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Lower left Abdominal Pain
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Lower left abdominal pain is pain experienced to the left of an imaginary line drawn from the level of the umbilicus, vertically down to just under the waist line.
Structures in this part of the abdomen that could cause lower left abdominal pain include:
• Part of the Descending Large bowel
• The sigmoid Colon
• The lower pole of the left kidney
• The left ureter
• Part of the urinary bladder
• The left ovary and tube in women
• Blood vessels and nerves on the lower part of the left abdomen
• Muscles, and skin covering the left side of the abdominal wall
Thus, any disease affecting these structures and organs could potentially cause lower left abdominal pain.
In specific terms, common recognised causes of lower left abdominal pain include:
Leaking or ruptured abdominal aortic aneurysm arises if the large blood vessel called the aorta that carries blood away from the heart become distended along its course in the abdomen and then starts to leak or even ruptures with or without warning. Ordinarily, this causes severe central abdominal pain, which typically spreads to the back. Patient may collapse suddenly, and become pale, cold and blood pressure drops. On occasions, the pain may be felt more to the left of the abdomen, thus causing lower left abdominal pain. To find out more about abdominal aortic aneurysm, please read on here
Bowel Cancer
Cancer affecting the left side of the bowel could cause left side abdominal pain. The symptoms expected would include weight loss, change in bowel habit, tending towards more constipation, poor appetite, and feeling generally weak. These symptoms may continue over months. Mind you, there are other conditions that would present like this (Crohns disease, ulcerative colitis, chronic constipation, celiac disease, irritable bowel syndrome, to mention a few),causing lower left abdominal pain with constipation, bloating and the like. It is only wise to see your doctor immediately if you are unwell.
Bowel Obstruction
Any cause of bowel obstruction could cause left abdominal pain, if the part of the bowel that is obstructed is on the left side. The symptoms of bowel obstruction would include abdominal pain griping or cramping, feeling like vomiting, or actually vomiting, with distension of the abdomen. The bowel may be making loud intermittent noises called borborygmy. If the obstruction is total, they will be no passage of faeces and wind, but passage of wind would still be possible if the obstruction is partial; even small amount of faeces on occasions.
Chronic constipation, or even ordinary constipation would cause abdominal pain. If the left side of the bowel is more affected, this will obviously lead to lower left abdominal pain. This will manifest as in ability to pass faeces as usual, feeling bloated, without weight loss, if the constipation is a straightforward one.
Crohn’s disease is one of the so-called inflammatory bowel diseases. The problem with Crohn’s disease is that it mimics so many other causes of abdominal pain. It is however usually a chronic problem. If it affects the descending or sigmoid colon, it would obviously give rise to a lower left abdominal pain. Please read more on Crohn’s disease here
Diverticulitis
This is the most common cause of lower left abdominal pain, especially after 60years of age. Diverticulitis is very rare on the right side, though it does occur. It is also a disease more of elderly ones. It is due to the out pouching of the wall of the bowel like out growing fingers outside the walls of the bowel, mainly affecting the sigmoid colon, causing nagging pain in the lower abdomen, 99% of the times on the left side. Please read more on Diverticulitis here
Ectopic Pregnancy
This is one of the first things all doctors think of whenever a woman of child bearing age comes in with complains of lower right or lower left abdominal pain. This age bracket is from 11 to 55 or even less than that. Ectopic pregnancy usually presents as lower right or left side abdominal pain depending on which tube or side that is affected. The pain is dull to sharp, and may be associated with vaginal bleed.
The woman may not even know that she is pregnant, as this tends to occur very early within the first ten weeks, after the last menses. There may be dizziness, shoulder tip pain, and weakness. Ectopic pregnancy is a very serious emergency.
It is due to pregnancy staying in any other place apart from in the womb, though commonly in one of the tubes. If this ruptures as the foetus grows, it could lead to massive blood loss and is potentially life threatening. If you have lower right or left sided abdominal pain, plus or minus dizziness, plus or minus vaginal bleed, please speak to your doctors as a matter of urgency.
