Lower Left Abdominal Pain

What Is Lower Left Abdominal Pain?

Lower left abdominal pain is pain experienced to the left of an imaginary line, which is drawn from the level of the belly button vertically down to just under the waist line.  It is a common pain for women and the elderly. 

Common causes of lower left abdominal pain include trapped wind, diverticulitis, irritable bowel syndrome, constipation, celiac disease, left kidney stone, left kidney infection, Crohn's disease, ulcerative colitis, left ectopic pregnancy, left ovarian disease and infection of the left Fallopian tubes in women.

Like other parts of the body, in order to have a better understanding of lower left side abdominal pain, an insight into organs and other structures found in the region will help.

The organs and structures include:

  • The lower end of the left Kidney
  • The left Ureter
  • Part of the Descending Colon or large bowel
  • The Sigmoid Colon
  • Part of the Urinary Bladder
  • The left Ovary and Fallopian Tube in women
  • The large Blood Vessels (part of the aorta and it's branches) and Nerves on the lower part of the left abdomen
  • Muscles, and Skin covering the left side of the abdominal wall.

Common Causes of Lower Left Abdominal Pain 

Any disease affecting these organs and structures could potentially cause such pain.  The most likely conditions that cause lower left abdominal pain include: 

Here we look in some detail at the most common causes of pain in the lower left abdomen and how the doctor may seek to confirm the diagnosis.

1. Trapped Wind

You can get air trapped in your gut whilst chewing or talking for extended periods of time.  It can also happen as a result of anxiety or after eating certain types of food.  This could then lead to the distention of the lumen of our bowel and therefore cause pain.

Trapped wind could just be a short term passing condition or it could be a sign of some other bowel conditions.  Excess wind or trapped wind in the large bowel or stomach can cause lower or even upper left abdominal pain.  Other symptoms could include feeling well but bloated.  You may struggle with cramping in the abdomen and the passing of wind out of the anus.

Trapped wind could be a symptom in other conditions such as constipation, IBS or celiac disease.  

You can read more on trapped wind here.

2. Irritable Bowel Syndrome

IBS is a disorder in how the bowels function, without any demonstrable physical or structural problem in the bowel.  This is a consequence of how the gut responds to environmental factors and is most common in young women. 

About 10-15 out of every 100 people will suffer this condition but it does not cause any serious long term effect to the health of sufferers.  However, it can cause:

  • Abdominal pain and cramping, often relieved by defecation
  • Bloating
  • Pain which is worsened by eating certain types of food items
  • A change in stool pattern and frequency - diarrhoea or constipation
  • Passing of mucus in stools
  • Associated lower back ache and pain
  • Waking up to pass urine at night more frequently than usual
  • Tiredness
  • For those with constipation as the predominant symptoms with associated abdominal cramps, they may be passing small hard stools like "rabbit droppings".

These symptoms should have been going on for at least 3 to 6 months.

If you suffering with a lower left abdominal pain or discomfort, on and off for the three months or more, with associated bloating, worsened by eating but relieved by defecation, with constipation or diarrhoea, it is most likely that you have a treatable condition called irritable bowel syndrome or IBS.

You can read more about Irritable Bowel Syndrome here.

3. Constipation

Constipation is the infrequent passage of stools or passage of hard stools and can cause lower left abdominal pain if it is this part of the bowel that is affected.  Constipation is characterised by a reduced frequency in the passing of faeces, feeling bloated, a reduced appetite and a passing of strong smelling gas from the anus.

You can read more about constipation here.

4. Diverticulitis

As we grow older our lower bowel stretches and develops pouches called diverticulum.  Faeces get stuck in these recesses and they become inflamed.  If there are a number of these pouches, then the pain can worsen.  

Such diverticulum (diverticula for more than one) can be found anywhere along the bowel, but tends to be more on the left lower end of our bowel - the Descending and Sigmoid colon.

Inflammation of the diverticulum is referred to as diverticulitis. If you happen to have a number of these inflamed diverticulum on your left lower bowel, they would cause pain in this part of the abdomen.

The symptoms of diverticulitis include:

  • Sudden or gradual onset of lower left sided abdominal pain especially in those 50 years and above
  • Severe pain which is worsened by movement or pressing on the lower left abdomen
  • Associated constipation or even diarrhoea
  • In severe cases, there could be passage of blood and mucus in the stool
  • A fever - temperature may get up to 38 or 39 degrees Celsius
  • Nausea and loss of appetite
  • There may be slight distention of the lower abdomen around the left lower area

If you are 40 years and over, have a severe left lower abdominal pain that is made worse on movement, feel unwell (feverish - hot and cold), nauseated, passing hard or watery stool with or without blood and mucus, it is very likely that you have diverticulitis.

Diverticulitis is a medical emergency. It would be important to seek medical attention as soon as possible.

