just right beside the pelvic bone…. is that colon cancer ?

  • Worried

    Samething I am having. Nobody answered you back bellyfull. I would like to know myself

  • Hi Disqus-sion. Not necessarily. Many conditions can cause pain in this region and it may not even be arising from the bowels. The only way to know is for your doctor to examine the area and run further tests if necessary. Of course colon cancer is one of the more serious conditions that need to be considered but there is a host of other diseases that can cause pain in this region.

  • Shauna Rohr Wilson

    I have been having pain on my right side at the flexor of large intestine and on left and have ran a low grade fever for about a month in the 99’s it hurts to bend sideways wondering of its just irritated or if it has somehow become twisted or something.

  • Beth Rutty

    Have been hospitalized numerous time with symptoms of fever , nausea, severe pain and bleeding. ( not just bloody stools but actual blood without stool ) Have several different diagnosis’s from bacterial infection, IBS, infectious colitis to a colon attack . These do have similair symptoms except for the blood without stool. ( dark red with clots). Am at a loss, dont know what is the cause or treatment

  • Hi Beth. You should be consulting with a gastroenterologist. IBS is unlikely to lead to bloody diarrhea. You may be referring to IBD (inflammatory bowel disease) instead. There are many possible causes of your symptoms and the final diagnosis will depend on the results of various tests, such as a stool test, colonoscopy and so on. As you can see from the article above there are so many possible causes for the symptoms that you are experiencing. Without knowing the exact cause, it is difficult to comment on the treatment options. Seek a second opinion if necessary.

  • Angeles Hg

    Hi! Useful post! I have inflammated the ascending colon. There is no pain or any other symptoms, but it is very noticeable by just touching the right lower belly, and the inflammation and rigidity goes until almost the beggining of the ribs. What could it be? The rest of the belly is ok.

  • Hi Angeles. As you can see there are many possible causes of an inflamed colon and there is no way of saying for sure until a medical professional assesses you. This may require further diagnostic investigations. The cause of your current symptoms could range from inflammatory bowel disease (IBD) to diverticulitis and even colorectal cancer is a possiblity. However, it is equally possible that your symptoms are unrelated to the colon. Remember that the abdominal cavity is packed with organs so it is difficult to pinpoint your symptoms to a specific organ when only pain is present. Follow up with your doctor.

  • Amy Cain Newsom

    I seem to wake every morning with pain( mild to medium, dull) in . . . It’s either the descending or Sigmoid colon (lower left and also affects the sciatic nerve) until after I have been up a while and have a bowel movement a while after that it goes away.. I used to have chronic diarrhea for years, in fact,
    but taking probiotics seems to have gotten rid of that for the most part. No blood in stool, no fever or severe pain, should I be worried?

  • Hi Amy. It is possible that your current situation is related to your previous history of chronic diarrhea. You have not mentioned what caused that previous diarrhea – remember that diarrhea is a symptom of some disease and not a disease on its own. However, it is equally possible that your current symptoms are unrelated to your previous diarrhea. Pain that is relieved with defecation may occur in a number of different conditions, including IBS, IBD, diverticulitis and so on. The lack of blood or fever does not mean that it is not serious. You will need to consult with your doctor and possibly undergo a colonoscopy by a gastroenterologist to be sure.

  • Hi May. It sounds like constipation which can be due to a host of causes. Often the cause of constipation cannot be identified. Most people with constipation find that its a chronic problem. Any treatment provides short term relief but then the constipation recurs thereafter. Your doctor would have advised you about increasing fiber and water intake, exercising and so on in order to ease the constipation. However, without knowin the exact diagnosis it is difficult to comment further. The thin stools can sometimes be an indication of a problem in the rectum or anus. You may wan to read our article on thin stools for further clarity. http://www.healthhype.com/thin-stools-pencil-thin-bowel-movement-causes.html

  • may

    i do exercising, i also increased the fiber on my diet and also the fluid intake, but nothings happen. but im just wondering why, the time im taking antibiotics my bowel movement became normal..