Acute & Chronic Left Lower (LLQ) Abdominal Pain – Diagnosis

ACUTE Left Lower (LLQ) Abdominal Pain

Causes of acute (sudden, newly appearing) lower left quadrant (LLQ) abdominal pain lasting from few seconds to several weeks include:

1. Constipation

Constipation may appear as constant or cramping pain, often in LLQ. Dry food (cookies) or low-fiber food (meat, cakes etc.), skipped meal, not drinking enough, pain anywhere in the body or lying in bed (like in hospital) for some days are main causes of constipation in a person with the otherwise healthy gut.

2. Diverticulitis

Diverticulitis is inflammation of pouches that bulge out (usually) from the end part of the colon, mostly in old constipated persons, but may also affect young people (rarely children though). Main symptoms:

  • Sudden or sometimes gradually developing LLQ pain
  • Bloating in lower or left part of abdomen
  • Fever
  • Diarrhea with occasional bright red blood

Diagnosis is often possible from symptoms alone. The presence of diverticles can be confirmed by ultrasound or CT. X-ray with barium enema and colonoscopy (to evaluate an extent of diverticulosis)  may be done only after inflammation has healed (to avoid perforation of the colon).

3. Pseudomembranous Colitis After Antibiotic Treatment

Antibiotics may destroy normal intestinal bacteria and enable overgrowth of bacterium Clostridium difficile(normally present in small amount) in the colon resulting in the following symptoms appearing from 5 days to several weeks after starting antibiotic therapy:

  • LLQ pain
  • Diarrhea
  • High fever
  • Barnyard smell of the stool and gas

Diagnosis is made by finding a Clostridium difficile toxin in the stool and NOT by regular stool culture test.

4. Volvulus

Volvulus, twisting of the end part of the colon (sigma) around its axis, is rare and occurs mostly in small children. Main symptoms:

Diagnosis is made by an X-ray with barium enema.

5. Appendicitis

Rarely, appendicitis may cause LLQ pain, even if the appendix is on the (normal) right side but especially in a rare “situs versus” with left sided appendix and liver (and right sided heart and spleen). For other symptoms and diagnosis check right lower abdominal pain.

6. Pain from Male and Female Reproductive Organs

Disorders of testes, spermatic cord and testicular veins in menand ovulation, rotated ovary, ruptured ovarian cyst and ectopic pregnancy in women trigger about the same symptoms in the left and right lower abdomen.

7. Abdominal Muscles and Skin Disorders

Psoas abscess, inguinal hernia and Herpes zoster can cause the same symptoms as on the right side.

CHRONIC Left Lower Abdominal Pain

Causes of chronic (several weeks to years or recurrent) lower left quadrant (LLQ) abdominal pain:

1. Constipation

Non-intestinal causes of chronic constipation include lack of exercise, low-fiber food, low fluid intake, depression, stress and certain medications. Constant or cramping pain on the left side or/and in other parts of abdomen is often associated with bloating.

2. Diverticulosis

Diverticles in the lower left colon can cause chronic LLQ pain even if the are not inflamed. Diagnosis is with an X-ray with barium enema and colonoscopy.

3. Chronic Colitis

Crohn’s disease and ulcerative colitis may cause:

  • LLQ pain
  • Urgency to have bowel movement
  • Diarrhea
  • Blood in the stool
  • Skin rash, mouth ulcers, low-grade fever, nausea, general malaise

Diagnosis is often possible only after several tests: specific antibodies in the blood and stool, an X-ray with barium enema and investigation of a sample of colonic mucosa (obtained during colonoscopy) under the microscope.

Chronic ischemic colitis usually affects old people (after 60) with diabetes. Microscopic (lymphocytic or collagenous) colitis affects old people from unknown reason. Symptoms include:

  • LLQ or LUQ pain
  • Diarrhea
  • Blood in the stool
  • Nausea

Diagnosis is often possible from symptoms; in doubtful cases colonoscopy and histological examination of colonic mucosa can be done.

4. Colorectal Cancer

Colorectal cancer is rare before 50 years of age. Symptoms include:

  • Blood in the stool
  • Urgency to have a bowel movement
  • LLQ pain, nausea, poor appetite, weight loss (late symptoms)
  • Constipation or diarrhea (rarely)

Diagnosis is by colonoscopy and histological examination of the tumor.

5. Polycystic Ovarian Syndrome – PCOS

PCOS may cause LLQ or RLQ pain.

About Jan Modric (249 Articles)
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  • chris

    i have a chronic lower left abdominal pain which radiates to the lower right abdomen>!!i have sought medical intervention but the pain still persists.I done investigations e.g urinalysis,VDRL but they have shown that no abnormality detected.what im i gonna do?

  • Jan Modric

    To chris.

    Do you have any other symptoms like diarrhea, fever change in stool color? Does pain increases after pressing on a painful spot? Pain is in the middle or far on the sides?

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  • Cathy Ross

    I have been having a pain on my left side for the pass 7 years. I have gone to so many doctors I stopped counting. I was diagnose with celiac disease however I have since found out that that diagnosis is incorrect. I notice when I eat smoke turkey,prunes,raisen, almond,chocolate and the list goes on the pain intesify and I’m unable to BM for days at a time. Trap gas and burping follows. When I’m experince the pain I noticed that I do not go to the bathroom as normal. If I stick to foods that I know my body can tolerate within a few days the pain will go away and I will start having regular BM. It quite fustrating because I’m not quite sure what I’m allergic too. I find out by trial and error but the conseqences are harsh (pain for 3-4 days). Any suggestion would be appreciated

  • Jan Modric

    Cathy Ross,

    *food allergies appear with tingling or swollen lips and often an itchy skin. Sometimes with diarhea, runny nose, lightheadedness or difficulty breathing. Symptoms may appear within few minutes after the meal or, in delayed response, several hours later, often at night.

    If you don’t feel any tingling or itching, it’s not likely a food allergy.

    All foods you’ve listed above are problematic in *fructose malabsorption:

    They are:
    – fructose (honey, prunes, apples, pears, just read the article above)
    – sorbitol (prunes)
    – HFCS (smoked turkey, many packaged foods, often soda)

    ..that cause problems in fructose malabsorption.

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  • Yinni

    Pain on left lower abdomen for past 2 years, on and off. Had scans on kidney and ovaries last and this year, both normal. I don’t know if I should be concerned or not. It’s not very painful, but the fact that it’s there and it’s been there for long time makes me worry. I also wonder if it’s muscle related, because I feel better if I stretched that part. But how can muscle pain be there for so long? I don’t exercise so maybe that’s why?

  • Jan Modric


    is the painful spot tender to touch? Change in bowel habit, bloating, change in color or amount of urine? Are you constipated?

  • Yinni

    No. It’s not tender to touch, bowel habit quite normal, no bloating nor constipation, but diarrhea a bit too often. Couple of times got green urine, but I read it happens sometimes. Urine different degree of golden probably due to concentration. Amount of urine, didn’t pay attention much. Awhile ago the stool was green for like a whole week, but that went away. Got stomach ache often though, often in middle of the night, I woke up and feel it, but then it didn’t really keep me up and I didn’t need to go to the bathroom for that. Don’t know if that’s significant.

  • Jan Modric


    green urine and stool can be from:
    – certain foods, artificial dyes (drinks, posickles), vitamin or iron supplements or medications.
    – bilirubin (liver disease)
    – intestinal parasites (giardia)
    – Clostridium difficile overgrowth in the colon

    Stool culture and “Ova nad Parasites” test and urine culture can prove or exclude several related infections.

  • Yinni

    Thanks Jan, for the info. I’ll get myself check up for those. Is any of those explain my lower abdomen pain?

  • Jan Modric


    revealing seemengly minor details, like it helps when you stretch, can help finding a cause a lot. Check medical history questionnaire and write down anything related or not:

    Muscular abdominal pain is common after exercise or physical work, but it goes away – you would kinda know this. Pain does not likely appear from just being un-trained.

    Think carefully, have you taken vitamin B supps or iron (green stool/urine). If not, then blood tests for bilirubin and liver enzymes, stool and urine tests for infections can give a lot of info. Bacterial or parasitic infections can cause left lower abd. pain (specifically ask for giardia and Cl. difficile). If all this is negative, colonoscopy is an option.

    Adhesions, when all tests are negative, should be considered.

  • Yinni

    Thank you so much, Jan. Really appreciate your thoughts and suggestions.

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  • StephenCapes

    Hi, I’m a 25 year old male who up until Jan. of 09′ seemed to be rather healthy. At that time I was having extreme pain in my right side. This went on for months. Finally it was to much and had to go to the ER. Well after numerous test we found out that my Gallbladder was less than 1% active. The next day it was removed by liposcopy. (How ever you spell it). For years I have never been regular as far as my bowels go. Abdominal cramping is a under statement. When I would get the pain, I would have to go. 3 – 6 times a day I would have forcefully loose bowels. I was under the impression that after having the surgery everything should level out. Well it hasn’t. For over 2 months now I have been having constant pain in my lower left area about two inches above my hip. The pain is always in that spot. The pain is also inconsistent when it comes to intensity. Some times it’s dull other times it strong enough to bend me over. The pain last all day but seems like it intensifies towards the evening. Sometimes when the pain spikes it feels like it is shooting towards my testicles. My bowels are extremely inconsistent. I never have a Normal bowel movement. Lately I go probably 8 – 12 times a day because of abdominal pain telling me to go. and when i do it is very loose and stringy i guess you could say. Seems like a lot of mucus. Also the color is never right here lately it has been extremely pale yellow. I also noticed that within 8 hours of eating I am passing it. I don’t know if this could be a clue or not … but my mother, her two sisters, her mother and her grand mother all have had similar pain. all have wrote it off as gas. myself by 28 year and 31 year old sisters have all had our gallbladders removed. My father has loosely been diagnosed with diverticulitis bad in Jan’ I had a ER version of a UP and Lower scope, everything came back ok. So do you have any ideas because i really would like some background before i get told that they can’t find anything.

  • StephenCapes

    oh yea about how far over the pain is… if you put your pain on your hip like your striking a pose where your middle finger is touch is about where my pain is, just a little higher

  • Jan Modric

    Stephen Capes,

    would you say your problems changed, worsened or lessened after galbladder surgery (stool color, loose stools, pain location…) or not really?

    Is your stool more on the bright yellow or pale/colorless side? Do you ever have white, sticky, floating stool?

    More symptoms? Check medical history questionnaire

    What is your diet in general?

  • StephenCapes

    The pain I had before the surgery went away after the surgery … now I have different pain then before. As far as stool differences I would say it would have to be worse. I am having more movements due to the pains, sometimes during a movement the pain creates so intense cramping behind my bladder area that I am honestly looking to grab something to vomit in. As far as color goes sometimes it’s just bright yellow liquid bile sometimes a little more consistency , then.. yesterday at 11am I ate a few Oreo’s by 6pm by stool was black as tar. after 3 movements in a hour period they stool started lightening back up… it is now pale yellow / tan. consistency of what comes out is stringy looking in the water and when i wipe that conisitency is a tan mucus / snot like. Almost all of the loose stools float. and yes when i have a firm enough movement i do see white mucus floating on the sides of the bowel. Pardon if my grammar is a bit off.. I have been up all night because of the pain. I have literally wiped so much that I have now broke the skin on this last go around. Even though I have nothing really left in me to come out I still the painful urges to go and is what i described to you last. My diet is all across the board. i will just name off some of what i’ve had this week. biscuit and gravey (twice) phili cheese steaks, hamburger, onion rings, green beans, roast, carrots potatoes, fuity pebbles cereal, macarooni, hot dogs, turnip greens, random sandwiches, corn dogs, BBQ chicken. popsicles, chips and dip, pork chops. and etc. Also I get the most relief from my pain when i lay on that side and have a heating pad. anything else that you need to know?

  • StephenCapes

    oh yea.. some more background on me.. I have had shingles about a year and half ago. It was on the same side as this, the left. I do had depression and anxiety treated with Zoloft. Had it since i was 11. been on lots of different meds. I have head and migraines all the time… I know its bad but i live on Excdrine. I do drink… Vodka probably 3 – 4 times a week about 5 – 11 drinks each occasion. I know this is a mad mixture… and am slowing down alot on the vodka and excdrine. Also i was told i have a heart condition that every once and a blue moon (maybe 2 -3 times a year) the bad around my heart gets imflammed and cause pain and irregular heart beats. I was told by my MD that this was caused from huffing gas when i was real a teenager like 12 or so. I have had several suicide attempts that failed o’ding, concentrated nicotin ingestion,Injecting 35cc of windex interveniusly. Yea I know i was young and dumb but now i have a family and am much happier now. ok family.. I had heart problems and cancer on both sides of my family. Variety of different cancers. from bladder to brain. one of my sisters is mentally handicapped. Myself and my two sisters have had our gallbladder’s out. I am a 25 year old Male, 5’11 , 232 lbs. I do not have fever and actually i am running a little cold all the time. oh one more thing i don’t know if it matters my MD blew me off as if i was lying… I used to donate blood all the time to the red cross and could fill the bag fast about 4 minutes but after the windex episode I can no longer give blood like that i imediattly clot off the needle within 1 minute. sorry if i am giving you tomuch information.

  • Jan Modric


    one thing is that after gallbladder removal, bile is constantly flowing into the small intestine, which can’t cope with all its amount, so it can’t be re-absorbed in the small intestine completely, as normally, but reaches the colon, irritatres it and triggers “bile site diarrhea” (read about treatment options):

    Next, all medications you’re taking maybe derranged your normal intestinal bacteria, which task is to prevent overgrowth of harmful bacteria, like Clostridium difficile, that, again, can cause diarhea with “barnyard smell”.

    Vodka, when your intestine is irritated by bile and possible infection(you also say – cold), can add a lot to irritation. Telling you openly – your doctor has reason not to believe you (explaining with vodka and anxiety), and exactly this can be dangerous for you.

    – drop vodka nad fatty foods
    – visit a doctor and ask for “stool test for Clostridium difficile toxin” and mention him posibility of “bile salts diarrhea”. Take your time and write down your complete medical history in a factual, chronological way – with the help of the link in my previous post. All details , as you disclosed them here are important for diagnoss.

    When you had colonoscopy?

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  • remi_imb

    i observe sudden lower left side abdominal pain past 2 days not much sever but i fear about this.any big problem for this pain

  • Jan Modric

    To remi_imb.

    Are you male or female and how old are you? Where exactly is pain located and does it worsen after pressuring on the affected part? Is the pain constant or crampy? Any change in bowel habit, excessive gas, raised (even slightly) body temperature, nausea? Do you have regular diet and do you take any medications?