5. Pelvic Inflammatory Disease (Women Only)

Pelvic inflammatory disease is another common cause of left lower abdominal pain in women. It is the inflammation of the cervix, uterus, Fallopian tubes and ovaries in a woman arising from an infection.

It is a condition is common in women between the ages of 16 and 65.

Should the left Fallopian tube and/or ovary be affected (Salpingitis or Salpingo Oophoritis), this could lead to pain in the lower left abdomen. The symptoms are usually those of:

  • Lower or left sided abdominal pain
  • Deep seated lower abdominal pain during intercourse
  • There may be abnormal vaginal discharge
  • In acute cases, there may be associated fever
  • There may be a history of multiple sexual partners
  • There may also be associated pain or burning sensation on passing urine.

Though not always, PID is often a sexually transmitted condition - following an infection with gonorrhoea and or chlamydia.

If you suspect that you may be at risk of suffering with PID as the cause of your lower left abdominal pain, see more on pelvic inflammatory disease here and best treatment options available.

6. Ulcerative Colitis (UC)

Ulcerative Colitis is chronic irritation and inflammation of the inner lining of the colon, large bowel and rectum.  The bowel wall can develop ulcers and sores, causing bleeding and passage of blood in the stool.  This is one of the inflammatory bowel diseases, along with Crohn’s Disease.

While ulcerative colitis affects only the colon and rectum, Crohn's disease can affect anywhere from the mouth to the anus. Crohn's disease also affects the wall of the bowel deeper than ulcerative colitis does.

The common symptoms of ulcerative colitis include:

  • Passage of loose stools stained with blood - you may need to go to pass watery faeces anything from 2 to 30 times a day!
  • Abdominal pain and cramping which is worse on the left side
  • Needing to wake up to pass stools at night
  • Feelings of incomplete emptying of your bowel 
  • Some patients, rather than having diarrhoea, suffer with constipation
  • Recent and unintended weight loss
  • Mouth ulcers
  • Joint pain in severe cases as well as eye pain
  • Red swelling or rash on the skin of the front of your leg or shin

Because ulcerative colitis can mimic many other serious conditions like bowel cancer, Crohn's disease, tuberculosis of the large bowel, rectal cancer, it is important to seek medical attention should you be experiencing a combination of any of the above symptoms.

7. Ectopic Pregnancy

This is one of the top conditions any doctor would worry about, whenever a woman of child bearing age comes in with complains of lower right or lower left abdominal pain. An ectopic pregnancy is a medical emergency. 

  • Ectopic pregnancy occurs where a fetus after fertilization is not able to find its way into the womb, thus gets located in any other site in the abdomen apart from the womb.
  • It is more often found to occur in one of the Fallopian tubes, though an ectopic pregnancy can be located anywhere in the abdomen.
  • If it is located in one of the tubes for example, and the tube ruptures as the fetus grows, it could lead to massive blood loss and is potentially life threatening.
  • 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 (usually found between weeks 4 to 8). There may be dizziness, shoulder tip pain, and weakness. Ectopic pregnancy is a very serious gynaecological emergency.

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.

8. Left Sided Ovarian Cyst (Rupture or Twist)

An ovarian cyst is likely in women aged between the ages of 13 – 55. It starts with pain from the left abdomen or lower back, hip or top of the thigh.  When sitting a woman is likely to feel cramping and will struggle to find a comfortable position.  If you are experiencing this type of pain which doesn’t go away after a few hours, then it is best to seek medical advice.

Other Causes Of Lower Left Abdominal Pain

The above eight conditions are the most common causes of lower left abdominal pain. However, other causes include:

  • Crohn's disease
  • Celiac disease
  • Abdominal aortic aneurysm
  • Mid Cycle Pain
  • Endometriosis
  • Henoch-Schönlein-purpura
  • Rectal cancer
  • Uretic coli
  • Testicular torsion in young boys and men
  • Obstructed or strangulated left inguinal hernia
  • Mesenteric Adenitis
  • Left sided Psoas Abscess
  • Left sided Rectus Sheath Haematoma

Reference

enkivillage,  6 Common Causes of Lower Left Abdominal Pain, http://www.enkivillage.com/lower-left-abdominal-pain.html (Accessed: September 2016)

Heathline, What causes abdominal tenderness? 16 possible conditions, http://www.healthline.com/symptom/abdominal-tenderness (Accessed: September 2016)

Livestrong.com, Causes of Lower Left Side Abdominal and Back Pain, http://www.livestrong.com/article/272665-what-causes-lower-left-side-abdominal-and-back-pain/ (Accessed: September 2016)

Left Side Abdominal Pain? Have Your Say

Are you or a loved one suffering with abdominal pain on the left side? Or do you have past experience with pain in this part of your body? Share your experience with others and get support from our online community. Feel free to leave comments here too, especially if you read contributions by others and feel that you can comment on any of the issues raised.

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