Pain in the left side, lower abdomen
Pain in the lower abdomen is described in the medical literature as pelvic pain. They are typical for acute and / or chronic diseases of internal organs, blood vessels, lymph nodes of the small pelvis, joints and bones of the pelvic girdle.
- Pelvic pain on the left side of the body
Causes of pain in the left side
- Spleen diseases
- Diseases of the small intestine
- Colon diseases
- Diseases of the genitourinary system
- Types of pain
- Other symptoms
What to do if there is pain in the left side?
- For diseases of the spleen
- With diseases in the small intestine?
- Colon pain?
- With diseases of the genitourinary system?
- Lymphadenitis as a cause of pain in the left side
- Gastritis as a cause of pain
- Pancreatitis as a cause of pain in the left side
- Neuralgia as a cause of pain
Pelvic pain on the left side of the body
This is an extensive group of unpleasant sensations in the abdominal wall and / or abdominal cavity with pain localization on:
- front side of the body (below the navel line);
- the back of the body (below the lumbar line).
Pain syndrome in the lower abdomen is relevant for almost all categories of patients with gynecological, urological, gastroenterological diseases, as well as surgical pathologies of the pelvic organs.
Lower abdominal pain on the left side most often brings patients to the following hospital departments:
- gynecology - 60-70%;
- urology 65-90%
- gastroenterology - 50-60%;
- orthopedics - 7-15%.
During life, pain in the lower abdomen on the left occasionally appears in every sixth person on the planet. Medicine associates pelvic pain with hundreds of various diseases of internal organs and systems. We have selected the most obvious and common causes of this problem.
The following organs are located on the left side of the abdominal cavity:
- The spleen is an unpaired organ related to the immune system. In the parenchyma, blood cells are formed, accumulated and utilized. The spleen acts as a reserve storage (depot) of blood due to the portal blood flow system. The total removal of the spleen does not lead to the death of a person, since in this case its functions are taken over by other organs (lymph nodes, liver).
- Small intestine. On the left side, the loops of the jejunum are partially located. This is the second section of the small intestine. The main diseases accompanied by pain are intussusceptions, blockages and inflammation.
Colon. The cause of pain is inflammation, violation of secretory functions.
- The left side of the transverse colon;
- The descending branch of the colon.
Organs of the human genitourinary system:
- The left side of the unpaired organs - the uterus, birth canal (in women);
- The left side of the paired internal organs (female and male, as well as the kidneys).
- Bones of the skeleton of the pelvic girdle, left hip joint, blood vessels, cartilage, nerves, lymph nodes of the pelvic girdle. Similar information (see here).
Pain is a complex pathophysiological process. With the same disease, it can manifest itself on both the left and right side of the body. Pain can migrate to areas of the body remote from the pathological focus. There are cases of pain without an obvious source of pathology.
The reasons for the formation of a focus of pain are:
- Local disturbance of blood circulation;
- Violation of cellular metabolism in the pathological focus;
- Inflammatory and / or dystrophic processes;
- Functional and morphological changes in internal organs.
Pain syndrome is characterized by several stages of development:
First stage. The appearance of unpleasant sensations at the site of localization of the pathological focus.
Second phase. The appearance of reflected pain, the formation of a secondary focus of pathology and the loss of an obvious connection with the primary focus.
Stage three. The spread of trophic disorders, the deepening of pathological processes, the expansion of the foci of the pain impulse.
Causes of pain in the left side in the lower abdomen
Pain in the left side in the lower abdomen, combined with symptoms of a disease of an organ located on the same side, is the primary stage of the disease. Irradiating and reflected pains are formed in chronic forms of diseases involving large areas of the body in the pathogenesis.
Pain with diseases of the spleen
In the early stages of the disease, localization of pain is most likely in the left side.
- Chronic lymph - and myeloid leukemia. Oncological disease, accompanied by damage to the hematopoietic organs - the spleen, liver, regional lymph nodes. There are three clinical phases of the disease: chronic, progressive, blast crisis.
Chronic phase symptoms. Pain may be absent. They appear as the tumor grows. The earliest symptom is increased fatigue, sweating, decreased appetite. In some cases, the disease is accompanied by weight loss. With an increase in the size of the spleen, pain occurs after eating. Many patients feel satiety too quickly. At an early stage, diagnosis is carried out using ultrasound and laboratory blood tests.