  • flacko

    About a month ago, started with pain in lower left abdomen, about 2″ in from hip, just above groin. I first experienced this a couple of years ago, had colonoscopy, nothing found. For a number of years have had very irregular bowel movements, sometimes nothing for a couple of days, then urgent movements, loose, several times a day. The pain this time is more severe and seems to be accompanied with bloating and burping. It is more painful when sat down. Be grateful for guidance.

  • Jan Modric

    To flacko:

    Few questions:
    1. How old are you? Do you smoke? What’s your diet in general?
    2. Have you ever had a stool test for parasites in this time? Or Hemoccult test – for blood in the stool?
    3. Have you ever noticed mucus or anything strange in the stool? Do stools have any prominent color – bright yellow, green, white, gray, black…? Do stools float or stick to the toilet?
    4. Would you say loose stools are triggered by something, like meal, specific food, like fruits or dairy?
    5. Did you have any abnormal blood tes results, like iron or vitamin deficiency?
    6. Have you taken any medications in this time?
    7. Do you have any chronic disease?

  • Flacko

    Sorry been unable to respond until now.
    I am 54 years old, never smoked, pretty fit not overweight, good varied diet.
    Stool tested few years back, probably about same time as colonoscopy, but not sure what for, never any evidence of blood.
    Often had mucus in stool or sometimes only mucus, No unusual co;our, but sometimes float.
    Alcohol creates very loose stools over several days, don’t know of anything else specifically.
    Just had full blood tests for an oil company medical, nothing out of kilter.
    No chronic disease and no medications taken.
    Pain still present, fluctuates in intensity but hurts most sitting or bending forward, feels almost like muscle strain.
    Thanks for response.

  • Jan Modric


    if I get you right, all of the following are your CURRENT symptoms: burping, bloating, urgency to have b.m., loose stools, mucus in the stool and pain when you sit down or bend forward.

    There may be more causes, but I want to emphasize two:
    – intestinal parasites. All your symptoms fit. Diagnosis is with stool test for “ova nad parasites”. These tests are sometimes false negative, so it’s important you take stool sample when you have symptoms, and you get additional tests if the first one is negative.
    – fructose malabsorption. In this case foods high in fructose or sorbitol (honey, fruits, like aples, pears, prunes and foods and drinks sweetened with sorbitol or HFCS) would aggravate your symptoms. Diagnosis is with breath test with fructose.

  • momof03

    i have been having a pain in my lower left abdomen area for two almost three years. it woke almost a year ago at 1 am in the morning. my husband had to call 911. well they said it was an air pocket in my colon. im like ok. my dr then told me to use a stool softner and i did that. pain is still there. i finally got her to get me a colonoscopy. well as it turns out there is a knot and it almost looks like a cyst and they dont know what it is. the dr said it was hard but could not figure out what it was. so now i have to have another colonoscopy done so they can do a biopsy and figure it out. does anyone know what it might be???

  • Jan Modric

    To momof03.

    If the doctor who has seen the knot does not know, you can not expect someone online will know. Colorectal cancer rarely appears before 50.

  • angiecan81

    Hi! I have had chronic Lower Left abdominal pain for the past 2 years. I have had Ultra sounds, CT scans, vaginal ultra sounds, x-rays, colonoscopy, pelvic exams, blood test, stool tests, urine tests, the works! Yet each test ALWAYS comes back normal. I had my gallbladder out about 1.5 years ago thinking that was my problem but the pain has just intensified and has gotten worse. I am wondering if i am missing any tests that could help diagnosis my problem? I am 28 and the only thing they found on my CT scan was scattered divirticula but did not come up on my colonoscopy. My pain comes and goes and i have not made any connection with my eating habits or mentrual periods. Altough my periods are always irregular. Im not sure where to go next 🙁 any advice would be appreciated.

    • Jan Modric

      To angiecan81.

      Do you have irregular bowel movements, constipation, diarhea, bloating, excessive gas? Have you discussed about irregular period with your gynecologist?

  • debs

    Wonder if anyone can help.I have had pain in left abdominal region increasingly over at least last 5 years-to extent now that rarely without it.I am 45,slightly over-weight,don’t drink or smoke.Can rarely sleep on left and often wakes me up or starts on waking.Have had lots of tests and told I have inflammed bowel and told I have IBS.Doctors seem to belittle this…it doesnt seem quite right as diarrhoea rare.Have regularly had blood in urine.When its really bad it also affects my lower left back and extends slowely to rightside and up my back.Also lots of burping.Have to get up a lot at night to pee.Can also have headaches.Please help its driving me mad as affecting sleep and have to tack painkillers a lot.

    • Jan Modric

      To debs.

      Blood in urine speeks for urinary disorder. You should see an urologist promptly. On basis of which investigation has your doctor concluded you have inflamed bowel? Colonoscopy?

  • MZ

    I’m 40 years old, male with lower left abdominal pain since Jan 15, 2010. Pain felt especially when standing up. I don’t have a fever, no diarrhea and not constipated. I have a once a day A.M. bowel movement but I have an inguinal hernia on my right.

    I would appreciate your soonest reply. Thanks.

    • Jan Modric


      you may have an inguinal hernia on the left side also. Untreated inguinal hernia may cause bowel obstruction, so I recommend you to check this with your doctor soon.

  • Nigel

    Hi there,

    I’ve had pain on and off on my left side about 2 inches from my hip bone and an inch down from my belly button. It seems to get aggravated by exercise like yoga (I’m a yoga instructor). When im bent foward and have to get up it’s quite painful. It also hurts to if i press into it. To me it feels like a sore muscle but I’m not sure. I am a 23 year old male and very active and healthy. Don’t smoke and rarely drink. Pesco-vegetarian diet.

    Thanks for your help!

    • Jan Modric


      any change in bowel habit, stool appearance? Flatulance? Would you say the left side of your abdomen is bloated? If not, it can be stretched muscle – in this case pyin should lessen in few days. If not, it could be intestinal hernia.

  • barry

    Since last Sept or Oct, been having pains on lower left side. Did not give to too much concern since my doctor has said I have diverticulitis.It flares up now and then and always disappears in a few days. Now its 3-4 months later, still sore when I sit bent or standing long periods. Pushing on it is also a little sore. Also noticed with this go around, my stool has changed, previous it was more sausage like, but now always soft blobs. If I use the bathroom everyday or skip a day, same difference. Not having the urges. I am in my late 40s, not overweight nor do I smoke. With this, seems I am always tired and lost all energy.

    • Jan Modric

      To barry.

      It’s possible you have diverticles, which get inflamed from time to time. You should get appropriate diagnosis.

  • kimg

    Nearly two years ago, I had my gallbladder removed. Ultrasound, multiple hydascans, x-ray, all showed gallbladder to be normal, no stones. Ended up having it removed and found it was full of “sludge”. Pain after eating is gone, but within hours after surgery, new pain developed. It is located in the center of my chest, about two inches below breasts. It is a pain much more intense than the gallbladder pain, but only lasts about ten minutes. I can’t even start to describe this pain, unlike anything I’ve ever experienced. If I can get to them quick enough, Levsin pills under the tongue seem to help. It is a twisting, burning pain that takes my breath away because it is so intense. Have had endoscope, another hydascan, and ct scan. All show nothing. I don’t know what else to do, and the second gastro doc I’ve seen is clueless also. Bowels are often yellow after these boughts of pain. Most importantly, they often happen during the night, when perhaps my stomach is emptying out, or in the morning between breakfast and lunch, just when I begin to get hungry for lunch. I have also been placed on twice daily omeprazole with no positive result or relief. Any thoughts on this would be appreciated.

    • Jan Modric

      To kimg.

      I can’t tell what could be the solution here, but it is possible you have developed a “biliary reflux” after gallbladder removal. Bile that now constantly flows into your duodenum, partly flows back into your stomach, irritates it and triggers acid reflux, which irritates your esophagus and cause a spasm in it. This would explain why Levsin helps. Yellow stools are probably from stimulated peristalsis: excessive bile irritates and speeds up your colon, so originally green bile does not have time to be fully changed by colonic bacteria into a usual brown color but only to yellow color. A prescribed drug cholestiramine may help you. Psyllium husk may have the same effect.


  • alwayslate

    I am a 24 year old healthy male, 5’9″, 160 lbs. I started to get constipated a week ago and have no prior history. I do not smoke and do not drink often (maybe every 2-4 weeks). I take 30 mg of Adderall and 180 mg of Allegra daily (I have been for 8 months). I had not defecated for a week and was feeling bloated and uncomfortable every which way I sat or lied down. My doctor prescribed me 17 grams of Polyethylene Glycol 3350 which has not helped much by itself, I’ll take Dulcolax with it as well. I have waken up at night 3 times in 2 weeks due to a sharp pain in my lower left abdominal area, the pain is also felt in my back. I’ve tried to use the bathroom, but am constipated, the only way to get rid of the uncomfortable feeling is to take laxatives. My doctor ordered a blood analysis in which everything came out normal with the exception of being slightly high in ALKALINE PHOSPHATASE with 119 U/L. I had an x-ray that showed severe constipation and and ultrasound that showed no negative comments. My usual bowl movement is every 3-4 days since I can remember. A lot of alcohol consumption gives me diarrhea or unusually loose stool. I’d appreciate any help, thanks.

    • Jan Modric

      To alwayslate.

      What did happen a week ago? Have you changed the diet, any excessive stress? Walking or other exercise, drinking enough water, fodd containing enough fiber, and regular meals can help you to fight with constipation, which is the likely cause of your pains.

  • alwayslate

    Nothing has changed except for I started eating a few tv dinners around that time, which I haven’t ate anymore but nothing seems to have changed. The tv dinners are all a little bit healthier than the norm too (so I think)…they’re all no MSG, low fat, etc. Other than that, I did just come back from a snowboarding trip at Angel Fire, NM about 3 weeks ago.

    • Jan Modric


      high fiber diet (whole-grain bread, salads..), not skipping meals
      – enough water intake throghout the day (to produvce at least 200 mL of morning urine), no exaggeration neded
      – daily activity
      – avoiding excessive stress or solving something what’s on your mind
      – thinking about Aderall (and eventual other drugs) that may cause constipation

      That’s it.

  • Justin

    Drink and smoke every night. Am having pain in lowers abs next to my navel about 2-3 inches from it. Hurts when I suck in my abs and bend over. Comes and goes. What’s wrong?

    • Jan Modric


      how old are you? Can you feel any lump when you check your lower abdomen with fingers? Any change in the bowel habit, like contipation, diarrhea, excessive gas, blood in the stool?

  • Justin

    No change in bowel what so ever. No lumps either. I’m 25. I also wrkout a lot too.

  • Justin

    I also suffer from panic attacks and anxiety.

    • Jan Modric


      if there is no lump, you are not constipated (?), and your abdomen is symmetrical (no visible bloating on the left side?), then, regarding you “workout a lot”, a stretched muscle is possible. In this case, the pain would be likely aggravated during leaning of your upper body toward the right leg. Such a pain should obviously lessen within a weak. If not, your doctor should examine you.

  • Justin

    Thank you for your time. I was hoping that’s what it was. It seems to be going away.

  • Andrew


    I have been suffering lower left abdominal discomfort for the last 12 months, in September 2009 I had surgery to correct an a hernia but I am still suffering some discomfort which is worse some days more than others but I can always feel something unless I am lying down when it seems to go away.

    I also suffer from quite bad wind/gas which leaves a very unpleasant smell

    I also get a burning sensation in my stomach which seems to be fairly constant – I am on medication from the doctor for this but it now seems to have stopped helping.

    I am a 40 year old male and I am getting seriously concerned regarding these stomach problems

    • Jan Modric


      hernia may reoccur at the same or another place, so I suggest you to get checked this again.

      Burning is in the upper abdomen, below the breasbone? Any burping? In this case you might have a Helicobacter pylori infection of your stomach.

  • Savvy

    I have been getting a pain in my lower stomach area, predominately on my left side above hip bone- which is painful to touch. It does spread across the stomach area to the right side but is less painful and it is also tender in the middle just below my belly button.
    It started 3 days ago – and although I am having my daily bowel movement, I do feel the need to go more often but then nothing comes out.
    I drink 3 glasses of cava a day but I do not smoke. I eat fairly well although I know that I do not get my 5 a day. I do not smoke and do not work out as regular as before (aerobic instructor but haven’t done much since daughter was born 2 years ago in terms of exercise. Do the occassional fitness video or pilates). Also – I have a bad habit of holding my poo when I need to go if I have something else to do.
    A bit worried now as the pain has not subsided as was initially thinking it could of been a period pain, but then it’s about a week too early. I am 44 years old.
    I would appreciate your comments.

    • Jan Modric


      if it is a bacterial food poisoning, it should go away in a couple of days. If they are parasites, symptoms may persist and you might want to have a stool test for parasites. But, if symptoms won’t worsen considerably, I suggest you to wait until your period is over, since, like you know, many women suffer from various symptoms in a week before the period.

  • Reagan

    I am having LLQ abd pain for four years from hip bone to colon to bladder and buring sensation while urinating. Blood occasionally when passing stool. Did CT and MRI. Negative on each. Any advice?

    • Jan Modric


      have you already had stool culture and urine culture test? It could be an infection (bacterial or parasitic).

  • Reagan

    Yes, did, both negative. Thinking its either diverticular or hernia. feeling a lump and doc said it could be a muscle. Another doc said could be sigmoid colon. Only choice may be laproscopy. Need another opinion before I go in.

  • Reagan

    BTW, what treatment would you prescribe for that kind of infection?

    • Jan Modric


      for now, regarding your symptoms last for four years and both stool and urine culture tests were negative, I would concentrate on other possibilities than infection.

      Blood in the stool (bright or dark red or black?) arises from the inside of the bowel (hemorrhoids?, Crohn’s disease…), so its cause would be likely discovered only by colonoscopy, sigmoidoscopy, upper endosciopy (if black), or capsule endoscopy. The lump – why would that be the muscle? Is it the same lump on the rigt side? Depending on its location, it could be a bowel (sigmoid) diverticle, hernia, maybe an ovarian cyst. I guess ultrasound could reveal more. Diverticulosis can be diagnosed by ultrasound (not always), colonoscopy, or X-ray with barium enema. Burning at urination (any urgeny or increased frequency?) could be from an inflammation (like cystitis) without an infection, also from urinary stones or other urinary tract disorder.

