Pain in Your Lower Left Abdomen
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Lower left stomach pain symptoms explained
Are you experiencing pain in your abdominal area, but it doesn't quite feel like your stomach? The abdomen can be separated into four quadrants. The lower left quadrant of the abdomen contains the transverse, descending, and sigmoid sections of the colon; part of the small intestine; the ureter of the left kidney; and the iliac fossa (part of the hip bone and pelvis). The iliac fossa is a gateway to the reproductive organs in both men and women.
See this image here for a visual representation of these multiple components.
Common characteristics of lower left abdominal pain
Due to its complexity, the lower left abdomen is susceptible to multiple conditions that can cause pain. The pain may be focal and remain in the lower left quadrant or move to other quadrants of the abdomen. The pain may be sharp and sudden or dull and achy.
Other possible symptoms of lower left abdominal pain
Take note of the above qualities and other symptoms you may experience including:
- Nausea and vomiting
- Flatulence or belching
- Constipation and/or diarrhea
- A bulge in the abdomen
- Discolored urine
Additional symptoms in women of reproductive age
If you fit this description, you may also experience the following:
- Pain during sexual intercourse
- Painful bowel movements
- Heavier menstrual periods or spotting between periods
- Vaginal bleeding
- Irregular menstrual cycle
Make an appointment with your physician as soon as you notice any of these symptoms along with pain in the lower left abdomen.
What can cause lower left abdominal pain?
The lower left quadrant of the abdomen is complex, leaving its many structures prone to inflammation, obstruction, or injury. You should seek care from a physician if your symptoms continue and for a definitive diagnosis.
Causes of pain in the lower left abdomen directly related to the abdomen itself may include the following.
- Digestive upset: Acid that the stomach makes to digest food can irritate the components of the digestive tract, including the lower abdomen. Furthermore, gas found throughout the digestive tract can also cause transient pain and discomfort in the lower left abdomen as well.
- Abdominal weakness: The colon (also known as the large intestine) is an extremely long organ that is folded upon itself in the human body. As a result, any particularly weak parts of the colon can be exposed to extreme pressure. Other parts of the colon can break through these weak spots and push through the muscle and surrounding tissue. This condition is called a hernia. The process itself can be extremely painful and any bulge will lead to more pain and associated symptoms.
- Obstructive: The kidney is prone to developing stones of hardened material that can obstruct the ureter. Since the ureter passes within the lower left quadrant, any irritation from the obstruction will result in pain.
Inflammatory causes of pain in the lower left abdomen may include the following.
- Infectious: Sometimes pouches called diverticula form along the large intestine. These pouches form when weak spots in the intestine balloon outward. Infection of the diverticula can cause characteristic pain and discomfort in the lower left abdomen known as diverticulitis.
- Dermatologic: Some inflammatory dermatologic conditions occur on the surface of specific quadrants of the body. For example, shingles, a painful rash caused by a virus, can localize to the left lower abdomen and cause severe pain, itching, and sensitivity.
Reproductive causes in men
The reproductive organs in men are within or very close to the lower left abdomen. Problems with these organs often cause referred pain to the lower left quadrant. In men, this may include a condition called testicular torsion. The freely mobile testes can rotate around themselves, obstructing blood flow. The lack of blood flow results in sudden, severe scrotal pain and swelling that often includes the left lower quadrant and other quadrants of the abdomen.
Reproductive causes in women
The reproductive organs in women are also within or very close to the lower left abdomen. Problems with these organs often cause referred pain to the lower left quadrant.
- Ovarian torsion: The ovaries often lie within the lower quadrants of the abdomen. The ovaries can also rotate around themselves like the testes and result in pain. Furthermore, the ovaries can develop cysts that can cause painful pressure. If these cysts burst extreme pain can result as well.
- Menstrual cycle patterns or irregularities: These may also result in lower left abdominal pain. Pregnancy-related complications can also be a cause.
Trauma to the lower abdomen from a direct blow or motor vehicle accident can cause pain that may be accompanied by bruising or internal bleeding.
Normal abdominal pain
The complaint of nonspecific abdominal pain and discomfort, with no apparent cause, is one of the most common in medicine. It is a primary reason for patients to visit a medical provider or the emergency room.
The cause of abdominal pain can be difficult to find, because it can come from many different sources: the digestive tract, the urinary tract, the pancreas, the gall bladder, or the gynecologic organs.