Progressive phase symptoms. Revealed by a physical method - deep external palpation, causing increased pain in the lower abdomen on the left. It grows as the spleen and inguinal lymph nodes enlarge.
Symptoms of the blast crisis phase (explosive cell growth). During this period, aching pains in the joints and bones of the pelvic girdle or at a distant distance from the localization of the lesion are characteristic. The body temperature rises and jumps. A decrease in blood clotting, a rapid increase in the volume of the spleen are revealed. Diagnosis of the disease is carried out using instrumental, laboratory studies.
- Spleen infarction. The reason is the blockage of arterioles, small arteries of the organ parenchyma and the development of a necrosis focus around a blood clot. Spleen infarction can be easily confused with the diseases that cause it: infections, oncology, heart defects, blood vessel pathologies.
Splenic infarction is manifested by a sharp pain in the left hypochondrium. As the pathogenesis develops, the pain can descend to the lower abdomen. It increases with deep inspiration, coughing and movement. Body temperature rises to 38.0-39.0 0 C. The disease is dangerous with massive blood loss. The diagnosis is made on the basis of instrumental studies. Treatment - surgery, physiotherapy, drug correction.
- Spleen volvulus. Partial or complete twisting of the splenic artery, veins and nerve bundles around its axis. The reason is the individual characteristics of a person who has long mesenteric ligaments from birth that hold the organ in the abdominal cavity, or injuries to the spleen.
It is accompanied by symptoms of an acute abdomen. There is a sharp pain in the left side, then it begins to go down and give to the groin area on the left. The pain is combined with vomiting, constipation, and bloating. There is a sharp deterioration in health. With incomplete twisting, the patient complains only of recurrent pain in the left side, aggravated by physical exertion.
In relation to a patient with symptoms of an acute abdomen, the question of immediate surgery is being decided. Slow pain with partial twisting is a reason for immediate clinical examination. After clarifying the diagnosis, the question of treatment is decided, including the conduct of a planned surgical operation.
- Acute enlargement of the spleen: The two main causes of enlarged spleen are impaired blood flow through the portal vein and inflammation.
Outflow disturbance. Characterized by paroxysmal dull pain on the left, in the hypochondrium, its migration to the lower abdomen is possible. Acute dilatation after blockage of a vein (blood clots, conglomerates of parasites, etc.) is manifested by a significant increase in the organ, smoothing of the sharp edges of the spleen on ultrasound.
Inflammation of the spleen. Rarely is an independent disease, more often the pathology develops as a secondary process with the involvement of the spleen in the pathogenesis, for example, of the liver. It is accompanied by symptoms of the underlying disease. The organ is much less enlarged, the pain is combined with an increase in body temperature, vomiting. The most common causes of inflammation of the spleen are diseases of neighboring organs, including the liver: Gaucher disease - a violation of fat metabolism in the liver; Bunty's syndrome - accompanied by cirrhosis or degeneration of the liver tissue; Hodgkin's disease - lymphogranulomatosis.
- Spleen abscess. This is the result of the development of limited purulent inflammation in the capsule or parenchyma of the spleen. The pathogenesis of small abscesses usually ends with complete recovery. With the formation of large or multiple abscesses, especially those that have opened into the abdominal cavity, peritonitis may develop. Its signs are severe diffuse pain radiating to the left side and lower abdomen, high temperature, a sharp deterioration in health, regression of consciousness.
Spleen cyst. It is a cavity made of a connective tissue capsule. Inside, it is filled with watery, slimy contents. A cyst forms as a result of the completion of an abscess. It can also be the result of rupture of the spleen in traumatic injuries. Small cysts are painless, and large cysts cause slight pain when pressed with a fist in the area of the left hypochondrium. Patients also note paroxysmal dull pain of low intensity during physical exertion.
Other pathologies, including congenital disorders and atrophy of the spleen, proceed without severe pain.
What to do? What to do with spleen diseases? >>
Pain in diseases of the small intestine
The small intestine is subdivided into the duodenum, jejunum, and ileum. Pain in the left side in the lower abdomen with a high degree of probability can be caused by damage to the jejunum, part of the loops of which is located on the corresponding side of the human body.