      Careful examination of the abdomen – to evaluate that lump
      Ultrasound of the abdomen – could show an ovarian cyst or sigmoid diverticle
      Urine test for proteins, parasites, cells, and other substances excreted in urinary stones or inflammation
      Stool test (O&P test) for parasites (not detected by stool culture test)
      Colonoscopy – could reveal inflammation or diverticles
      Laparsocopy can reveal sigmoid diverticles, ovarian cyst, endometriosis, hernia, but not changes within the bowel or urinary tract

      What you can do is to write down your complete medical history and put it all symptoms in a time line. Also, have you traveled before 4 years or something other happened then…

  • Reagan

    Hi Jan

    After visiting another doc yesterday, I may have either diverticular or hernia. Going to see a gastrointerologist next week. will let you know.

    The hernia may be possible as I have a slight bulge in that area as well as all other associated symptons.

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  • Amber M

    Good Afternoon,
    I apologize in advance for this being so long. I am attempting to get everything you need in writing down.
    Family history:
    ( I have none for the fathers side of my family)
    2 aunts and my sister have had their gallbladders taken out.
    2 (same) aunts have chrones disease
    Grandmother has a blood disorder where she has too much blood in her body. However, now due to her diabetes she is bleeding internally and has to go in and get transfusions.
    Grandmother has diabetes
    Aunt has PCOS and her doctors want to put her on insulin shots because metformin is not regulating her sugar right.
    Mother has never been diagnosed but when she eats certain foods she gets pain. When she was young ( 1960’s) she was hospitalized for two weeks and tested because of pains similar to mine but no diagnosis was made other that “spastic colon”

    I am a 22 year old, white, female. 5’3, 150 pounds. Before all this started I was working out 3 times a week at least 30 minutes because I was diagnosed with PCOS a year ago. I am currently on 1000mg of Metformin a day because of this condition. The metformin has kept my sugar under 100. I also started eating better to lose weight because my Gyno said this would help the symptoms. I also adopted a very healthy diet about a year ago as well. (Low fat, high fiber, 1500 cal. a day, 6 small meals a day). My bowl movements would be considered “constipated” I would only go one or twice a week.
    My symptoms started 4 months ago. I had three weeks of constant diahrriah at this point it was once or twice a day. I also noticed that my sugar was 20 – 40 points higher than it usually is. I also started having pain level 8 cramps in my lower abdomen and level 5- 9 pain an inch away from my left hip that was very tender to the touch. Because of this I went to my General Practitioner. He did a pelvic , felt my ovaries for inflammation, and searched for any STD that may be causing my symptoms ( I have been married 4 years, so I was pretty upset about this) he also put me on a 3 day regimen of bactrum for a UTI that I had contracted. He also asked me why I was taking my sugar, and I mentioned the PCOS and he still looked at me like I was crazy. Now I’m unsure if I should even be taking my sugar.

    The third day on the bactrum I had a very bad allergic reaction. He took me off the bactrum and sent me home. All my test results came back fine except for my blood and urine. I had a slightly elevated white blood cell count and a little blood in my urine. No medications were given and no diagnosis was made.

    About three weeks later the pain escalated and I was worried because I still had the diahriah. I went back and the doctor stated I had IBS, he placed me on an IBS medication and I took it for only a week because it made my symptoms worse. Instead of going 1-2 times a day there was one day I went 7 times. Because of this he decided to run blood tests. I mentioned Chrons Disease because two of my aunts on my mother’s side have this disease and he said one of the blood tests should ping if I have it. The results came back and showed nothing abnormal.

    After this appointment I also started showing more symptoms and the bathroom issues picked up. I also starting having pain level 9 pain in my left shoulder area, at first I thought it was a pulled muscle but the pain never went away. It felt like I was being stabbed in the back. Sometimes this pain would “shoot” across my back or “through” my chest. Also anytime the smell of greasy food would cause me to get very nauseous. This caused me to throw up for a total of 3 or 4 times since the symptom started.

    About three weeks after the last appointment the symptoms were increasing in pain and duration enough (along with another UTI) that I decided to go to the doctor again. I was given a referral to a gastrinologist and more antibiotics.
    Two days later, I came in to work and someone was cooking sausage in the microwave. I nearly threw up immediately at my desk but made it to the bathroom, my bosses sent me back to the doctor. This time I decided to see my Gyno because my GP had been basically; in my opinion; not doing enough. I got an ultra sound of my ovaries that showed up negative for anything except the PCOS, all the cysts were in normal range for PCOS. She did a lot of poking and pressing. When she pressed on my back it hurt so bad I jumped off the table. She said that where she was pressing is where my kidney was. She also pressed on below my right ribcage and asked me to breath, again the pain was so bad I tried to get away from her. She repeated pressing below my ribcage on top, and then pressed from the bottom at the same time. The pain was again so bad I wanted to get away from her. She stated that that was a test for my gallbladder.
    She ran urine and blood tests on me. I had blood in my urine but my kidney and liver functions were fine. She said my white blood cell count was barley elevated ( a 10.2 ) and she said that because my symptoms were so bad and because the other referral never called to set an appointment that she set me an appointment with one for two days later.
    A week ago, I went to see the gastro. and was a little let down. He did not even read the log that I had been keeping for two months that included, bowel movements, pain ( where and pain level) and the foods and drinks I had throughout the day. This was faxed over to him with my referral paperwork. I asked him about the gallbladder and he stated that “my pain wasn’t right”. This did not coincide with what my Gyno stated. He said that I needed to provide a stool sample and set me up for a colonoscopy. I provided the stool sample the same day and set the appointment for the colonoscopy for wends. This appointment lasted less than 10 minutes.

    The colonoscopy showed nothing abnormal. They did take biopsies to test for Microbial issues. I still have not gotten the results of the biopsy or the stool sample.

    Right now I’m getting very depressed because of this and I’m contemplating going on anti-depressants. I have had to stop working out because of the pain and the bathroom problems so I haven’t worked out in 4 months. I am at an impasse because I do not know what to do and not counting my gyno I feel like none of my doctors are taking my symptoms very seriously. If you could please shed some light on the situation and show me what I should be saying to these doctors to make them pay attention I would greatly appreciate it. I am very upfront with them and have done everything to make their job easier but at this point I feel like if nothing is done, I’m just going to breakdown. The bathroom problems are very embarrassing and the pain is emotionally distressing.

    • Jan Modric

      Amber M,

      there can be more than one disorders responsible for your symptoms.

      Pain below the right rib cage, nausea triggered by a smell of the greasy foods, and gallbladders removed in the family history strongly suggest a gallbladder disorder: either gallstones in the gallbladder or bole duct (can be usually detected by an ultrasound of the gallbladder) or abnormal contractions of the bile duct, called biliary dyskinesia, which can be detected by a HIDA scan. You can read more about gallbladder tests. I want to emphasize that a negative result of gallbladder ultrasound DOES NOT exclude a gallbladder disorder and further tests should be done, when necessary. Also, in a gallbladder full of stones, blood tests, including liver enzymes can be perfectly normal

      Back pain when tapped by a doctor, pain in the left shoulder, blood and white cells in the urine strongly suggest a kidney disorder. An ultrasound of the kidney is usually the first investigation. Again, the severity of a kidney disorder is not always reflected in urine or blood tests.

      Pain in the lower left abdomen could be from (among other):
      – bloating (?) caused by unabsorbed fats (this would cause sticky, foamy, floating, smelly stools – diarrhea) due to a gallbladder
      – bloating from overgrowth of bacterium Clostridium difficile caused by antibiotics. Diagnosis is with stool test for Cl-diff toxin.

  • Shawnna

    Jan: I have recently (<2yrs) had a full hysterectomy due to benign tumours in my stomach. One of tumors killed my ovaries and one wrapped around my lower bowel leaving me constipated for months before the hysterectomy. After the surgery it seemed all was well. Now I have been told that my transverse colon is swollen twice its normal size and am awaiting colonoscopy to confirm/ diagnose Crohns and or colitis. Recently I am having major sharp pains in my lower left abdomen that seems to come and go several times each day. I am also very crampy pretty much all over my lower abdomen. I also feel some form of a lump in the lower left area when i stretch or stand up. I have frequent bouts of diarrhea and constipation on a never ending schedule. I am very concerned about this and wonder if maybe you could help me figure it out? Please, I need to find some form of relief as my dr wont treat until he is sure of the cause. I should mention that I have recently had an MRI to diagnose what "lump" was in my stomach and they only found the colon swelling.

    • Jan Modric


      they are pelvic/abdominal adhesions (strands of scar-like tissue) that may develop after the surgery, especially when the initial disorder was a tumor (fibroma?). These adhesions are often missed by MRI and can be sometimes seen only during laparoscopy. Adhesions may cause partial bowe obstruction, causing constipation/diarrhea cyscles, colon swelling…I’m not saying you have adhesions, but this is one thing you might want to speak with your doctor, especially with the surgeon that has operated you.

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  • Stacy

    Hi. And help! I’m 46, F, obese, 4 kids. Recently off Prozac, no recurrence of depression so far. Have had chronic LLQ pelvic and back pain for 18+ months, radiating down left leg into 4th toe. Regular periods, no other symptoms. One normal ovarian U/S, one ovarian cyst 25 yrs ago. On BCPs for 10+ years in my 20’s. Pap & UVS came back normal. Doc doesn’t seem to think it’s diverticulitis. So what is it then?

    • Jan Modric


      LLQ and back pain radiating to the 4th toe is probably from a pinched nerve in the lumbar spine. CT or MRI of the spine is needed for confirmation.

  • Ann

    I hope you can help me with my lower left abdominal pain. I am a 37 year old woman, 5″4′ and 150lbs. I had an abortion at 19, my gallbladder removed about 5 years ago, and have been celibate for over 2 years. I was discovered to have HPV backin the mid-90’s, and have had “pre-cancerous” lesions removed once by freezing and again by LEEP about 10 years later. My last full check-up was in January, and I was told by my GP to make a GYN appointment because my last Pap was still irregular. I have not gone yet. I am on 8 different medications, including clidamyicin, Levoxyl, lovaza, wellbutrin, Trazodone, and lithium. I see my psychiatrist once a month to monitor my medication, and we have determined that I also suffer fromPMS related episodes of extreme irritability and frustration. My worst day will occur the day before or day of the onset of menstruation. All of last week I was in a pms like state. Quick to anger, difficulty planning and remembering things, fits of frustration.

    A few days ago, I noticed that the lower left section of my abdomen (between my hipbone and underneath my bellybutton) felt sore, as if I had pulled something or bruised myself deep down. It hurt more when I tried to move or stretch, but I didn’t think much of it.

    This morning I was awakened by intense, cramping pain in the same area, and when I went to use the bathroom, I found blood when I wiped my vaginal area. I assumed that I had gotten my period and the pain was menstrual cramps. I put in a tampon and took some advil to take care of the cramps. Since high school, I have often had heavy, intensely painful cramping sometimes accompanied by vomiting, cold sweats, and even fainting. This stopped happening most of the time in my late 20’s , and only occurred when I was unable to “catch” the inmpending cramps and take a preventative dose of advil.

    Instead of receding, the pain in my left abdomen intensified, and I attempted to relieve it with a hot bath. It worked for about 15 minutes, but then the pain came back. I lay down on my bed andtried to rest and relax. When I happened to cough, the pain intensified, and I observed that the cramping was still sensitive to movement or pressing directly on the area. Next time I used the bathroom, I had a healthy, bulky bm. This did not affect the pain at all. When I changed my tampon, I observed that it didn’t have anything resembling menstual blood, only regular red blood, and something that had no color, more like everyday colorless discharge.

    The pain is still ongoing, but now the rest of my lower abdomen is painful when I press on it. Is this normal ovulation or menstrual activity, or something more serious? Thank you for you help.

    • Jan Modric


      if the pain was from gas built in the colon, you would probably have some flatulence. Anyway, bloated colon is often tender to touch and pain is affected by moving. Ovulation pain is usually short (seconds). The question is where the blood during wiping came from – from the vagina or bowel. Pain from disorders in the uterus, Fallopian tubes or ovaries is less likely affected by moving or pressing over the area.

      Not sure why are you taking clindamycin..

  • Stacy

    Thanks! This is akin to what I suspected. The leg pain just didn’t make any sense as far as gastro/gyne disorders. I’ll let you know what they find.

  • echo2001

    hi, i have levels 7-8 pain in my LLQ 2″ right from my hip bone with a constantly sore large lump, level 8 pain in my abs upon waking, level 7 headache, constipation, dry mouth, ringing in my ears, pain all over, fatigue and frequently urinating at night. this has been going on for app. 2yrs. had a colonoscopy, upper GI, dr. found nothing. very frustrated

    • Jan Modric


      a gastroenterologist should be able to find a cause of a “sore large lump”.

      Dry mouth, ringing in ears and fatigue can be from dehydration and can be related to frequent urination at night. Urine tests can reveal kidney infection or other disorder of urinary tract, or diabetes…

  • adgraha

    Hi, it seems like you are very intelligible in the area of abdominal pain. So, I was wondering if you may have any information that could help me. I am a 24 year old female, 2 children (7 & 5), 5 ft 6 in, overweight at 185 lbs. As far as I know, my family has no history of abdominal issues, except my biological father, who has had cancer but I’m unsure what kind because I don’t have contact with him.

    A little over a month ago, I started having pain in my lower left abdomen, around the area my ovary is. The first couple days it was just uncomfortable, so I blew it off. When it got extremely painful a few days into it, I made a doctor’s appt. They couldn’t fit me in for a couple days, so I waited. It was doubling me over, but it felt better when I would lay down.

    I got to the doctor; she said probably ovarian cysts, which made sense. She pressed on my abdomen; I had tender points, but no lumps. My breasts had been oddly tender since before the pain started, so of course we did a pregnancy test. It was negative. She also tested for an infection with a urine sample, negative as well. She had me keep a log of my pain, and gave me Naprosyn. The pain at first was unexplainable, but it really hurt. Over the next 2 weeks the pain changed, the Naprosyn didn’t seem to help. Sometimes it was sharp and stabbing, sometimes it was dull and achy, sometimes crampy, sometimes throbbing. I debated going to the ER at points. And it started to move upward to the left of my belly button. I had a kind of hot spot where it was hurting most at this point. Warm and tender to the touch, but oddly my temperature never went up. It was a little lower than usual (I’ve always ran right around 98.6, often exactly that). So, I wasn’t concerned with it. I saw the doctor again; she looked at my log and ordered an ultrasound. It came back fine. Nothing unusual, but pain still persisted. At this point, the pain and hot spot had moved again, this time to the right side of my belly button, and my temperature was in the 96 area. Next appt. when she pressed on my left side it didn’t seem as uncomfortable, but still not pain free either. But, oddly when she pressed on my left side, I about jumped off the table it was so uncomfortable. She asked if I had my appendix out, I haven’t. She spent some time checking out that side, but didn’t seem concerned. That day she did a pelvic exam. It all came back normal too. She gave me an antibiotic shot and put me on doxycycline. She said maybe I had an infection that wasn’t showing in my urine samples. I’m on my 7th day of the medicine. It hasn’t seemed to do much. Now my right side seems fine, but I have an added pain in my left inguinal area that seems to protrude into my upper thigh. The pain in my abdomen has seemed to centralize itself to the left of my belly button, down a couple inches now. It is not quite as intense as it was before, but it is still present. My temperature since my last appt. has been in the 95 area. I have another appt in a week and a half, but my doctor seemed so adamant that it was something to do with my reproductive organs, that I hate to continue moving in that direction if it is not. I voiced to her at my 2nd appt that because of the way it had changed and kind of moved, I wasn’t completely convinced that it was reproductive. She said that she believed it was, and sometimes pain could radiate to other areas, so I just left it at that. Do you have any ideas of what else is possible? I hate to keep spending money, since I don’t have any insurance, on something that may be a waste of time. Any ideas you have would be extremely helpful. Thank you.