The pain may simply be caused by overly sensitive nerves in the gut. This hypersensitivity can occur after repeated abdominal injury and/or it may have an emotional cause due to fear of the pain itself.
Diagnosis is made through physical examination, patient history, and simply ruling out any other condition. CT scan is often requested, but can rarely find a specific cause. The benefits must be weighed against the risks of radiation.
Treatment first involves making any needed lifestyle improvements regarding diet, exercise, work, and sleep, in order to reduce stress. In some cases, counseling, hypnosis, mild pain relievers, and antidepressants are helpful.
Top Symptoms: abdominal pain (stomach ache), vaginal discharge, fever, nausea
Symptoms that always occur with normal abdominal pain: abdominal pain (stomach ache)
Symptoms that never occur with normal abdominal pain: fever, vomiting, diarrhea, nausea, severe abdominal pain, unintentional weight loss, vaginal discharge
Normal variation of constipation
Constipation means bowel movements which have become infrequent and/or hardened and difficult to pass.
There is wide variation in what is thought "normal" when it comes to frequency of bowel movements. Anywhere from three times a day to three times a week is considered normal.
As long as stools are easy to pass, laxatives should not be used in an effort to force the body to a more frequent schedule.
Constipation is usually caused by lack of fiber in the diet; not drinking enough water; insufficient exercise; and often suppressing the urge to have a bowel movement.
A number of medications and remedies, especially narcotic pain relievers, can cause constipation.
Women are often affected, due to pregnancy and other hormonal changes. Young children who demand low-fiber or "junk food" diets are also susceptible.
Constipation is a condition, not a disease, and most of the time is easily corrected. If simple adjustments in diet, exercise, and bowel habits don't help, a doctor can be consulted to rule out a more serious cause.
Top Symptoms: abdominal pain (stomach ache), nausea, stomach bloating, constipation, constipation
Symptoms that always occur with normal variation of constipation: constipation
Symptoms that never occur with normal variation of constipation: vomiting
Intestinal inflammation (diverticulitis)
Diverticula are small pouches that bulge outward through the colon, or large intestine. Diverticulitis is a condition where the pouches become inflamed or infected, a process which can cause fever, nausea, vomiting, chills, cramping, and constipation.
Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation
Symptoms that never occur with intestinal inflammation (diverticulitis): pain below the ribs, pain in the upper right abdomen
Urgency: Hospital emergency room
Ovulation pain (mittelschmerz) or midcycle spotting
Mittelschmerz is a German word that translates as "middle pain." It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.
Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.
This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.
Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.
Diagnosis is made through patient history.
Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.
Top Symptoms: abdominal pain (stomach ache), last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain
Symptoms that always occur with ovulation pain (mittelschmerz) or midcycle spotting: last period approximately 2 weeks ago
Constipation from not eating enough fiber
Constipation is defined as having stools which are large, hard, and difficult to pass. This leaves the person feeling bloated and uncomfortable. Many things can cause constipation, and a common one is lack of fiber in the diet.
To determine whether lack of fiber is causing the constipation, all other causes are first ruled out:
- Not drinking enough water, sometimes to the point of dehydration.
- Lack of exercise, which helps increase blood circulation and therefore motility (contraction and movement) of the bowel.
- A very low or no-fat diet.
- A need for probiotics, which replenish the "good" bacteria in the gut.
- Medications, or certain illnesses, which have a constipating effect.
- Constantly ignoring the feeling of needing to move the bowels, and delaying going to the toilet.
If fiber is needed, the best sources are fresh vegetables; fresh or dried fruits; and whole wheat and brown rice, because those include the fiber-rich bran. Over-the-counter fiber tablets can be tried, though laxatives should only be used if recommended by a medical provider.
Top Symptoms: constipation, constipation, pain in the lower left abdomen, pain when passing stools, feeling of needing to constantly pass stool
Symptoms that always occur with constipation from not eating enough fiber: constipation, constipation
Symptoms that never occur with constipation from not eating enough fiber: vomiting
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is very common problem that affects the large intestine. It can cause stomach pain, cramps, bloating, constipation, or diarrhea. Doctors think that IBS is caused by the brain sending wrong messages to the bowels, such as during times of high stress, causing physical changes. The formal criteria for this diagnosis requires 3 months of symptoms. Therefore you may have an early presentation.