- Malabsorption. Disease of a congenital or acquired nature. The pathogenesis is based on the inability of the mucous membranes of the small intestine to absorb one or more foods in the intestine, such as milk or fruit. The disease is characterized by frequent (three or more times a day) defecation, loose, fatty stools. The pain is localized in the left side, and when the jejunum expands with gases, it is accompanied by cramping attacks. Additional symptoms are rumbling in the intestines, increased gas formation, an unpleasant taste in the mouth. Bursting pain subsides after bowel movement, and cramping decreases after taking antispasmodic medications (no-shpa, she is drotaverin). The final diagnosis is made on the basis of laboratory and instrumental research methods.
- Celiac disease It usually develops in newborns who switch from breast milk to complementary foods from cereals. There are known cases of celiac disease in adults. The disease is based on gluten intolerance. Gluten is a vegetable protein found in the gluten of cereals. The symptomatology of the disease is in many ways similar to malabsorption, the same pulling pains in the abdomen appear. Due to indigestion, depletion develops rapidly. At the age of six months to one year, the appearance of a sick child with ineffective treatment takes on a rickety appearance: the abdomen is enlarged, growth and development lagging behind, the mucous membranes are brightly colored.
What to do? What to do in case of diseases of the small intestine? >>
Pain in pathologies of the large intestine
The large intestine includes the cecum, colon, sigmoid, and rectum.
The colon, in turn, is subdivided into:
- ascending - located on the right;
- descending - located to the left;
- transverse - located horizontally in the epigastric region, partially on the left.
Pain on the left side of the lower abdomen is usually associated with a lesion of the descending or transverse colon:
- Irritable Bowel Syndrome. Disease of unknown etiology. Some researchers prioritize the stressor. Men and women of all ages are ill, but two thirds of patients are middle-aged women. They observe an aggravation in themselves during the period of monthly cycles and during hormonal surges. Irritable bowel syndrome is manifested by chronic pain in the abdomen, sometimes on the left side, as well as flatulence, constipation, or diarrhea. A distinctive feature of the disease is the absence of visible morphological changes in the intestinal walls. The disease periodically subsides and aggravates again, for example, after eating certain types of food and after stress. The main method of treatment is a special diet and medical correction.
- Hirschsprung's disease. Hereditary pathology. Mostly boys are ill. The disease is a consequence of the congenital absence of areas of innervation in separate, limited areas of the large intestine. The main symptoms are constipation, bloating, and increased gas production. The development of pain in the left abdomen is a consequence of an acute expansion of the large intestine. The main method of treatment is surgery, namely, the removal of sections of the intestine that do not have nerve endings.
- Crohn's disease. Nodular inflammation of the gastrointestinal tract. We will consider isolated inflammation of the descending colon, since it is precisely this that is characterized by pain in the lower abdomen on the left. The cause of the disease has not been fully established. The disease manifests itself in general symptoms - fatigue, loss of appetite, lethargy; as well as specific signs - pain in the left side, diarrhea, vomiting. If other parts of the intestine are involved in the process, the symptoms will be more difficult. Crohn's disease is very difficult to diagnose and is often disguised as other pathologies. When involved in the pathogenesis of the intestines on the right side, the symptoms are very reminiscent of inflammation of the appendix with the same vivid pain manifestations.
- Nonspecific ulcerative colitis. Polyethiological chronic inflammation of the large intestine. It is accompanied by morphological changes in the intestinal walls. There is no exact information about the causes of the disease, but it is believed that hereditary factors, combined with disorders of the immune system, are at the heart. There are medical hypotheses about the influence of allergies and bacteria. Clinically, NUC is manifested precisely by pain in the left side in the lower abdomen. The nature of the pain is paroxysmal colic of varying intensity. Other symptoms are joint pain, diarrhea mixed with blood and pus, fever, as a result of the introduction of microbes into the mucous membrane. The final diagnosis is based on the study of the intestinal mucosa using instrumental methods.