    • Jan Modric


      pain, tender and hot spot moving around the pelvic and lower abdominal area could be from peritonitis – an inflammation of the “abdominal membrane” that covers abdominal and pelvic organs. An inflamation could spread in a quite localized manner, as your symptoms did. Inflammation could be from an infection (pelvic inflammatory disease (PID), caused by vaginal infection, ovarian rupture..), and this might explain why your symptoms have subsided somewhat with antibiotic treatment. The negative urine culture test probably excludes urinary infection, and inflammation/infection of the colon/small intestine also does not seem likely regarding you have no bowel related symptoms.

      Inflammation could also affect ovaries and hence sex hormone production and this could explain breast tenderness (which can occur even in a slight sex hormone imbalance). Fallopian tubes could be also inflammed; this would cause crampy pain. Ultrasound can easilly miss peritonitis and even MRI would not necessary reveal it. Sometimes a peritoneal lavage during a laparoscopy (performed by a gynecologist or gastroenterologist), is necessary to find the cause of inflammation.

      In appendicitis, a part of peritoneum that covers appendix is inflammed and this causes typical “rebound tenderness” – pain, when the pressure of the fingers is released. This rebound tenderness can also occur when other parts of peritoneum are affected. In appendicitis, pain often starts around the belly button and then moves to the right, settles there and does not move around. Pain in the lower left abdomen and thigh kinda reduces possibility of appendicitis.

      Lower than usual body temperature could be from lowered progesterone caused by an ovarian condition. You did not mention any change in period regularity, vaginal discharge…

      You can check your armpits, area above both clavicles, neck on both sides of the throat, and groin for eventual enlarged or painful lymph nodes, and remind your doctor to do the same. Mention the possibility of localized peritonitis. Note: normal blood test does not exclude peritonitis. It’s quite possible, the doctor will suggest a CT or MRI of the abdomen, but you should be aware that both investigations could miss peritonitis, and even if they were positive, a laparoscopy would still maybe be required to determine the exact cause and to start with appropriate treatment.

  • adgraha

    I forgot to state that there are no traces on blood in my urine or stool. No constipation, and no diarrhea. Normal BM every day.

  • adgraha

    Also, I meant to say when she pressed on my right side I almost jumped off the table. Sorry, I’m very tired. Haven’t been sleeping well because of all of this.

  • adgraha

    Thank you very much for the information. I have a little more information for you. I apologize in advance because it is a little graphic. I have had no major changes in discharge, but during my last period, I was passing “clots” that were large in size. A couple times I suddenly had severe cramping, worse than usual, and then had rushes of blood that would make me have to change my pad immediately. Both times this happened there were “clots” that were bigger than half dollar size. That was the 18th through the 22nd of May. I woke up this morning with about 10 red spots and 2 bruises (one about dime sized and the other is kind of thin, but over an inch long) on my arms. I don’t know what they are or where they came from. They’re not chicken pox. I got a call from my doctor yesterday afternoon saying my blood work was normal. So now, I have all of this, but all the tests have come back normal. Do you still think it could be peritonitis?

    • Jan Modric


      large clots, if unusual for you, are not normal, in combination with unusual smell, suggest an inflammation/infection in the uterus. A spot “warm and tender to touch” strongly suggests a localized inflammation, which could spread from the uterus to Fallopian tubes or into the abdominal cavity and to peritoneum. Clinically, the term peritonitis is usually used for a diffuse inflammation affecting the large area of periotoneum (and it is not likely you have this), but a localized area of inflamed peritoneum is pathologically still called peritonitis (and can be caused by inflammed appendix or ovaries or Fallopian tubes). I can’t explain the drop of body temp from 98 to 95 °F, but it can be related either to inflammation or to resulting reduction of progesteron production…Rashes on arms are strongly suspicious for…something..I don’t know, but rashes commonly appear in abdominal/pelvic inflammation/infection. Pain that has moved from LLQ to RLQ + mentioned clots, strongly suggest uterus and Fallopian tubes are affected.

      The inflammation/infection could be limited to your female organs and would not necessary spread to urinary tract or blood, and would be not necessary revealed by an ultrasound. Now, after antibiotics and when your symptoms has subsided, it’s hard to tell, if you need any further investigation at this moment. I can’t operate with any diagnoses here, but it’s quite possible your female organs were involved (endometriosis, pelvic inflammatory disease or juts a “simple” infection…). If there will be another abnormal vaginal discharge, then this should be tested (culture). If you will later develop some vague pains in the lower abdomen, think about pelvic/abdominal adhesions.

  • adgraha

    Oh, I forgot to mention, during my period, there was an unusual smell. There was not a smell and has not been since then though.

  • mwolff

    My husband is 45 yrs old. He has been having pain on his left side, a dull aching pain for at least 4 months. It starts above his hip bone and below the rib cage. It is literally his side as if you put your hands on your hips. I’m very concerned, it is tender to the touch. It is constant but not bad enough to take pain med. it never goes away. He is not overweight drinks alcohol on occasion, he leads a very active lifestyle. Bowel movements are normal. Any advice would be appreciated!! Thank you

    • Jan Modric


      both distended colon (from gas) and enlarged spleen could be tender to touch, and both would be likely visible like abdominal distension or asymetry on the left side. An abdominal ultrasound can detect most mass lesions in the abdomen.

  • mwolff

    Hi Jan, Thanks for your response. Are either of those serious? What would cause an enlarged spleen? There is no visible swelling in the region.The tenderness is strange as it changes location at times from upper to lower (if that makes sense)I know he is young for colon cancer but my mind does overthink these issues. I worry about him being tired alot but he does do physical labor and alot of hiking so that could explain him being so tired. On another note that I don’t think has anything to do with it but he did mention about 2 years ago he did have an injury to the same side and still has a mark on him from it years later (I think it was motorcycle handle bars jabbing into his side) I just can’t believe over 2 years later he could have a problem from that. Thanks again 🙂

    • Jan Modric


      changing location of tenderness could be due to colon distension that moves as gas within it moves (within the descendent part of the colon that runs from below the ribs toward the hip on the left side). This would not necessary cause any visible bloating. Gas could be caused by irritation by certain food; in this case symptoms would be likely aggravatedd by meals, and relieved by bowel movement (which would be probably changed..).

      One possibility are stretched muscles in abdominal wall (regarding his physical work). These would be tender even after slight touch and would be obviously affected by walking and other movements. Note that pain from gas in the colon can be also affected by certain movements, like bending over.

      Theoretically, an injury could cause some inflammation in the abdominal cavity and abdominal adhesions (scar like tissue) couod develop thereafter and pull the intestinal loops and cause various pains. Such adhesions may develop (even years) after abdominal surgery or after intraabdominal inflammation.

      Colon cancer usually affects people after 50, and it usually does not cause any tenderness or pains in early stages.

      Spleen swelling has many causes and most of them are serious, for example lymphoma or leukemia. Swelling is not always visible, but it can be palpable: normal spleen cannot be detected by deep palpating, but swollen spleen can be felt like a solid mass below the left rib cage on the side.

      Tiredness can be a symptom of a chronic disease. Visiting a gastroenterologist would be appropriate.

      EDIT: OK; I’ve seen your other comment now. Frequent urination can be a symptom of urinary tract (any part) infection, or something (distended colon, adhesions, a benign tumor..) pressing on the bladder from the outside. I think, he should see a doctor.

  • mwolff

    Jan, one more thing, he has to urinate frequently, he has always stayed very hydrated but the urnating urge comes on sudden but he really doesn’t have to go that much (very little urine output) could this be a bladder infection?? Thanks

  • Audrey

    Hi, I’ve been experiencing recurring pain just above my pubic bone, a burning pain and now I have pain on my lower front left side, too… in the lower colon area. This pain is sometimes relieved after I have a bowel movement (often 2-3 times a day). I mostly notice the pain after my period and it often lasts for about 2 days. But this time it is not going away. My periods are regular and the only noticeable change is that I have LESS period cramps, which feels like a good thing to me. I take oil of oregano off and on and wonder if this might cause pseudomembranous colitis? As I understand it is possible that oil of oregano destroys all bacteria. I am also going to the doctor to see if I have a bladder infection… but even though it burns above my pubic bone it doesn’t really burn when I urinate! The pain on my left side is also relieved slightly after a bowel movement or if I’ve passed some air. Anyway, I hope I’ve shared enough. Sometimes I have trouble sleeping from the pain. Thank-you!!!!

    • Jan Modric


      you can stop taking oil of oregano and see if it helps. Distended rectum alone can cause pain in the lower left abdomen, and it can also press on the bladder. Urine (and maybe stool) test seem to be appropriate.

  • Audrey

    Thanks so much!!

  • Charles B

    The past couple months i’ve had on and off diarrhia, I am diabetic, 24 years old, 5’7 weigh approx 175 pounds, pretty fit, my diet consists of poor foods unfortunately, Fast food, lately i’ve been cooking meat and fish in attempts to eat healthier.
    It seemed to happen when I started drinking coffee a few months ago so I stopped doing that, but it continues still and just recently i’ve gotten this dull pain in my lower left abdomen.
    I couple months ago I had started to take Multivitamins with assorted B vitamins but I have stopped taking those as well. For how much food I eat I dont seem to have many bowel movements. Once a day, sometimes not even once and when I do it sometimes is Diahrria and comes pretty urgent.
    a1c is pretty good at 6.7, though I eat bad foods my blood sugars are generally good. Also thought that it could be due to drinking which I do every friday about 7 or 8 beers. I smoke about 3 cigarettes a day.
    Any idea what this could be // how to fix it, please?
    Thank you for your time.

    • Jan Modric

      Charles B,

      one possible cause of long-term diarrhea is food poisoning with parasites, like Giardia. Stool test can reveal this. Fructose malabsorption and irritable bowel syndrome are also common – a low-FODMAP diet could help in these cases. Another two food-related disorders causing diarrhea are lactose intolerance (lactose-free diet would help) and celiac disease (gluten-free diet would help). If it’s not food related, it could be inflammation of the bowel (Crohn’s disease..) (a gastroenterologist can confirm diagnosis).

  • Lucy

    What types of abdominal pain are associated with anxiety?

    • Jan Modric


      constipation, diarrhea and IBS can be related to anxiety.

  • peaches

    I’ve had LLQ dull back pain for about 8 months now, some days worse than others, but in the past week it has gotten so bad I cannot touch my toes (I usually do yoga every day and can normally place my palms flat on the ground in forward bend). I don’t have any urinary symptoms and have daily bowel movements. Today it has really been uncormfortable to the point it hurts even laying down (feels like I have a softball stuffed in my back). I’m 5’4″ about 140 lbs and just had my anual bloodwork done for my physical – all came out great. I forgot to mention it to my doctor at that appointment since it was not so bad and would come and go a bit, but today I became very dizzy and threw up. I have to keep lying down every hour or so to get the dizziness to abate. I have no idea if these symptoms are related to the increase in dull LLQ back pain but am interested in any advice.

    • Jan Modric


      pain that comes and go and is accompanied with vomiting is often due to cramps in the muscular wall of a hollow organ – in LLQ this could be the colon or Fallopian tubes, for example. Dizzines and vomiting do not appear in IBS, so don’t let your doctor to give you this diagnosis. A gastroenterologist would probably want to perform an ultrasound of the abdomen as the first investigation.

  • peaches

    Thank you!

  • Shamrock

    I have had some sharp pains in my lower left side of my stomach. For about 2 days the pain has increased as time has passed. To the point I had trouble sleeping last night. Now today I can barley walk or move with out pain. It is also tender to the touch. I’m male, 29 years old, slightly overweight. I don’t smoke but I do drink about 3 to 5 alcoholic beverages a week.

    • Jan Modric


      intestinal hernia is possible, among other. I recommend you to visit a gastroenterologist.

  • Dan P

    I have lower left back pain which seems to also radiate to lower left (close to groin) abdominal pain. I was originally diagnosed with diverticulitis, and treated with strong antibiotics but that didn’t help. Subsequent CT scans and colonoscopy showed no diverticuli issues at all. So back to the drawing board. I have had urine tests for kidney stones which were negative, 2 CT scans, back X-Ray, Lumbar spine MRI, and a colonoscopy with no resolution of the problem. It has been 1.5 years now, and the pain has gotten worse over time. Worst case is when I wake up in the morning. It takes a while to get out of bed and I have a hard time even walking right away. I assume it’s because I sleep in a position that is bad for my lower back. I’ve tried different beds with different mattresses, but no difference. The pain is there all of the time. I have a hard time bending over, and sitting for long periods of time. Any suggestions??

    • Jan Modric

      Dan P,

      to make this more clear, you would need to tell: is the lower abdomen or any other part of your trunk (like area over the left kidney) tender to touch, or distended (bloated) or can you feel any mass in the abdomen? Does pain radiate into the leg at any time? Excessive gas, abdominal sounds or any other GIT symptom? How old are you? When you bend over or sit for a long period – where do you feel the pain? This personal medical histry questionnaire may help you recall additional details.

  • Jacklyn

    For the past two days I’ve had a sharp constant pain in my lower left abdomen, just a little higher and further in from my hip bone. I’ve had regular bowel movements, I drink lots of water and am fairly active. The pain does not increase when I press on the area where the pain is and as far as I can tell there is no bloating. I have recently started drinking alot of aloe vera juice, I don’t know this will affect anything. It also makes me feel like I have a sour stomache. I’ve never felt this type of pain before and I’m just concerned that its the same for two days. Thanks for any assistants you can provide.

