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Published on: 9/30/2024

When I Feel the Pain in the Left Side of the Abdomen What Are Some Possible Causes?

A wide ranges of diseases can cause left-sided abdominal pain that often involve the underlying organs in that area.

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Explanation

Even when we say left side of the abdomen or left flank, the possible causes often depend on if it is in the upper left or lower left part of the abdomen.

Pain in the left upper side (quadrant) of the abdomen

When there is pain in the upper left side of the abdomen, we first consider the organs in that location: such as the spleen, lungs, or kidneys.

Diseases of the spleen

Diseases such as splenomegaly (an enlarged spleen), rupture of the spleen and splenic tumors are possible. However, diseases of the spleen itself are not very common.

Lung disease

Cases such as pneumonia and pneumothorax in the left lung can cause pain in the left upper abdomen.

Kidney disease

Diseases such as ureteral stones, pyelonephritis, and renal infarction occurring in the left kidney can lead to pain in the upper left side of the abdomen.

Pain in the left lower side (quadrant) of the abdomen

The left lower side of the abdomen is mostly taken up by the large intestine with the bladder adjacent to it. Therefore, we consider the diseases of these organs.

Diseases of the large intestine

One of the most common reasons for pain in the left lower quadrant is constipation. As stool backs up in the large intestine, it can be quite painful. Other less common diseases include enteritis and diverticulitis. They are often accompanied by abnormalities in bowel movements.

Bladder disease

When a kidney stone gets stuck near the bladder, the lower left side of the abdomen can ache.

Ovarian disease

Pain may occur in the left lower area during ovulation or more rarely can come from ovarian bleeding or tumor in the left ovary.

Both upper and lower left abdominal pain

We need to consider diseases of all abdominal organs. In addition to diseases suspected when the left upper or lower abdomen hurts, we also consider diseases of the stomach, duodenum, small intestine, large intestine, pancreas, and aorta.

Diseases of the stomach and duodenum

When there is inflammation or ulcers of the stomach or duodenum, pain often comes before, during or after eating.

Aortic disease

Diseases such as aortic dissection and aortitis can be considered, particularly in elderly people or those with other risk factors. Overall, it is quite uncommon.

Rash on the Skin

If there’s a rash in the left abdomen, shingles should be considered. Preceding the rash is often superficial pain that can become severe.

Musculoskeletal Pain

In young and healthy people, musculoskeletal pain is the most common cause of left-sided abdominal pain from muscle strain or overexertion or rib fractures.

(References)

  • Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.

  • Sabo CM, Grad S, Dumitrascu DL. Chronic Abdominal Pain in General Practice. Dig Dis. 2021;39(6):606-614. doi: 10.1159/000515433. Epub 2021 Feb 25. PMID: 33631744.

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Dr. Kenji Taylor

Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Kenji Taylor, MD

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