- Diverticulosis of the large intestine. A disease accompanied by the development of diverticula - pathological sacs formed when the intestinal walls protrude. Elderly people are more likely to get sick. Diverticula interfere with normal peristalsis, and fecal matter accumulates in them, causing congestion, fermentation, gas and intestinal expansion. Finally, dense fecal stones (calculi) form in the diverticula. With the defeat of the descending colon, pain occurs in the left side, may be in the lower abdomen, as well as constipation and black feces due to intestinal bleeding. Diagnosis of the localization of diverticula is carried out using instrumental methods for examining the intestines, and diverticulosis is treated only surgically.
- Colon polyposis. A multifactorial disease, accompanied by the appearance on the mucous membranes of the colon of benign formations - polyps. The formation of these polyps is associated with a violation of the absorption of water from the contents of the intestine and the difficulty of passing the contents. As a result, diarrhea is combined with constipation, in severe cases, a dangerous state of dehydration develops. Pain in the left side occurs when polyps are affected by the descending part of the colon.
- Atony of the large intestine. It develops with a decrease in the patient's body resistance against the background of the underlying disease, for example, with prolonged motionless lying during the illness. Atony is most often diagnosed in older people. The main clinical symptom is a violation of peristalsis, constipation, intestinal distention, noises and rumbling as a result of fermentation processes. Bloating causes dull, bursting pain. With the accumulation of gases in the descending part of the colon, aching pain appears in the left side in the lower abdomen.
- Malignant formations. Colon cancer is a generalized name for several diseases of oncological etiology. One of the reasons for the development of malignant tumors is malignancy or transformation of benign cells into cancerous ones.
Pain syndrome develops first on the side where the tumor originated. An increase in the intensity of sensations is characteristic, and with tumor necrosis, the pain intensifies and grows around the focus.
What to do? What to do with colon diseases? >>
Pain in diseases of the genitourinary system
Some of the diseases were mentioned in connection with damage to the right kidney (see here). In this text, information is supplemented.
- Hydroureteronephrosis This is an expansion of the renal pelvis. It develops due to impaired outflow of urine from the kidney. Causes - urolithiasis, narrowing or diverticula of the ureter. Since the kidney is a paired organ, a unilateral lesion is subclinical for a long time. Acute enlargement is accompanied by sharp pain in the lower back, which can go down to the lower abdomen.
- Allen-Masters syndrome. It develops in connection with the rupture of the ligaments of the uterus during difficult labor and abortion, or during rapid labor. It appears soon after these pathologies. The most common symptom is cramping pains in the lower abdomen, sometimes on the left or in the anus, especially when straining. Burning pain inside the abdominal cavity radiates to the left iliac region. Additional symptoms are fatigue, pain during sex and menstruation. Diagnosis is based on physical research: the doctor detects abnormal mobility of the cervix, torn ligaments do not hold the organ in a stable position. The uterus is painful when pressed against the abdominal wall. Ligament rupture causes venous congestion in the pelvic area.
External genital endometriosis. Pain develops with pathological proliferation of myometrial cells with external endometriosis:
- Ovaries. The clinic resembles an ectopic pregnancy with pain in the lower abdomen of varying intensity. The defeat of the left ovary is accompanied by aching pains from the corresponding side, the pain increases during menstruation and during intercourse. The accompanying pain is associated with the development of adhesions;
- Peritoneum. Perhaps asymptomatic, characterized by menstrual disorders, the development of infertility, pain during intercourse and pain in the lower abdomen, often on the left;
- Fallopian tubes. It is manifested by pain during palpation of the cervix and during menstruation. The development of infertility is observed, sometimes there is an ectopic pregnancy with the localization of the embryo in the fallopian tubes;
- Cervix. Characterized by persistent pain in the pelvic region, possibly on the left. Often the pain descends into the rectal area and intensifies with bowel movements and sex;
- The vagina and labia. Visually, bloody nodules on the vaginal mucosa and labia are found, combined with discharge and pain on palpation. Sex is impossible due to severe pain, and in a calm state there is pain in the lower abdomen;
- Recto-uterine cavity. With rectal palpation on the walls of the rectum near the uterine cavity, endometriotic nodules in the form of a rosary are palpated. Patients complain of a pulling pain in the perineum and lower abdomen on the left with a predominant lesion of the left side of the rectum.