    • Jan Modric


      discontinuing a suspected food/drink is the first thing one can try. Constant pain without any change in bowel movements may originate from a pelvic organ like the ovary, though. After physical examination, the firts investigation is usually abdominal ultrasound (performed either by a gastroenterologist or gynecologist).

  • Jacklyn

    I should also mention that there is some left hand lower back pain as well but the abdomen pain makes it so I hardly notice.

  • Jacklyn

    I posted something here yesterday hoping for some help but it was deleted so thanks for nothing.

    • Jan Modric


      readers’ comments appear here only after we approve them, and as you see your comment was not deleted.

  • Jacklyn

    I’m so sorry, I’m not normally so rude, thank you for trying to help me despite my comment.

    • Jan Modric

      Jacklyn, I’m aware it may be shocking when a comment disappears when you post it…, we’ll try to fix that.

  • shawny

    Can someone please give advice.. i am a 21 year old male. ive been having lower left abdominal pain for 8 months just below my rib cage on the left. it is so sensitive to touch. when i sit i hav to put a pillow under my arm so it doesnt bother me. if i dont i get constant burping. as we speak im burping. it never goes away n gets worse if i eat. i thought it was an ulcer but im not sure. the doctors tested me for Hpilory n found none. ive also had y chest x-rayed. because at times the dead center of my chest hurts n if i press it it helps the pain. the belching is so annoying. i hav regular bowel movement n no constipation. smoking makes it worse. it seems like i get access air trapped in my stomach n lungs if that makes sense.. please someone with knowledge help me out. i have no insurance and cant afford anymore hospital bills. thanks

    • Jan Modric


      here is an article about causes of excessive belching.

      Besides H. pylori, common causes of excessive belching include:
      fructose malabsorption, in which fructose and sorbitol from fruits and certain artificially sweatened foods are not properly absorbed. Here is a chart to see which foods to avoid.
      – lactose intolerance, in which lactose from milk and other dairy products are not properly absorbed. Here is a lactose-free diet described.

      In case you have a fructose malabsorption, you could get quite some relief after a 4 day low-fructose diet. If you have lactose intolerance, lactose-free diet would help.

      Other fairly common causes of excessive burping include intestinal parasites (diagnosis is by a stool test for parasites) and celiac disease.

  • Adam

    You seem like you’ve helped a lot of people, so maybe you can help me.

    I’m a 25 year old male, don’t smoke, don’t drink, 6ft 2in, about 270lbs.

    About a week ago, I had a night of really uncomfortable gas and bloating, after which I stopped having bowel movements. I know I don’t get enough fiber in my diet, and I recently had an ankle injury that kept me from walking as much. So I figured okay, constipation, no big deal.

    Four days ago (when I really noticed I hadn’t being going), I took a dose of milk of magnesia and upped my daily fiber intake with bran flakes, oatmeal, and some Activia yogurt with added fiber. Also made sure to increase my water intake. When that didn’t show any relief after a day or two, I added a stool softener (100mg ducosate sodium).

    I had a few small bowel movements today, mostly soft solids, but there’s still a lot of LLQ discomfort and I’m starting to get some back pain (it feels mostly like muscle strain). I haven’t had any bloody stool, no fever, and nothing I’d describe as sharp pains — nothing more than some acheness and the occasional small cramp.

    I’m not sure what else to do other than go to a doctor, and I don’t have insurance — but I suppose I’ll probably bite the bullet on that one and go tomorrow. Any thoughts?

    Thank you in advance.

    • Jan Modric


      the day before the gas and bloating started, have you eaten something unusual or were you under a lot of stress? Or have you eaten out or traveled somewhere in the past weeks? Acute bloating and gas and constipation (without having much problems with this in the past?) could arise from
      – eating large amount of foods containing soluble fiber (oatmeal, oranges…) or foods high in fructose or sorbitol (fruits, like prunes, apples, pears, grapes..or foods or drinks sweetened with HFCS or….),
      – food poisoning, including intestinal parasites,
      – partial intestinal obstruction, from intestinal hernia, for example
      – certain medications or supplements, such as acid lowering drugs or iron…

      Chronic bloating and gas can be caused by fructose malabsorption, lactose intolerance, celiac disease, Crohn’s disease (in these cases, you would likely have constant problems). Colon cancer at your age is extremely unlikely (usually occurs after 50).

      This personal medical history questionnaire can help you to prepare for the doctor’s appointment.

  • Feel Helpless

    Hi, I have had constant lower left abdominal pain for almost 2 months. I was hospitalized twice as the pain became so intense. I was treated with antibiotics even though I did not have a fever & my White Cell Count was normal. I had a colonoscopy which showed diverticulum. Thye Dr’s keep treating it like diverticulitis, but I’m not so sure? The pain is an almost constant ache and I am also very tired even though I am getting a lot of sleep. My bowel motions are all over the place – sometimes constipation, other times diorhea. I am 38 years old and not overweight, and I’m starting to get very depressed. Any thoughts? I had my gall bladder out 4 years ago. I also seem to have a problem absorbing vitamins & my cholseteral can be high at times. I’m too young for this! Help!!

    • Jan Modric

      Feel Helpless,

      diarrhea and constipation can actually be caused by diverticulitis; fever and elevated white blood cells do not always occur. Having a diverticulum is not already diverticulitis, though. Anyway, in diverticulitis, antibiotics should be effective in few days. If not, other disorders should be considered, like Crohn’s disease, intestinal parasites (stool test for parasites), or disorders in other organs, like left ovary.

  • apurvanand31

    Hi I am 26 year old, height 6’3″ weight 97 kgs.

    I smoke 10-11 cigs a day…… drink around 1-1.5 litre of alchohol a week

    have asthama but occasional.

    past two-three months I am having pain in lower leftabdominl area

    also have pains in my ribcage again at lower left end of rib cage

    back pain lower left

    pain subsides when i press at back

    I have started burrping and farting quite often then I used to

    My belly has become stiff.

    I am suffering from some dreadful disease….. i am really worried whether my kidney /lever has gone bad because of excessive drinking.

    Pain is acute after i wake up in the morning after a booze party.

    Please help me

    • Jan Modric


      belly stifness, burping, gas, and pain in upper and lower left abdomen speak for gas built in the colon. There are several causes of excessive bloating and gas possible, including intestinal parasites, lactose intolerance, fructose malabsorption, celiac disease, and so on. You could find the cause by having some diet trials, like lactose-free or low-fructose diet, andif no relief, you can vist a gastroenterologist to get a proper diagnosis.

  • apurvanand31


    “I am suffering from some dreadful disease”

    Am I suffering from some dreadful disease?

  • nidhi

    Hi Jan,
    I went to a marriage on last Tuesday that is 3rd august 2010, due to too much hot climate in India at this time, I was not feeling hungry. So i ate very little. This caused constipation and then 3 painful ulcers in my mouth. To relive the ulcers and constipation I took milk 2 times daily along with food from home. I ate paneer/cheese for 2 days at it softened the chapati(Indian bread). yesterday i drank around 6-7 glasses of water(small glasses). I usually do not drink more than 2 glasses of water per day. I drank lassi(sweet dairy product)also. After this my constipation disappeared and rather it went the other way round and i went to pass stool around 3-4 times in the day. When i went back home after work, i ate dominos pizza and garlic bread, immediately i stared to bloat and have severe pain in the left lower abdomen. I just kept on passing stool. this went on till 3:30 at night. After this the pain became unbearable and i had low fever with chills and bloating and so i took crocin pain relief for the pain and pudin hara for the bloating and the diarrhea.
    Now in the morning I took half glass milk and added half glass soda to it.
    Immediately i had dome gas pass from my mouth, it eased me but still i am having a lot of pain in my lower right abdomen.

    Please help!!

  • nidhi

    Hi Jan,
    Also to add i am a 25 years old female. Married since 2.5 years. I am beta thalassemia minor and my HB is between 9 and 10, does not get any better. yesterday i also took a folic acid, some b complex and an iron tablet.
    my stomach is very soft and it remains like that always.
    the pain is very strong some times i think that it might just be the gas problem as i had constipation for the full last week, also i think that might be there is some stomach infection that developed due to the week long constipation. I went to pass stool around 20 times since the past 24 hours and i am having soft stool. i am feeling the urge to go to toilet again and again and while passing the stool also i have a lot of pain. But the pain is hurting a lot, Please help, i am in lot of pain.

    • Jan Modric


      your symptoms could be from a bacterial food poisoning (in this case symptoms would likely went away within a week from the start of infection) or parasitic infection (which can last longer). Pain can be from bloating, so try to avoid foods and drinks that may cause bloating (milk, soda, sugary foods, foods, high in fructose or sorbitol and foods high in soluble fiber, like oats, pulses…). If bloating and loose stools don’t resolve in few days, you can visit a gastroenterologist who can order stool tests and give you antibiotics or antiparasitic medications if necessary.

  • cutegal

    I was pregnant couple months back and had a miscarriage in June (12 weeks ) . while I was pregnant I felt a bit of discomfort on my left side pelvis not huge pain thought was round ligaments ….now that I miscarriaged..I still feel it especially when I’m sitting …when touch it there is no lump …but tender when I press on it’s alongside pelvis …sometimes it’s around my varies or below it and it’s only on left side. saw my physician and says to me ..not to worry could uterus going back in its place…I mean would it take that long for a uterus to go back? anyways saw my gynecologist …told him about it ….doesn’t seem he verified my left ovary to see if there’s a cyst…nothing . took sample of my vagina and send for test , said wi call back if anything ..but he said nothing to worry about. I personal feel it’s not right to feel that. what if they are wrong and have something they overlooked. I don’t have fever ;or anything ..just that tenderness … now I’m that it can ube serious.

    • Jan Modric


      I guess you would kinda know, if it were gas in the intestine. There had to be some cause of miscarriage, and I agree, pain or tenderness is not normal. If tenderness persist you can discuss with your gynecologist about investigations of the ovary or Fallopian tubes. MRI of the abdomen and salpingography are two possible investigations.

  • cutegal

    Well the reason I had a miscarriage was due to a tear in my placenta and my gynecologist said the results of the placenta analyse were that apparently there was an inflammation in the placenta…and was wondering t if I had an infection like chlamedyia or something …told him no…dont know what are the symptoms…but did feel sick or anything

    • Jan Modric


      it would be fine if you can ask for an exact medical name of the “inflamed placenta” and is it possible that kind of inflammation would affect the uterus or Fallopian tubes. You can also ask about the possibility of endometriosis and pelvic/abdominal adhesions. These conditions can be only sometimes detected by an ultrasound. Fallopian tubes can be checked by a salpingography, if necessary; other possible investigations are MRI and laparoscopy.

  • cutegal

    thank you very much i will look into this..

  • Bigmama


    I`m 37, female 225lbs, was in a car accident 6 months ago. I have been experiencing pain in the lowerback region constantly. I rate the pain at 8-10 reactivly. 3 days ago I started having a different pain on my lower left side above my hip to my ribs and shooting to the back and just staying there. I didn’t pay it any mind, but the pain is increasing and last night I collapsed in pain so intense I wanted to die. I didn’t go to the ER as I have a small child and can not leave her.

    As I write this to you I have not slept because of the pain it is off the chart and I doubled my doses of gabapentin (300×2) and mylan-baclofen(10mgx2) now I took my oxycodone and still the pain persists.

    I can barely breath the pain is so much. I felt the need to pee but no pain or burning. I have iregular BM so I don’t pay it any mind. My cycle is regular and ended last week.

    The pain is a sharp shooting and pulling pain. Pain shoots outward to my back and hip and then comes back to my lower left side. I am already having sleep problems, haven’t slept more than a couple of hours a day since my accident. But the pain is too much to even lie down it susides only when I curl up and rock about.

    I had an MRI to investigate my previous lower back pain radiating to my toes. I have lost partial sentitivity to my toes and sometimes I just fall down for no reason but no loss of concouness. I have also recently developed shakes that come and go as randon as the falling but not at the same time.

    I do not smoke and I have not drank since new years, I am quite over weight but can’t do nothing about that till the pain is managed. Is there a pill I can take that can eleviate this pain so I can take care of my daughter and myself?

    Forgive the gramma and spelling errors I have not slept for over 38 hours now.

    I just want to get a general idea of what could be the problem.

  • Bigmama

    Sorry forgot to mention I have a high fever and am tender to touch, particulrly from my waistline to my back where the pain is constant. Pressing my stomach is not painful but moving or walking about is out of the question.

    I am completely inactive have been for 6 months since my accident. I am already living with chronic pain that I can scale and manage somewhat to apear at ease for my daughters sake, this new pain is driving me mad. I can’t manage it.

    Any thoughts will be appreciated.

    • Jan Modric


      I recommend you to ask someone to carry you to your personal doctor. It sounds you have an infection, I can’t say where, probably in your abdomen or pelvis – your doctor should decide, which medication to give you and to which specialist to send you. Please, pick up the phone and call the doctor. If you don’t know, who should carry about your daughter, explain to the doctor, he should find a solution.

  • Dawn

    Hello, I’m a 19 year old female, 120-ish pounds, who doesn’t smoke or drink that has had abdominal pain for close to 9 years.

    When it all started, I didn’t know what my problem was at all. There was just intense pain in my lower abdomen that would come in and out and at varying intensities. It wasn’t related to my period, and I slowly started to discover that it was coming from the foods I was eating.

    As of now, I know for certain that I cannot have milk products. But I have other issues linking to meat. My first real problem started with steak/ground beef. I kept eating it until a few years ago. Every time that I ate it, I would get this unbelievable sharp pain in my abdomen. It’s been awhile since I’ve had it last, so I don’t remember what side of my body it was on. The pain was extremely powerful, though. It gave me this rush that I needed to go to the bathroom about 10-20 minutes after I had just ate. But when I got there, I couldn’t relieve myself. It would take close to an hour or more, and that would result in painful and smelly loose stool.

    I’ve grown accustomed to not eating beef, but I’ve never figured out why it was such a problem. Now, the problem only seems to be worse.

    In July, I had made a trip to stay with friends for a week or so. I ate chinese food that was chicken, but it was a little bit spicy. Around 10-20 minutes after eating I began to feel intense pain in my lower left side. It’s about an inch and a half from my naval, and if you put your hand on your hip it reaches right where the middle finger stops. The sensation of pain would go from a dull ache back into painfully intense and then would die down to nothing, only to repeat the process. I had this painful feeling that I needed to go and couldn’t sit directly on my bottom. About an hour or so later I had my first BM but it wasn’t much. It was very watery and very painful to pass.
    After that, I was unable to go to the bathroom (#2) throughout the whole week I was there. Because of my diet, I was restricted to eating chicken and crackers. I cannot eat sugary foods because of this issue, and greasy foods are also out of the question. Often times fruits are too acidic for my stomach, and eating certain vegetables, like corn, just gives me the runs.