Top Symptoms: fatigue, abdominal pain (stomach ache), nausea or vomiting, stool changes, constipation
Urgency: Primary care doctor
Menstrual cramps, also called dysmenorrhea, are actually contractions of the uterus as it expels its lining during a woman's monthly period.
A certain amount of mild cramping is normal, triggered by hormone-like substances called prostaglandins. However, painful cramps may be caused by underlying conditions such as endometriosis, uterine fibroids, high prostaglandin levels, or pelvic inflammatory disease (PID.)
Severe cramping may be present, as well as nausea, headache, and dull pain that radiates to the low back and thighs. It is most common in women under age 30 who smoke, have heavy and irregular periods, and have never given birth.
An obstetrician/gynecologist (women's specialist) can do tests for underlying conditions such as those mentioned above. Women over age 25 who suddenly begin having severe cramps should see a doctor to rule out the sudden onset of a more serious concern.
Treatment of mild cramping can be done with heating pads to the abdomen and with over-the-counter pain relievers such as ibuprofen. Birth control pills, which regulate the menstrual cycle, are often effective in lessening cramps.
Top Symptoms: abdominal pain (stomach ache), abdominal cramps (stomach cramps), painful periods, lower back pain, abdominal pain that shoots to the back
Symptoms that always occur with menstrual cramps: abdominal pain (stomach ache)
Symptoms that never occur with menstrual cramps: being severely ill, disapearance of periods for over a year
Viral (rotavirus) infection
Rotavirus infection is a contagious gastrointestinal virus that most often affects babies, toddlers, and young children. It causes severe watery diarrhea, sometimes with vomiting and fever.
Adults may also be infected, though usually with milder symptoms.
Rotavirus spreads very quickly when any trace of stool from an infected child contaminates food or drink, or gets onto any surface. If another child consumes the food or drink, or touches the surface and then their mouth, the child will become infected.
Rotavirus in adults does not usually need a trip to the ER unless the degree of dehydration is severe but dehydration can set in quickly in children and is a medical emergency. A child can die if not treated immediately. Take the child to an emergency room or call 9-1-1.
Treatment consists of drinking fluids or IV fluids in severe cases and supportive care, usually in a hospital. Antibiotics will not help rotavirus because they only work against bacteria.
The best way prevention is frequent and thorough handwashing, as well as washing toys and surfaces when possible. There is now a vaccine that will either prevent rotavirus infection or greatly lessen the symptoms if the child still gets the virus.
Rarity: Ultra rare
Top Symptoms: diarrhea, vomiting or nausea, nausea, fatigue, abdominal pain (stomach ache), headache
Symptoms that always occur with viral (rotavirus) infection: diarrhea, vomiting or nausea
Symptoms that never occur with viral (rotavirus) infection: constipation, tarry stool
How to treat pain in lower left quadrant of the abdomen
Some of the causes of lower left abdominal pain are serious and often difficult to determine on your own. You should consult your physician for lower left abdominal pain that doesn't resolve.
After your doctor makes the appropriate diagnosis, he or she may suggest the following treatments.
- Bowel rest: Your doctor may suggest a liquid diet. This will allow your intestines and digestive system to recover from the obstructive or infectious causes of your left lower abdominal pain.
- Anti-inflammatory medications: If your symptoms are due to inflammatory conditions, your doctor may prescribe antibiotics or steroid creams.
- Menstrual cycle regulation: Your doctor may prescribe birth control pills or other options for menstrual cycle irregularities.
- Surgery: For conditions such as ovarian or testicular torsion, surgery is the first-line option for restoring blood flow and preventing complications. Surgery is also a treatment option for different pregnancy-related complications.
You can try the following at home to possibly counteract preventable causes such as digestive upset.
- Eat meals slowly: This will allow your body to fully digest foods and prevent you from swallowing air, which can cause bloating and pain.
- High fiber diet: A lack of dietary fiber may contribute to weak intestinal tissue, making the left lower abdomen susceptible to obstruction and infection.
When it is an emergency
Seek immediate medical attention if you experience symptoms including:
Questions your doctor may ask about pain in the lower left abdomen
To diagnose this condition, your doctor would likely ask the following questions:
- Have you experienced any nausea?
- Any fever today or during the last week?
- How would you describe the nature of your abdominal pain?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.
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