Lower Left Abdominal Pain

The lower left abdominal area is a common site of pain, especially among women and elderly people. This area includes structures located to the left of an imaginary line that runs vertically across the level of the belly button, and an imaginary horizontal line below the left lower ribs. The organs and structures that may cause pain in this area include parts of the large intestine, the sigmoid colon and descending colon, parts of the small bowel, the left ovary and the fallopian tube, and the left ureter.

Symptoms of lower left abdominal pain may be experienced as an acute or chronic type of pain. Pain may be described as a dull aching pain or a sharp, stabbing or burning pain. The pain may be intermittent, spontaneous, or persistent. In addition, left lower abdominal pains may be accompanied by other symptoms including loss of appetite, nausea, vomiting, tenderness, fever, heaviness or fullness, and more. Some causes may be harmless, while others may require immediate medical attention. To learn about some of the possible underlying causes of lower left abdominal pain, read on.

Diverticulitis

Among older people diverticulitis is the most common cause of pain in the left side of the abdomen. It occurs when a bulge develops in the wall of the left bowel, forming finger-like projections and causes nagging pains in the lower abdomen. The pain is often sudden and severe, but less commonly starts out mild and worsens over time, potentially fluctuating in intensity.

Accompanying symptoms include changes in bowel habits, diarrhea or constipation, abdominal tenderness, nausea and vomiting, fever, bloating and less commonly, bleeding from the rectum.

Mild cases may be treated with rest, diet changes, and antibiotics. However, more serious cases may require surgery.

Constipation

Chronic or acute constipation can cause left-sided lower abdominal pain. This is characterized as an inability to pass fecal matter regularly, and is usually relieved by a bowel movement. Constipation occurs when they pass stools, which are usually hard, less than 3 times per week. Other symptoms include bloating and a feeling of fullness or pressure in the rectum. Laxatives and a high-fiber diet with lots of fluid intake usually resolve the problem.

Intestinal Obstruction

Any condition that causes an obstruction in the left part of the small or large intestine can cause left lower abdominal pain. These may include volvulus or twisting of the large bowel, strangulated inguinal hernia, tumors or adhesions (fibrous bands of tissue in the abdomen). An intestinal obstruction prevents food and liquids from passing naturally down the intestines and can cause inflammation and pain.

The pain in the left lower abdomen is an intermittent cramp-like pain. Nausea, vomiting, and diarrhea or constipation accompanies this. As the obstruction worsens one may experience inability to pass gas or stools and may develop a swelling in the abdomen. This pain may also spread and become more generalized.

Seek immediate medical consultation for these symptoms, as there is a risk of tissue death in the intestine, which could lead to complications such as severe infection and septic shock.

Mittelschmerz

Ovulation pain or mittelschmerz involving the left ovary occurs when an egg is released two weeks before an expected period. This may cause a mild to moderate discomfort in the left lower abdominal area and may be experienced either as a sharp and sudden pain or as a dull, cramp-like pain. This may be accompanied by spotting. Left-sided ovulation pains are common and often relieved by rest and pain relievers.

Left Ovarian Cyst

An ovarian cyst is a fluid filled sac on the surface of the ovary that may grow large and produce lower abdominal discomfort. They are usually harmless and should not be a cause for worry, but sometimes may grow very large and twist, producing left lower abdominal pains that may be a dull, aching pain. This may be constant or intermittent, and may radiate to the lower back. Pelvic pains may occur near the beginning or end of a menstrual period. Women may also experience nausea, vomiting, fullness or heaviness of the abdomen, menstrual irregularities, and pressure on the rectum or bladder.

Most ovarian cysts go away without medical treatment but one should consult a doctor when experiencing sudden, severe lower abdominal pain associated with fever and vomiting.