    As of recently, the pain has pretty much stayed in the same spot. This issue usually happens at least once a week. Every single day I have difficulty with it in the morning. I usually have to wake up and wait for myself to be hungry to eat, and then after eating I can’t do anything because any movement or too much excitement seems to instantly trigger the pain and cause me to have this constipated/diarrhea experience.

    Sometimes I experience the pain right below my left ribs, which usually accompanies the pain described before in the LLQ.

    I have gone to a doctor a few times when I had to be pulled out of school for the intense pain I was feeling, but they always told me to eat jello and drink water for a full 24 hours and then to reintroduce foods (non-dairy ones).

    I’m wondering if you have any suggestions on what this is and whether I should go to the doctors again, as I’m tired of being unable to eat food, or to even have a good time with friends. It’s really inconvenient.

    • Jan Modric


      both lower and upper left abdominal pain probably arise from the colon, and you might have an irritable bowel syndrome (IBS), since constipation, diarrhea and abdominal pain/cramps appear 20 minutes after the meal and depend on type of the food. Various random foods may irritate you, but still often some food groups and nutrients are more problematic, and it may come out you actually have one or more specific food intolerances.

      Dairy causing symptoms speak for lactose intolerance. In this case not only dairy products, but any food containing lactose (as an additive) could irritate you.
      If fruits, like apples, pears, melons, grapes, prunes, peaches irritate you, you might have fructose malabsorption. In this case wheat and onions could also (not necessary) irritate you. Maybe only sweetened corn and processed meat or certain types of meat irritate you. I suggest you to start a food diary and write down which foods irritate you and which not. If you are prone to constipation, foods with soluble fiber, like oatmeal, may help you.

      A low-FODMAP diet combines lactose-free and low-fructose diet and could help you. It is not necessary every form of corn and meat that irritate you.

  • Dawn

    Thank you, Jan.

    Unfortunately, I’m allergic to oatmeal. It causes bumps to form on my skin that are really itchy, and I tend to avoid it because of that discomfort.

    But the FODMAP link looks helpful! Thank you, again.

  • Shiloh

    I wonder if you could offer me some advise. I am 34 years old female with no apparent health problem. About 5 months ago I started having a sharp twinging pointy pain in my left lower quadrant, just on where my ovaries or fallopian tubes are. It is always the same point and ache is not spreading. I went to see my gp, she ordered me an ultrasound and a transvaginal scan. Those 2 scans took less than a minute, I found it rather short. Anyway the person who did the scan told me that there was not any cyst or fluid. Everything looked normal. I don’t have any other abnormalities, normal bbt, no fever (I take my bbt everyday as I am in ttc) I only had a bit of spotting 1 week ago before my period on my last menstruation which I thought I was having implantation bleeding. The pain is always there I especially feel it a lot when I bend over to fix my shoe ties or when I am squatting. During my last ovulation I notice that the pain has increased. I live in England and here it is so hard to convince your GP to get a referral to a gynaecologist or getting more testing. Since the pain is low degree I don’t know what to do. Could it be something important? We are also trying to concieve for the last 6 months so that I am worried that something is wrong with my reproduction system. Could you offer me some advise for example what kind of tests should I be given?
    Many thanks in advance.

    • Jan Modric


      I recommend you to try to arrange an appointment with a gynecologist. It may be something in your left ovary (cysts?) or around it (adhesions?), for example. Gynecologist should know which excat investigations to do (progesteron/estradiol blood levels, ultrasound of the pelvis…). Pain being low grade does not mean you don’t need to be checked by a specialist.

  • Yona

    Having LLQ pain consistently for last few months. Have noticed significant increase in gas. Also, bowel movements are irregular. Have noticed much more diarrhea than usual, but it’s also sporadic. Sometimes lasts a day or two, then might go away for a few days. Stools usually float, but are not unusually colored. Sometimes the pain, though dull, seems to pulse. Will appear to pulse between three and five times. Pain is greater when that happens. I would describe the pain as similar to bruising. I did have a fall accident there a couple years ago. I fell and hit the corner of a cabinet and had large bruising and pain for two months. Wasn’t able to go to the doctor at that time and probably not able to go this time (because I’m a poor college student). My diet is quite terrible actually due to the the meal plan they have us on. High in fatty foods. Have gained about 30lbs in the last year. If I hold the area in pain, it seems to subside. Seems to be worst when I’m laying down, however- sometimes to the point of keeping me from sleeping. Most concentrated where the lowest part of ribcage is. I’m 26, 5’11”, 196lbs. I’m not physically active to due to busy schedule.

    • Jan Modric


      common causes of chronic excessive gas and diarrhea include: irritable bowel syndrome, lactose intolerance, fructose malabsorption, intestinal parasites, celiac disease, Crohn’s disease, gallstones, and, more rarely, liver or pancreatic disease.

      Gas and loose stools may be from a diet high in soluble fiber, like legumes or oats. You may try a lactose free diet – if you have lactose intolerance, it should help in 3-4 days. If no improvement, you can try a low-fructose diet – if you have fructose malabsorption it should again help in fgew days. I also believe you do have a chance to choose the food you eat to some extent. So try to avoid what you think bothers you. Stools are yellow because during fast bowel motion in diarrhea, bile salts do not have time to convert in an usual brown color. But, if your stools are colorless (clay, gray), this speaks for a bile duct obstruction or liver disease.

      Anyway, I strongly recommend you to visit a doctor, since the sleepines is not something what would usually occur in food intolerances.

  • Yona

    I forgot to mention, I’ve been extremely sleepy lately as well, to the point where I don’t ever feel rested. I feel the need to sleep nearly perpetually. I don’t know if it’s related, but I thought perhaps important to mention. I’m usually one to be able to function on very little sleep, but lately, I’m needing about 12 hours, sometimes more a day.

  • Shiloh

    Thanks Jan,
    They did an ultrasound and apparently they could not find anything no, cysts nor fluid. Perhaps they did not do it properly. I will press my gp to refer me to a specialist.
    Many thanks again.

  • rosie

    Hi Jan, just wondering if you could give me some advice…

    I am an 18 year old female, just over 8 stone, fairly active – although not as fit as I used to be, don’t smoke but drink regularly on nights out.

    Over the past few months I’ve noticed a fairly dull but constant pain in lower left abdomen about two inches across and one down from the navel. It comes and goes usually lasting about week. I first noticed at after a heavy night out, however it continued for another 10 days, even though I didn’t drink for another 2/3 weeks. It usually occurs after drinking but then other times it has just reappeared – seemingly without a trigger.

    I am also experiencing noisy guts and a the passing of gas more than I am used to – especially at night. My bowel movements are just slightly harder to pass though, yet I am still going to the toilet every day. Feeling slightly lethargic aswell. Just wondering what this could be?


    • Jan Modric


      to mention on the start, intestinal parasites are one possible cause. Dx is by a stool test for parasites – the letargy made me thought so. You may have some diet trials to see, if you have developed some food intolerance: a low-fructose diet, or a bit more extensive low-FODMAP diet for 3-4 days.

  • Chris

    On day 1, I felt a small localised tender spot on the lower left side around the belly button, quite near the “front”. Over the next two days I seemed to feel the sensation slightly move downwards as if I was slowly digesting some slightly painful food! Two days later I have a general feeling of an “upset tummy” as well as a more localised tender point, I get occasional sudden (ish) onsets of a cramping kind of pain, not severe by any means, but not negligible. Tummy feels a bit bloated and have had generally dihaorrea’y stool, sometimes fine, constipation is a small issue, it is sometimes a struggle to go, also slight pain when I try and “force” it out.

    Any help greatly appreciated,


    Chris Phillips

    • Jan Modric


      if the tendr area is small (few inches), it could be an intestinal hernia (a lump would be likey felt under the fingers in this case) or maybe an intestinal diverticle. If all symptoms appear mainly in the left lower abdomen, the cause probably arises from the colon (like diverticulosis).

      A common cause of lower left abdominal discomfort with bloating/constipation/diarrhea is an irritable bowel syndrome – symptoms appear or worsen in minutes after the meal and are relieved by a bowel movement. Fructose malabsorption or lactose intolerance or any disorder with excessive bloating could be the cause, though. When symptoms last only for few days, the probable cause is some food incident/poisoning. If symptoms last for more than a week, and are not severe, some diet trials, like low-fructose diet, lactose-free diet or low-FODMAP diet could be done for few days each.

  • ymsl

    I am having lower abdominal pain on the left side between thigh and navel. It started just this morning, but I have severe pain when I walk, I sort of bend over to alleviate it. I mostly do not feel it when in a sitting position, though.
    I am 28 – 5’6 – 140. No history of medical abnormalities, I don’t smoke or drink and constipation is not an issue.

    • Jan Modric


      causes of abdominal pain in men and women differ…It is also important to tell, when the pain has started, is it a dull or crampy pain, any change in bowel habit or stool color, is your lower abdomen distended or tender to touch, is there any lump..?

  • ymsl

    Thank you for the response. I am female, and I pretty much felt the pain when I first got out of bed in the morning. I did not see any changes in bowel habit or stool color, and it is not sensitive to touch. There is nothing different that I can tell.

  • ymsl

    also, the pain is crampy in nature.

    • Jan Modric


      lower left abdominal cramps may arise from any hollow muscular organ there: the colon, left ureter or Fallopian tube. Cramps could also arise from abdominal wall muscles (after exercise or in certain mineral disorders, like hypokalemia or hypocalcemia).

  • ymsl

    Anything I can do to alleviate the pain?

    • Jan Modric


      if the pain persists and you think it is not from constipation or bloating, it could be good to visit a doctor, who can examine you and judge where the pain is coming from. I’m not sure how much relief OTC antispasmodic medications could provide in your case.

  • Juliajoy

    Hi there,
    On Tuesday night ( today is saturday) I started feeling pain in my stomach. I hadn’t eaten much and thought it was caused by hunger pains and would go away the next day. WEdnesday, the pain is still there… try to eat well during the day… but pain is still there kind of hidden underneath my food. THursday, I am noticing the pain is more like a direct spot in my lower abdomin, it hurts to walk, laugh, sneeze and and in some positions that i sleep in… go to bed early holding onto my stomach, hoping it will be gone the next morning. Friday… still there, so off i go to the doctor. I told him my symptoms which also included sudden loss of colour in my face, goosebumps and the hair on my arms to stand on end. My toilet activity is very minimal, no diarrhea and not many normal stools. HE gives me enemas to put up my rectum to release constipation and maybe an infection in my large intestine… they didn’t seem to work much, so today i did a salt water flush and have a lot of diarrhea, which i will hope clean out my system!!
    however i get the feeling this problem goes deeper, as the pain feels too specific, like a big ball is just stuck in my lower left side.

    I am 25, pretty fit and healthy. However in the past 2-3 week my diest changed drastically. I start work at 5:30 in the afternoon until 12:30 at night.. in this time, I do not eat anything, besides maybe a passing few pieces of bread. So i have gotten used to one big meal a day for lunch , besides a small breakfast… so i know my stomach is not used to this. but the sudden pain, just seems a little too big of a reaction.

    any help????

    • Jan Modric


      if your symptoms appeared after you started to eat less, I recommend you to start eating as you did before. Paleness and goose bumps may be from dehydration or simply feeling cold due to less eating. When you don’t eat, constipation and bloating that follow may cause quite painful cramps anywhere in the abdomen.

  • Anton

    Hello,l am suffering with lower left abdominal pain now for approx.4 months and prier on and off for approx.4 years.lately l ‘ve had blood work done a few different times only to show there isn’t a problem with kidneys ect.l do not generaly have constipation,l do drink a fair amount of water,l am active,and this pain has caused me and my docter concern,l am 58 yrs old.l have had both hernia and a ruptured alcer,could one of these old problems be creating a new one?

    • Jan Modric


      was the hernia in the groin, and ulcer in the stomach? It is important to say where excatly is the pain (in inches from the navel), what triggers it, how long it lasts when it starts, is it affected by moving, tender to touch…

  • Anton

    Hi,thanks for returning a reply,yes the hernia was the grion and the ulcer was of the stomach.the pain is at the back side,left side approx l think were the kidney might hurts after l fall asleep,which it wakes me up,it is hurtfull when l get out of bed , then it disappears.if l move around on my left side then it persists,however ,when l turn over to my right side,and go back to sleep ,l am ok untill l am on my left side again.any suggestions are gratefully appreciated as this is driving me bonkers.thanks again for for patience and time and concern.
    hopefully yours

    • Jan Modric


      kidney pain would be more likely felt on the back, toward the left side, just below the rib cage. If the pain is in the front, and the spot is tender to touch it is more likley a gas built in the transverse colon. This is sometimes caused by certain food intolerances, and a low-FODMAP diet could help in few days.

  • Anton

    the pain is while l lay on the bed it seems sensative to the touch only in bed but not after l stand up or when l am on my right side,thanks again

  • Zilpah 5

    Hi Jan, I wonder if you have any suggestions. I am a 54 year old female with a rather stressful and demanding job. For the last 15 months I have suffered on and off (mainly on) from lower/mid left abdominal pain. The pain occurs predominantly after a bowel movement, sometimes immediately and sometimes after an hour or two. Sometimes it lasts for a few hours and sometimes all day and can be quite severe. It rarely bothers me at night. The type of pain and location within the lower left quadrant also varies (sometimes like a stitch and sometimes an ache). I am prone to constipation and take 4 teaspoons of benefiber a day. Bowel movements can be difficult, I tend to get an urge which dissipates before I get to the toilet.
    I also suffer from GERD and take one Pariet tablet a day. I had a colonoscopy and endoscopy a year ago, which showed a hiatus hernia and mild diverticulosis respectively. I had a fecal occult test which was clear. However a fructose breath test showed moderate fructose intolerence (52 something?). I have been on a low FODMAP diet for about 3 months. At first it seemed to work but now the symptoms are back for no apparant reason.

    • Jan Modric

      Zilpah 5,

      I can’t give you an exact answer, but pain in the lower left/middle abd. after a bowel movement might originate from the colon (more likely rectum). You have confirmed diverticles, so these could worsen in one year…A rectoscopy or sigmoidoscopy, or X-ray with barium enema would all reveal diverticles. Thrombosed hemorrhoids would be also possible. Ulcers caused by ulcerative colitis, Crohn’s disease or colorectal cancer would possibly cause blood in the stool, and this can easily occur within a year (from your last fecal occult test). Bowel urges also speak for a process within a rectum. So, I recommend you to visit a gastroenterologist.