Pain in diseases of the hip joint, cartilage, blood vessels, nerves, lymph nodes (see here). Diseases of the right side of these anatomical structures are identical to the left-sided lesion.
What to do? What to do in case of diseases of the genitourinary system? >>
Types of pain
Pain caused by injury or trauma differs significantly from internal pelvic pain in terms of its pathophysiological significance for the body. Pain caused by injuries should usually be treated immediately with pain relievers.
The pain caused by pathologies of internal organs, on the contrary, should be stopped with great care. If internal pain occurs, anesthesia is allowed by applying a cold compress to the focus.
Dull aching pain in the left side
This type of pain is a common complaint of patients with unilateral gynecological pathologies. With dull pain in the left side in the lower abdomen, women are usually faced with violations of the cycle, during sex, with inflammation of the genitals and non-inflammatory (endometriosis) diseases. Inflammatory pathologies, accompanied by dull pain, are usually combined with an increase in body temperature, weakness, and increased fatigue. In addition to gynecological diseases, dull pain accompanies varicose veins of the legs, acute expansion of the bladder, hemorrhoids. A dull, aching pain is felt with inflammation of the lymph nodes on the left side of the body.
Drawing pain in the left side
Such pain is characteristic of purulent pathologies of the pelvic organs on the left side, usually it is characterized by a debilitating course and low intensity. A pulling pain on the left is felt with inflammation of the scrotum, external male genital organs, as well as with strangulated hernias, accompanied by stretching of the ligaments in the groin. The pain gradually increases with oncological diseases due to irritation of the nerve ganglia by a growing tumor. In severe pathologies, the presence and intensity of other symptoms should be taken into account: (fever, vomiting, diarrhea, swollen lymph nodes)
Sharp pain in the left side
Resi is accompanied by pathologies associated with spasms of the pelvic organs when the intestines are distended with gases or by direct action on painful nerve endings. Sharp pain is sometimes evidence of acute expansion of the bladder and renal pelvis, inflammation or rupture of ligaments, rupture of the ovary, passage of uralitis along the urinary tract. Alternatively, in the above cases, there may be dull pain.
Stitching pain in the left side
Colic usually occurs with diseases of the kidneys and intestines. Stitching, throbbing pain is possible with ulceration of the mucous membrane of the ureters and urethra. A type of stabbing - shooting pain, which indicates inflammation of the lower back, joints, cartilage. Stitching pain occurs when the intestines expand due to increased gas formation. After a bowel movement and urination, this pain subsides. Stitching pain is a formidable symptom that should not be neglected. It can be a harbinger of a ruptured ovarian cyst.
With rare exceptions, pain is never the main symptom, while it accompanies all serious pathologies of internal organs. Modern diagnostic methods (CT with contrast, types of spiral MRI, ultrasound, laparoscopy) significantly expand the ability to identify signs of diseases that cause pain. Only 1.5% of cases of pain in the pelvic organs are not accompanied by pronounced morphological changes in the internal organs. The pain is often combined with the symptoms of the underlying disease: fever, vomiting, and others.
Its sharp increase is evidence of serious malfunctions in the body, including:
- infectious nature - infectious diseases with damage to the pelvic organs are usually combined with fever;
- inflammatory pathologies of the internal organs of the small pelvis in men and women with the threat of peritonitis;
- traumatic injuries with the threat of rupture of the walls of internal organs.
The combination of pain on the right, less often on the left, or unclear localization with fever and vomiting is characteristic of appendicitis. In medical textbooks they write that vomiting with appendicitis is usually one-time, but in practice it is different. Repeated vomiting and pain in the lower abdomen on the left, often of a shingles nature, also develop with pancreatitis and cholecystitis.
Persistent, indomitable nausea and vomiting, combined with pain, should cause particular alertness.
What to do if there is pain in the left side?
What to do with spleen pain?
With diseases of the spleen, the patient often needs surgery. This is especially true in the case when the pain in the organ is caused by a cyst or a growing tumor.
To make a person feel better, the following drugs can be used:
- Spazmalgon, Ibuprofen, Drotaverin. They are prescribed to relieve pain.
- Linex, Espumisan, Mezim-forte. The drugs can help reduce bloating.