Left Kidney Stones

Kidney stones are small, crystal materials that are deposited inside the kidneys and often result from concentrated urine. When kidney stones pass through the urinary tract from the kidney to the bladder a sudden, severe pain may be experienced in the left side of the abdomen below the left side of the ribs. The pain may radiate to the left side and back, and to the lower left abdominal area and groin. The pain usually comes in waves and fluctuates in severity. Other symptoms include nausea, vomiting, fever and chills, pain on urination, red, pink, or brow urine, foul-smelling, cloudy urine, and frequent urination.

Taking pain relievers and drinking plenty of water may relieve the pain associated with kidney stones. However, medical consultation may be necessary if the pain is severe, and surgical removal of stones may be performed.

Left Kidney Infection

Urinary tract infection can spread to the left kidney, causing left-sided abdominal pain that can spread to the back, flank, and groin. The pain is not sudden (unlike kidney stones) and the patient usually feels unwell, and presents with such symptoms as fever and vomiting. Urination is painful and frequent. Blood or pus is seen in the urine.

Kidney infection should be immediately treated with antibiotics as it can lead to widespread infection and kidney damage.

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg is implanted in the left ovary, fallopian tube, or anywhere in the abdominal cavity outside of the uterus. As the fetus grows it will cause severe left lower abdominal pain. It may be recognized because it is usually associated with symptoms of early pregnancy, a missed period, and vaginal bleeding.

Since an ectopic pregnancy cannot proceed like a normal pregnancy, immediate medical consultation is required because the fallopian tube may rupture and bleed, becoming life threatening.

To summarize the most common causes of left lower abdominal pain:

Cause

Character of Pain

Accompanying Symptoms

Treatment/Remedy

Diverticulitis

Sudden and severe pain or mild but worsening (less common)

Changes in bowel habits, diarrhea or constipation, abdominal tenderness, nausea and vomiting, fever, bloating and bleeding from the rectum.

Rest, changes in the diet and prescribed antibiotics

Surgical treatment, if severe

Constipation

Dull abdominal pain due to failure to pass stools

Infrequent bowel movement, hard stools

Straining, bloating and pressure in the rectum

Relief of symptoms with passage of stool; use laxatives, modify diet, hydration

Intestinal Obstruction (volvulus/hernia/

tumor/adhesions)

Cramp type of pain that comes and goes

Nausea, vomiting and diarrhea or constipation, inability to pass gas or stools, swollen abdomen

Surgical treatment

Mittelschmerz

/Ovulation Pain

Dull and cramp-like type of pain or sharp, sudden pain

Occurs 2 weeks before period, with or without vaginal spotting

Pain relievers, rest

Ovarian Cysts

Dull, aching, pelvic pain that may also radiate to the lower back and thigh.

Irregular periods, heaviness, spotting, nausea, vomiting, pressure; sometimes none

Mild pain - none, or analgesics

Severe - possible surgery

Kidney Stones

Sharp flank pain, comes in waves, fluctuating, may spread to back and groin

Frequent, painful urination, pink, red or brown urine, cloudy foul-smelling urine, nausea, vomiting, fever and chills

Mild - none or analgesics

Severe - surgery

Kidney Infection

Lower abdominal pain, back pain, flank pain or groin pain

Painful urination, persistent urge to urinate, pus or blood in the urine, fever

Antibiotic treatment

Ectopic Pregnancy

Severe lower abdominal or pelvic pain

Missed period, signs of pregnancy, vaginal bleeding

Surgery

Less Common Causes

These conditions can also cause lower left abdominal pains:

  • Crohn's disease - an inflammatory bowel disease that tends to run in families; it is characterized by severe abdominal pains, severe diarrhea, and malnutrition. This condition can be debilitating and may even lead to life-threatening complications.
  • Ulcerative colitis - another inflammatory bowel disease that is chronic and debilitating; it is characterized by severe, cramp-like pain and bloody diarrhea, leading to weight loss.
  • Abdominal aortic aneurysm - occurs when the lower part of the aorta, the largest blood vessel, is weakened and bulges, causing abdominal and back pains.
  • Endometriosis - occurs when uterine tissue grows outside of the uterus, such as on the left ovary, fallopian tube or bowels, causing severe pain that usually coincides with menses.

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