      You can check these articles about low-fructose diet, and low-FODMAP diet.

  • Zilpah 5

    Sorry, I probably didnt make myself clear. There is no evidence of any blood in my stool and the clear stool test test was about 6 months ago. The problem is the daytime pain, which while not constant is very bothersome.

    • Jan Modric

      Zilpah 5,

      you were clear, but probably I wasn’t. I wanted to say, if there was no blood in the stool at your last test, it can be now, even if none can be seen with a naked eye. Blood could come from an ulcer in the rectum. But some other causes, like thrombosed hemorrhoids would not necessary cause any bleeding. In summary, pain after a bowel movement and urgency, to me, speaks for some organic disorder in the rectum. In food intolerances and IBS it’s usually just the opposite – symptoms resolve after a bowel movement.

  • Zilpah 5

    Thanks, I’ll check it out. By the way I went to the phyio today for a shoulder problem and mentioned the abdominal stitch like pain near my waist. He applied some pressure with his hand and the pain disappeared. He has also given me some suggestions to reduce the straining for bowel movements.

    • Jan Modric

      Zilpah 5,

      pain, disappearing after applying some pressure may disappear due to redistribution or release of gas in the colon/rectum. I still can’t reliably exclude some organic disorder, like thrombosed internal hemorrhoids, since it might be possible that gas built could aggravete pain from hemorrhoids. An experienced gastroenterologist could answer this. Straining at stool could maybe stretch some diverticles to the point they would be painful for some time after bm.

      Here are some foods that may relieve constipation mentioned.

  • src30945

    I have been having perdiodic episodes of shard LLQ abdominal pains on & off for about a year. It is not constant, it comes in waves, quite sharp. The area is not tender or painful to palpate.Everything esle is normal (stools, urine, etc) I am 49, great health, fitness enthusiast. The only thing out of the ordinary is that I take lots of vitamins. Multi, C, B complex,D, Quercetin, Alpha Lipoic acid, elderberry, resveratrol,Creatine capsules. I am beginning to get the feeling that the vitamins are causing this. A couple of times i stopped the vitamins for a few days and didnt get these episodes. These episodes are now occurring for several days at a time, every other week or so. Could the vitamins really be causing this? Or is this something more serious. Its becomming very nagging. It has even woken me up from sleep a few times recently.

    • Jan Modric


      in case your vitamins and other supplements were not prescribed by a doctor, and you are otherwise healthy, I don’t see the reason why to take them. Vitamins are usually taken where some vitamin deficiency is confirmed by blood tests. Supplements contain sweeteners, like fructose or sorbitol and other substances that may irritate your bowel.

  • natetzhba

    hi i am a 25yr old male about a year ago i started getting a dull pain in my lower left back usually only felt it on my drive home from work when sitting in the car. i didnt think much of it cause at the time i had an infected tooth so i thought maybe the infection was causing some pain in my kidney, so i took the meds for my tooth infection, and the pain seemed to disapate, got my tooth fixed and about a month later started feelin the lower left back pain again usually when sitting mainly in the car, than as time went on started getting the pain more and worse i was feeling it more even when standing it would radiate across my lower back also into my left leg, my growing area,im alsways tired and i was getting like a crampy feeling in my stomach cramping pain would radiate all over and for about a week i was urinating alot i would get up in the middle of the night 3-4 times to go, well the constant urinating went away but i was still having the pains. so i went to the hospital and they took a urin sample, said it was fine, than said it was just muscles, so they gave me flexeril, i never took the flexeril thinking if its just muscles pain than ill deal with it, but than shortly after that i felt constipated so i started drinking crannberry juice and took a laxative, than i had loose stool for a while than started having 3-4 small bowel movements a day soft with mucas, so i went to the family doctor he took a urin sample and an x-ray and said it was just muscle problems and probaly a little dehidrated, told me if i was to get any better i would have to take the flexeril and possibly therapy, so i started taking the flexeril it helped some i was still feeling some back pain on the left lower back side across my lower back and on my right lower back side and and usually have a bowell movement three times a day regular size bowel movements are usually softer with mucas always brown color and the last month or so iv been burping alot sometimes makes me feel better when burping. than i started peeing alot again for about a week usually always clear no blood not cloudy than about bedtime wed night i got a really bad pain worst pain iv had in my back in my left side back kidney area and my right side back kidney area so i had a bowel movement took a cyclobenzaprine for flexeril, got in a comfortable position where the pain wasnt as bad than went to sleep the next day i woke up i had diareah and very nausas i went to work and by 5pm i was feelin alot better diahreah pretty much went away, but iv been havin alot of nauseah since along with burping and my back pain, so i went to the hopsital sat (3days later) they did a urin test said it was fine and to see my family doctor so now its back the family doc, back pain is worse when sitting sometimes i dont even notices it till im sitting other days it hurts all day but its getting worse, always burping specially after eating the last 4 days iv felt nauseah and i have at least 3 bowell movments a day, do you think this is all related i cant seem to get a doctor to help me. im always worry about this very scared, please help thanks nathan

    • Jan Modric


      excessive burping and diarrhea arise from the gastrointestinal tract. Intestinal parasites, fructose malabsorption, small intestinal bacterial overgrowth (SIBO) are some possible causes. A gastroenterologist can tell which tests to run (stool test for parasites, breath test for fructose malabsorption or SIBO, etc). Frequent urination, but normal urine, can arise from gas in the rectum pressing upon the bladder.

      Pain radiating toward the inner (?) side of the upper leg and groin could arise from the urinary tract…but burping and diarrhea is from the bowel.

  • sameasmoe

    I am writing this to find some help with my problems. Here it goes i am a 28 yr old female 185 5’5 i know i need to lose weight but thats another thing. I have been having frequent loose stools, 5 to 8 x a day sometimes hard not always though. Occasional blood in stool and when i wipe( bright red) . Always bloated and just had a colonoscopy( came back fine) and 4 days after that was in ER for severe stomach pain ( always have pain in LLQ )and vomiting.. Had to have an operation on colon had a henia. They put a 15cm mesh inside. Also i have been on a lactose free diet now for month’s ( still having bathroom trouble. Doctors are giving me no answers … Can anyone help?

    • Jan Modric


      red blood in the stool may arise from a disorder in the colon (including hemorrhoids), and if this is excluded by a colonoscopy, a disorder in the small intestine (celiac disease, Crohn’s disease limited to the small intestine), or by intestinal parasites, for example. Small intestine can be investigated by a capsule endoscopy.

      Lactose intolerance can be accompanied by fructose malabsorption – in this case a low-fructose diet would likely help in few days.

  • sameasmoe

    Thanks Jan,
    I will mention this to my doctor. I will be relieved when i know what exactly is happening with my health. Thankyou for your help.

  • mike

    i am 22 year old male active, i was sick about 2 and half weeks ago with fever sore throat, i took my mothers old antibiotics from 2007 only 3 days then went to the docs and got amox for 7 days and finished it on the 5 day of amox i felt better fever gone throat clearing up but started felling a nagging pain in the lower left side near lower rib cage kinda towards my lower back left side i read online my sypmtoms, thought it was mono so got tested …came back negative (but i read mono doesn’t show for the first week of symptoms) so i went back to the doctors few days later its been almost a week since the naggin still naggin and im always tired. My urine seems normal i drink alot of water so its clear, i had diarrea but went away when i got off the amox now just light brown/green/yellow stool normal looking just wondering what it could be the pains not extreme but really annoying and dont know what it could be from Mono? Antibotics? or something else

    • Jan Modric


      sore throat, fever, and tiredness occur in flu, including swine flu. In infectious mononucleosis, sore throat, enlarged or painful lymph nodes in the neck, armpits and groin, tiredness and rash are common; symptoms may lat for a month or more. High fever, enlarged red tonsils (?), and enlarged lymph nodes in the neck or back of the head (but not armpits and groin) appear in bacterial (streptococcal) infection of the tonsils.

      Pain in the lower left rib cage could arise from the spleen or gas built in the colon. Green/yellow stools may be simply due to quick travel of the stool through the gut, or antibiotics, cant say. If you had no rash or enlarged lymph nodes, and if ssymptoms persist, I recommend you to ask a doctor about which investigations would be reasonable (swine flu, ultrasound of the spleen…).

  • rbg


    I am a 30year old male and have been suffering from constant upper left abdominal pain since the last 1 year. The CT scan with contrast and colonoscopy all came out negative and the doctor told me that all reports were perfectly fine there were no issues reported. Infact i am suffering from this pain a lot and not knowing on how to proceed. When i press in the area it is very painful.

    Please advise.

    • Jan Modric


      is the pain there just all the time, I mean is the affected site tender at any given time? Is the pain aggravated by meals or relieved after bowel movements? Does the pain changes with the body movements or deep breathing? Any change in bowel movements, or excessive gas? What is your diet in general?

  • rbg


    I have discomfort all time. Anytime when i press under the left abdomen there is pain or tenderness. It increases a lot before bowel moment after which i have discomfort.

    Please advise

    • Jan Modric


      according to your symptoms, one possible cause of your pain is gas built in the part of the colon that runs below the left rib cage. If you are otherwise healthy and have no diet restrictions, you can try the following:
      – a low-fructose diet for 2-4 days. If it helps, it’s likely you have fructose malabsorption. If no relief, you can try…
      – a lactose-free diet for 2-4 days. If it helps, it’s likely you have a lactose intolerance.
      You can also try a low-FODMAP diet, which is a combination of above two.
      – a gluten-free diet for at least a week. If it helps, it’s likely you have a celiac disease.

      If nothing of above helps, you can ask a gastroenterologist for a stool test for parasites or other investigations which would reveal the cause of excessive gas.

  • rbg


    Forgot to mention, i was having a lot of gas and hence was asked to use aciphex. The gas has reduced to some extend but not the pain & discomfort.

    When i lie down on my back and press the abdomen below the left ribcage i can feel it like i am wounded.

  • rbg


    I have mild pain and discomfort all times and this increases before passing the stools.

    When i lie down on my back and press the tender area under the left rib its intense pain as if i am wounded.

    I was passing gas which is under control by using Aciphex. But these symptoms would never come down.

    Please help me

  • DNaz


    I have had upper middle to left side bloating & pain for over a year. I had an endoscopy and was diagnosed with gastritous due to H.Pylori and was treated with meds. The first treatment failed and had to be re-treated. I was retested via Endoscopy and was told all results came back negative. I still feel the same though. I have been on Nexium for over a year through this process. I was told after the 3rd endoscopy I still have slight gastritous and should stay on the meds. I was told to try a new med (Dexilant) which i have been on for about 4 weeks. I still feel the same. About 9 months ago I noticed a lower left crampy type of pain which has gotten more noticeable thru the more recent months. I told my doctor and he gave me another med to try (dicyclomine)for what the doctor said was spasmatic colon. I had a colonoscopy a year ago, and had a copy of non cancerous small polups removed and diagnosed with diverticulosis and was told to add fiber to my diet. I have also had 2 pelvic ct scans and 1 ultrasound with all negative results. Whew – that is about everything I can remember. Any help would be appreciated. – Thanks

    • Jan Modric


      do you burp excessively or have a heartburn?

  • DNaz

    No heartburn, I do burp a little.

    • Jan Modric


      – a low-FODMAP diet for few days could help in irritable bowel syndrome
      – a low-fat diet for few days could help, if there is a problem with a bile flow (biliary reflux)

  • DNaz

    Hi Jan,

    The lower left pain comes and goes.
    The upper Bloating/Pain seems to build as the day goes on. In the morning I feel pretty good but it seems to come on as the day goes by. I have a followup appt. with my gastro doc this Wednesday to discuss this more. Is there anything I should ask him to help diagnose the problem? Not sure what other tests he can suggest?


    • Jan Modric


      for me, the first question is, does the bloating arises from the stomach or colon? Stomach is located below the spot where the ribs meet (pictures) and slightly to the left, but not far toward the left side. With bloated stomach you would likely burp excessively during and shortly after the meals. H.pylori infection is a common cause of a bloated stomach. It is a breath test that can reveal if you have an active H. pylori infection again. The other common cause of stomach bloating is gastroparesis (slow stomach emptying). Diagnosis is made by a stomach emptying test (you eat a specific meal, and a scan is made to show how far the food has traveled in a certain time).

      A lower left abdominal pain may be caused by gas built in the descendant colon (the diverticles, even if not inflamed, can contribute to pain, and if pain comes and goes, diverticles are not likely inflamed). So, if this lower pain was caused by gas, you would likely have excessive gas, and some bloating there. Gas could be due to fructose malabsorption or some other food intolerance like celiac disease or lactose intolerance. It could help a lot, if you can identify any group of foods (wheat products or fruits or milk products) that aggravate your symptoms.

      This personal medical history questionnaire may help you to recall more symptoms or circumstances.

      In “spasmatic colon” which is also called irritable bowel syndrome, you would very likely have some constipation or diarrhea or both, aggravated by meals and relieved by bowel movements.

  • DNaz


    The most recent Lower Left Pain has been in the morning upon wakeup (not today though, no pain today). The upper Bloating/Pain first thought to be the H. Pylori still appears as the day goes on. I was recently tested via endoscopy and biopsy samples (all negative). The pain is not severe, just more annoying & mentally stressing. I was wondering if this is more stress related or something the tests do not show.

    • Jan Modric


      if I got you right, your last endoscopy/biopsy revealed no H. pylori, but there was some gastritis detected. In this case, gastritis is probably due to excessive gastric acid secretion, and this could be caused by stress, irritant foods or medications or biliary reflux (the bile flowing up from the duodenum)…You could additionally have a gastroparesis – a slow stomach emptying, which would explain upper middle bloating. Diagnosis is made by a ‘stomach emptying test’. In both gastritis and gastroparesis, symptoms would lessen at night and worsen during the day, especially after the meals. The lower left pain, coming and going, is probably caused by gas built in the last part of the colon. In this case, pain would be likely relieved by a bowel movement.

  • DNaz


    Thanks for all your input, I’ll let you know what they say.


  • Ana

    I am a 29 year old female, weigh 120 pounds and have been suffering from occasional stomach pain, bloating and constipation all my life. The pain is sometimes strong but more often uncomfortable, accompanied by bloating and made worse by intake of more food or liquid. The silly thing is it stops hurting AS SOON AS I lie down although the bloating and an uncomfortable feeling are still there. The only remedy is BM that usually happens after 2-5 days. I would say I have a pretty good diet, eat home cooked meals every day, love eating fruit and veg. I have noticed sometimes it is provoked by stress or excitement (it happens a lot when I’m travelling and having irregulars/different meals than usually). Sometimes it may occur twice a week, sometimes once a month. I have tried introducing more fibre into my diet, avoiding gluten thinking it might be a gluten intolerance… It is possible my father and a cousin are suffering from the same condition because they seem to have similar symptoms.
    I hope you can help me because I am out of ideas. Any information would be greatly appreciated. Thanks.