For more on Ectopic pregnancy, please see here
Endometriosis
This is the presence of normal womb tissue outside the womb. It could cause lower left abdominal pain, if it is on the left tube, ovary, or first part of the large bowel. Usually the pain is worse on that side with the menses. You may be able to feel a soft swelling on the affected side too. This problem is not easy to diagnose nevertheless. Learn more about endometriosis here
Food Poisoning
After a meal in a resturant, depending on the type of bug, left side abdominal pain could start within 1 hour to 48 hours. There would be associated feeling of vomiting or actual vomiting plus or minus fever. It could be from contamination of food with chemical gents. Please read about this cause of lower left abdominal pain here
This is a very rare but possible disease. It affects less than 200,000 people in the United States. It is a cause of abdominal pain, which could be a lower left abdominal pain. Other symptoms associated with this condition include purple spots on the skin, joints and kidney problems. It is usually preceded by the occurrence of cold-like illness weeks before the emergence of the purple rashes. It is commoner in children, with boys been more affected than girls.
Hernia
A hernia is the out pouching of the gut or part of the bowel through an abnormal opening in the wall containing it. Other structures can be found in a hernia apart from the gut. If a hernia occurs on the left side, it could lead to lower left abdominal pain and or bowel Obstruction
IBS
Irritable bowel syndrome known as IBS for short, is a disorder of the gut’s function, without any demonstrable physical or structural problem. IBS is characterised by bouts of crampy abdominal pain, bloating, gas, passing of little hard stools (sometimes looking like pellets), alternating with diarrhoea. It is one of the commonest causes of lower left side abdominal pain, especially in women. Please read more on IBS here
Kidney Stone
Left side kidney stone would cause a lower left side abdominal pain if the stone is trapped down the ureter. The pain usually comes on suddenly, described as the most severe pain ever felt, cramping, leaving the sufferer rolling around seeking a position of comfort. There may be associated vomiting or feeling of wanting to vomit, plus or minus passage of small frequent urine.
Kidney Infection or Pyelonephritis
Infection of the kidney on the left side could cause lower left abdominal pain too. The patient is usually unwell, may be feverish, and vomiting, with pain especially in the upper to lower abdomen, worse on gently hitting the lower back. The doctor will easily diagnose this with a few examinations and tests. The character of pain here is different from that with kidney stone, and usually may have been on-going for some days.
Ovarian Cyst (Twist or Rupture)
The pain from ruptured ovarian cyst is usually sudden, and localised to the side of the womb where the ovary is. It is differentiated from appendicitis by its suddenness, no fever, no change in appetite, and the patient may be rolling in pain. It is diagnosed with the aid of an ultrasound scan
Psoas Abscess
Some infection for example in the kidney could tract down to the muscle on the floor of the lower left abdomen called the psoas muscle. If pus collects there as in cases of tuberculosis, there could be swelling and lower left abdominal pain. The sufferer may lose weight, poor appetite, night sweats, and a mass may be felt in the lower left abdomen.
Rectus Sheath Haematoma
Rectus sheath haematoma occurs when one of the blood vessels from the groin that moves up to the abdomen is what is damaged.
This causes blood to track under the muscle covering on the affected side of the abdomen, thus forming a mass with considerable pain. Obviously, on the left side, it would cause lower left side abdominal pain. Read more about rectus sheath haematoma here
Sigmoid volvulus
This is a cause of large bowel obstruction especially in elderly ones in nursing homes or those in long term institutions and mental homes. It results from twisting of the sigmoid part of the large bowel on itself, causing large bowel obstruction. The presenting symptoms would be sudden lower left abdominal pain, massively distended tummy and inability to open the bowel. The diagnosis is often made following an X-ray examination. You could read more on this condition here
Transverse colon volvulus
Volvulus involving the transverse colon could present as left abdominal pain. It is often dramatic in onset, and would cause symptoms like those of intestinal obstruction. This is though a rare cause of intestinal obstruction, and in very fatal. Please read about this here
Trapped Wind
Excess wind or trapped wind in the large bowel or stomach can cause lower or even upper left abdominal pain respectively. The symptoms would include feeling well, but bloated, crampy abdominal pain, loud bowel noises, and this bloating and pain is relieved by passing wind from the anus (farting). Please read more about this common cause of left sided abdominal pain here
There are myriads of other causes of lower left abdominal pain not mentioned here, but we have presented the more common ones here. Should you have specific type of left side abdominal pain you thing is not mentioned here, or if you want help with diagnosing your abdominal pain, please send us a note on the contact us page.
Useful links
Pain-free Advice for Pregnant Women
Paediatrician’s Advice For Babies With Abdominal Colic
Causes of Upper Abdominal Pain
Causes of Central Abdominal Pain
Causes of Lower Abdominal Pain
Causes of Right Side Abdominal Pain
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