- Heparin, Fraxiparin. These absorbent and anticoagulants are indicated for use in case of organ infarction.
- Panadol, Aspirin, Ibuklin, Paracetamol. They are prescribed to lower body temperature.
What to do with pain in the small intestine?
If a person suffers from celiac disease or malabsorption, then he needs to stop eating highly fermented foods. Their small intestines simply cannot digest.
When a patient is diagnosed with peptic ulcer disease, drugs such as:
- Pariet, Esomeprazole, Ranitidine, Famotidine, Pirenzepine. These are antisecretory drugs that reduce the production of hydrochloric acid in the stomach.
- De-nol, Vikalin, Vikair - preparations containing bismuth.
- Clarithromycin, Tinidazole, Tetracycline, Amoxicillin are antibacterial drugs.
- Gastal, Maalox, Almagel, Nimesil - drugs for relieving heartburn.
- Loperamide, Acylact, Lactobacterin, Normobact - means to eliminate diarrhea.
- Tisaden, Bisacodyl, Senalex, Glycelax - remedies for constipation.
- Smecta, Bobotik, Sub Simplex, Meteospazmil - drugs to reduce bloating due to gas.
What to do with colon pain?
If a person suffers from pain in the large intestine, they may be prescribed medications such as:
- Enzymatic agents: Festal, Creon, Pancreoflat, Entsipalmed.
- Painkillers: Spazmalgon, Baralgin, Kolotal, Nirvaxal, Maxigan.
- Drugs to lower body temperature: Paracetamol, Citramon, Ibuklin, Nurofen.
- Preparations for stopping vomiting: Trazin, Senorm, Bonin, Zofran.
- Means for stopping diarrhea: Phtalazol, Bifiform, Hilak forte, Enterol.
- Drugs to cope with constipation: Lactitol, Glycerol, Duphalac, Romfalak.
- Preparations for bloating: Linex, Mezim-forte, Enterosgel.
What to do in case of diseases of the genitourinary system?
Diseases of the genitourinary system require a professional approach to treatment, self-administration of drugs is unacceptable. Sometimes patients need surgery, for example, with advanced endometriosis, or with a ruptured ligament.
To eliminate symptoms, medications such as:
- Antibiotics: Azitral, Biseptol, Normobactin, Moximak, Ospamox.
- Preparations to relieve the inflammatory reaction: Nurofen, Ketonal, Meloxicam, Melbek, Voltaren.
- Preparations for relief of pain symptoms: Spazgan, Nurofen, Movasin, Indomethacin.
- Drugs to reduce body temperature: Pentalgin, Paracetamol, Diclac, Metindol, Naproxen.
Lymphadenitis as a cause of pain in the left side
With lymphadenitis, accompanied by inflammation of the lymph nodes, drugs such as:
- Nimesulide, etc.
Also, patients are prescribed physiotherapy procedures: UHF, laser therapy, galvanization.
Gastritis as a cause of pain
Gastritis is treated by a gastroenterologist.
The doctor prescribes drugs to the patient such as:
- Activated carbon
Pancreatitis as a cause of pain in the left side
Developing pancreatitis requires medical advice. If the doctor thinks that the disease has a severe course, he will hospitalize the patient. Although sometimes home treatment is possible.
For this purpose, medications such as:
- Enzymes: Pancreatin, Festal, Mezim, Creon, Kontrikal.
- Antispasmodics: Papaverine, No-shpa, Baralgin.
- Diuretic drugs: Diacarb, Lasix, Furosemide.
Neuralgia as a cause of pain
Neuralgia is treated by a neurologist.
The doctor may prescribe medications such as:
- Ibuprofen, Panadol, Analgin, Nimesulide, Diclofenac. They help relieve pain. Sometimes drugs are taken by mouth, and sometimes they are used for topical application. Diclofenac, Voltaren, Nimid are produced in the form of an ointment.
- B vitamins. Deficiency of these vitamins often causes the development of neuralgia.
- To relieve muscle spasm and eliminate inflammation, the use of drugs such as Tempalgin, Baclofen, Clonazepam, Sirdalud is indicated.
You can increase the therapeutic effect with the help of physiotherapy. Therefore, patients with neuralgia may be prescribed solux, electrophoresis or UHF.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.