    • Jan Modric


      a combination of your symptoms sounds like what is known as irritable bowel syndrome (IBS). It was found out in last years that people diagnosed with IBS often have some underlying problem, like some sort of a food intolerance, though.

      With a low-FODMAP diet, nutrients that often irritate the bowel and cause constipation, diarrhea, bloating and gas, are removed. These nutrients include fructose (in fruits), lactose (in milk), sorbitol and certain types of fiber known as fructooligosacchardides (FOS), fructans and galactans (in legumes, wheat, onions and certain other vegetables). I recommend you to read the article about the low-FODMAP diet and maybe have a low-FODMAP diet trial for few days. One part of this diet is a low-fructose diet, which usually helps in fructose malabsorption. It’s quite possible a combination of stress and certain foods trigger symptoms in your case.

  • DNaz


    My currect doctor has me getting a Gastric Emptying Study next week. But does not have anything else to check. He said all the previous tests have been done. We decided to discontinue the nexium to see if it make a difference in my symptoms. If this comes up normal, where do I go from here? Should I try a new doctor or specialist?

    • Jan Modric


      you can check this personal medical history questionnaire:

      and write down all your current symptoms, and then past symptoms, tests results, medications..and anything other, like the form says. From a combination of all details a doctor may imagine more clearly what could be the cause. If the emptying test will be negative, you may want to have some diet trials, like a low-FODMAP diet trial (link in one of my above comments) before jumping on the next investigation.

  • bj

    I am 59 yr old male.
    I have chronic on and off, consistent LLQ ab pain since 2006 spring.
    Since then, I had MRI yearly, CT yearly and blood, urine tests, which are all unremarkable or unrelated to the LLQ ab pain.
    Doctors had sent me to hernia surgeon (because the area of burning and pressure and dull pain has been about 1″ about midpoint of inguinal canal), osteopath surgeon (to clarify femoral head necrosis concerns). I also had colonoscopy yearly, that the doc said I do not have diverticuli or other colon lining findings. I also had seen urologist and although have some BPH (and frequent urinations with residual drippings) but they said the sensation should not be at LLQ ab area. One GI doc said I may have IBS or Crohn diseases, but I do not have constipation or diarrhea or BM abnormalities. The symptoms (currently I am feeling it now), is not exertion related (went to Gym, ok) not bowel movement related, no bloating. Usually can I feel it when waking up lying on bed (but the dull pain does not severe to hamper sleep), but can persist the day. It feels like a pencil sticking taut in my LLQ ab that produces dull, some burning sense pain.
    Docs mostly are fed up with my complaints (because I understand their points that I can carry out daily functions without wt loss, or clear and relevant clinical testing results supporting my claims). They usually prescribed anti-anxiety drugs or NSAID to discharge me (helps slightly but not consistently, did not take anti-anxiety drugs).
    I did some diary and have upload some excel spreadsheet data of mine that I ask if you can please download and take a look. As soon as you respond me, I will delete that from my hotmail skydrive.

    • Jan Modric


      I can’t open the file; it says it was probably deleted; but I have few questions:
      – Is the pain always on the same spot?
      – Is the area tender to touch, can you feel any bulge?
      – Is the pain obviously affected by body position, like sitting, walking, and if yes, how quickly after body position the pain appears?
      – Any pain in the back, buttocks, legs?
      – Is pain aggravated by meals or relieved by bowel movements?
      – Have you ever had any abdominal injury or surgery?

  • Justin Graham

    I am a 26 year old male, 5’6″, 175 lbs. A little over a week ago I began having pain in my abdomen on the lower left side. I thought it may be kidney stones. The pain increased, but as it did it moved around my side and has now been in the front of my abdomen for a few days. Now it is just in the front, no pain on the side or in the back, only to the left of my belly button. I also have an uncomfortable throbbing and tingling feeling inside, along with heat. The only way I can describe it is that it feels like someone took one of those heat packs and dropped it inside of my stomach. I went to the hospital, they ran urine and blood work, and said they looked fine and sent me home. I’m still not feeling well. Do you think I should be more concerned, or will it go away since those tests “looked fine”.

    • Jan Modric

      Justin Graham,

      to diagnose urinary stones, specific urinary tests and some imaging investigation, like ultrasound, would be needed. Another set of causes could arise from the bowel – constipation, diverticles, partial bowel obstruction, hernia…In shingles (a virus reactivation in one or more spinal nerves) rash would appear in a band-like pattern (from back to front) in few weeks. If you think, it could be constipation, try to solve that with appropriate diet with more fibers, exercise, drinking enough fluid..If this does not help, or if pain becomes worse, visit a doctor.

  • termsak

    Hi, first of all let me tell you what a fantastic job you are doing.

    I am an Asian 35 year old male. Height 1.83m. Weight 74kg.

    For the past 3 days I have had extreme pain on my left lower abdomen. Nothing particular triggered it. Made me have night sweats but no fever. Took some Tylenol and it helped for a while. Food appetite was reduced the following day. Didn’t feel like I was hungry until 5pm. After meal, the pain would come back and last for hours. I am quite tolerant to pain, but this was really annoying so I decided to go to hospital. Did an ultrasound and blood test. All came out normal. Doctor just prescribe me colofac. It didn’t help and the pain got even worse last night. It used to be all over my abdomen and back, but last night it was exactly at left side slightly at the back. It hurt especially when I lift my left leg sitting or if I had to pull a sock up. It also hurt there when I took a deep breath. This morning it seems fine just bruised a bit. I have not eaten today (only water) so it might tell you something.

    I have a slight constipation problem (been only once to bathroom the past 3 days and only a small solid sample came out last night) and I am kinda bloated (for the past year). I took some Dulcolax last night 4 hours before bed time, but so far no luck.

    I have had occasional irritation in my bowel for the past year, but nothing particular painful as this. Did stool test back then and nothing abnormal.

    I drink a lot and smoke. I don’t drink milk and don’t eat seafood. Most of my diet is beef and pork. Spicy food as well. I am not allergic to any food. Have often non smelly gas. Normally I would go 1-2 times a day to toilet (one in the right after digesting first food) and maybe one later.

    I was also diagnosed with mild SLE (if there is such thing) 15 years ago. The SLE has never affected my internal organs such as kidney and liver.

    I am planning to admit myself to hospital today. I do not trust the doctors here in Thailand. Would appreciate your recommendation on what it could be and what they should look for/what kind of tests should be done.

    • Jan Modric


      pain in the lower left abdomen aggravated by meals strongly speaks for a bowel involvement, probably large bowel, but I cannot exclude small bowel involvement. Constipation, intestinal hernia, diverticulosis or polyps are examples of possible causes of a bowel obstruction. Colorectal cancer is extremely rare in your age. Eating green leafy vegetables, whole-grain bread, brown rice, fruit/vegetable juices and avoiding alcohol, meat, chips, French fries and other heavy sugary/fatty foods may help to prevent constipation. Doctors may suggest you having a stool test for parasites, or (when a disorder within the bowel is suspected) X-ray with barium enema or colonoscopy, or (when a disorder outside the bowel is suspected) an ultrasound or CT or MRI of the abdomen. They might offer you a laxative to clear the bowels. They might run blood tests to evaluate if the SLE (systemic lupus erythematosus) has worsened. They might order a urine test to exclude kidney disorders. They may ask you several details about pain triggers and other circumstances, so you can use this questionnaire to prepare for the visit.

  • termsak

    Additional info: I take 1 tablet daily of Cellcept and one of Azithoprine for the SLE. This been taken for 3 years now. I stopped taking Prednisone 2 years ago.

  • CJ

    I have had a nagging, low-intensity LLQ abdominal pain for ~4 weeks. It is very slightly tender when pressed. Over the same period, my bowel movements have fluctuated between regular and diarrhea (sometimes somewhat urgent). I go 2-4 times per day, often just after eating. The pain is usually present, but occassionally abates (seemingly at random).

    This is the second time I have experienced a similar pain, though the first time (~6 months ago) it was accompanied by intense constipation and was ultimately relieved after ~1 week by going on first a high-fiber and then a 2-day liquid-only diet. I have not yet tried the same thing due to difference in symptoms.

    I’m male, 30 years old, 5’11”, ~160 lbs. I take no medications. I quit smoking ~1.5 years ago, and was two-pack-per-week smoker for ~8 years prior. I have 1-3 drinks with dinner usually 3 out of 5 week days, sometimes a few more on weekends. I eat a varied diet, usually relatively healthy, but have indulged somewhat over the holidays despite the pain. I walk to and from work, and run occassionally, but have not exercised regularly since summer.

    My bowel movements have been somewhat irregular over the last few years (without pain), but generally seemed to improve with my diet and flare up only with fatty foods.

    How urgent is it that I see a doctor? Should I try dietary modifications again first? Any help or advice would be much appreciated.

    • Dr. Chris

      Hi CJ

      You should see a doctor about this and have it investigated further. Cannot comment on the urgency but bowel disruptions should not be taken lightly given the prevalence of inflammatory bowel disease (IBD) and colon cancer these days. This is not to say that you have colon cancer. A more likely cause would be IBS (irritable bowel syndrome) but this should only be diagnosed once other conditions like IBD have been excluded. The fluctuation between constipation and diarhhea, improvement with dietary change and possibly quitting smoking may all be indicative of IBS. Other digestive disorders that may be affecting digestion of fats and so on would also be responsible but this will be confirmed with a stool test. It is advisable to see your doctor as self-medicating could exacerbate the condition and cloud the clinical presentation thereby making it more difficult for your doctor to reach a diagnosis.

  • OTD

    60-year-old female, obese, pain in LLQ (2-3 years), now radiating somewhat down the outside of my left leg, but not reaching the knee. I’m quite fearful, my father had colon cancer. Also extreme itching in my vulvar region (unhelped by Vagisil), 2-3 small nodules felt in the labia.

    • Dr. Chris

      Hi OTD

      The priority here is to exclude any gynecological and urinary tract conditions. I would advise that you first start with your gynecologist. The lack of symptoms (gastrointestinal and urinary) means that this is not a priority right now but should be followed through after gynecological examination. There is no reason to suspect colon cancer just yet but regular examinations (colonoscopy) would be advisable.

  • Chris

    Hi, I have had lower left pain for a while, but mine comes on with eating rich tea biscuits or especially choc or plain digestives, could this be a wheat intollerance or something like ibs, I did a home celiac tsst 2 years ago and that was negative, I am on omeprazole 15 mg, for acid reflux and the doc reckons I have a hiatus hernia, but I have never had an endoscopy, also my liver enzymes were slightly up and gilberts syndrome was a maybe, but not really sure about those two because the liver test is bound to go up and down anyway and gilberts is benign

  • Dan

    Hi, I have had lower left pain for a while, but mine comes on with eating rich tea biscuits or especially choc or plain digestives, could this be a wheat intollerance or something like ibs, I did a home celiac tsst 2 years ago and that was negative, I am on omeprazole 15 mg, for acid reflux and the doc reckons I have a hiatus hernia, but I have never had an endoscopy, also my liver enzymes were slightly up. have a slight constipation problem (been only once to bathroom the past 3 days and only a small solid sample came out last night) and I am kinda bloated (for the past year). I took some [LAXATIVES] last night 4 hours before bed time, but so far no luck. i actually more info on [WEBSITE].Wonder if someone can confirm this data is correct?!

    • Hi Dan, we do not review other websites so we cannot comment on the accuracy of the content. As per our comment guidelines, we do not allow links to other websites (unless it is to one of the trusted sources like WebMD .com) or the use of brand names of drugs. You have mentioned many gastrointestinal symptoms that definitely warrants further investigation.

      A hiatal hernia can be diagnosed on a barium X-ray without an upper GI endoscopy. You mention biscuits but not bread or other foods containing flour which may be eaten in larger quantities. If it was gluten intolerance then it is unlikely that you would react to only these biscuits and not other wheat products. Gluten intolerance and IBS are two different conditions and you should not confuse both.

      We would rather not comment about home testing for celiac disease. While there are blood tests for celiac disease (that is done in a pathology laboratory), an upper GI endoscopy and colonoscopy would definitely be warranted in your case since you have so many symptoms and the raised liver enzymes would be another cause for concern. Regular use of OTC laxatives in your case would be discouraged as a medical professional needs to assess your condition. Constipation is a symptom and needs to be assessed in conjunction with all your other symptoms.

      You need to see a gastroenterologist as soon as possible who can assess your entire condition, proceed with further investigation where necessary and then reach a diagnosis. Our comments and the information in the article above are solely as a guideline and you should not delay medical attention.

  • Kaylin Ingersoll

    Hi, I’ve been seeing many doctors the past five yrs cuz I have terrible pain. I’ve had like every test under the sun done and the best answer for my pain was nerve pain until I moved to Florida. I had another ultrasound on pelvis and they think I have a bicornuate uterus and/or possible endometriosis cuz my periods are bad. I’m on a bunch of meds that barely keep me from going to the ER. Cramps from period and from poop make my pain worse. Most of my pain is around my tailbone. It’s through out my whole body. It feels like my insides are burning. My legs always have to be moving cuz the vibration goes up to my lower back. Vibrations on the intestines help.

  • HH

    Hello. I am a 30 year old female g3p3 with an our in place for the past 4 1/4 years. The past 2 days I have had a feeling in my llq like I have a “bruise” near my hip left lower abd. Yesterday was closer to hip now all of my left side lower feels like,it’s “bruised” and there is no visible,bruise and there was no trauma to cause it. Today also the left,side of my,abd. Feels like it’s filled with fluid….like when I walk it’s like a water balloon feeling. I am slightly overweight but my,abd is noticably larger today and it,looks like it actually caused a stretch mark to form over night…… I’m not,sure if I should,be concerned about a,gyn concern. Or something else?? Thanks!

  • Nathan Wells

    I am a 34 year old male and have had mild constant lower left quadrant discomfort/slight pain for months…no other symptoms…I have regular bowel movements with no constipation or is not going away and I won’t have insurance to go to the doctor for another month…please advise.

    • Hi Nathan. As you mention, there are no other symptoms apart from this discomfort/slight pain. There are a host of possible causes of discomfort/pain as you will see from the article above and on its own pain can be a difficult symptom to diagnose. The only way to know for sure is to run further diagnostic investgations. Do not ignore it. What may be just mild discomfort/slight pain for now can be an early symptom of a host of conditions that may worsen over time as the condition progresses. Speak to your doctor.