Left Side Abdominal Pain

Common Causes, Diagnosis & Treatment Of Left Side Abdominal Pain 

Why Left Side Abdominal Pain?

Some common causes of pain in the left side of the abdomen.

Pain on the left side of the abdomen is very common.

Because women obviously have more organs (womb, fallopian tubes and ovaries) in the abdomen, they are more likely to suffer with abdominal pain than their male counterpart - be it on the right or the left.

Also certain conditions that causes a left sided abdominal pain, like irritable bowel syndrome are more likely in women, thus making pain in this region more commonly seen in women.

Any injury or infection or strain on any of the organs on the left side of the abdomen could lead to a left sided abdominal pain.

Pain to this part of the abdomen could also arise from organs that are not directly found here - like pain in the left testicle in males could be "referred" to the left side of the abdomen.

For a better understanding of the origin and causes of pain on the left side of the abdomen, it is important to review the organs on the left side of the abdomen in which things could go wrong.

Organs On The Left Side Of The Abdomen

If you are experiencing pain on the left side of your abdomen, it is very likely that one or more of the following organs found on the left side of your abdomen is being affected.

So, what are the common causes of pain on the left side of the abdomen? 

Common Causes Of Left Sided Abdominal Pain

There are a range of conditions that can bring on left sided abdominal pain. The list below highlights the most common causes. They are:

Diagnosis And Treatment of The Top Five Causes Of Left Sided Abdominal Pain

Despite the long list of common causes of abdominal pain shown above, most of those conditions are actually not that common. The following are the top 5 most common causes of left sided abdominal pain and how to recognise or diagnose them as well as treatment options available for them:

1. Trapped Wind

• Trapped wind or trapped intestinal gas is the accumulation and retention of more than the normal volume of gas in our gut.
• We all produce gas in our bowel following the further break down of indigestible food by the bacteria found in our gut, as well as the air we swallow during talking, chewing and eating.
• Normally, this gas passes out of our system by belching or farting. If for any reason we are unable to expel the excessive gas, it could cause distention of the wall of our gut, causing abdominal pain.
• The Pain from trapped wind could be anywhere in the abdomen, though tends to be more common on the left side.
• Have you ever heard your bowels making those loud noises after hurriedly having a meal or after a long speech? This is likely due to trapped wind.
• Trapped wind is a very common cause of abdominal pain in babies, older children and adults.
• It can be diagnosed just from the history and examination.
• Treatment options could include doing nothing, or in severe cases, the use of peppermint oil capsules.
  
• You can read more about trapped wind here.
  

2. Constipation

• Constipation is the infrequent passage of stool or passing hard stools.
• It is another common cause of central or left sided abdominal pain.
• The suffer might not even realise that they have not been passing stools frequently.
• Diagnosis is usually from the history, though an abdominal x-ray could help your doctor make a diagnosis of constipation.
• Treatment for constipation include the use of simple pain killers like Paracetamol or Tylenol in severe pain cases as well as use of laxatives.
• You can read more on constipation here.

3. Irritable Bowel Syndrome (IBS)

• Irritable bowel syndrome is a condition characterised by the presence of abdominal pain or discomfort and bloating that tends to be worse after eating and relieved by defecation. 
• There could be associated passage of watery stools (diarrhoea-type ibs), hard stools and mucus (constipation-type ibs) or a mix of the two.
• Other associated symptoms of ibs could also include lower back ache, increased frequency of urine, waking up to pass urine at night more than usual, tiredness and even pain during intercourse in a woman.
• These symptoms must have been going on for 3 to 6 months to be able to make a diagnosis of ibs.
• You would find more information and treatment of ibs here.

4. Diverticulitis

Diverticulitis is a very common cause of left sided lower abdominal pain, especially in older patients after the age of 50.

The wall of our colon is usually rugged though smooth.

Sometimes, especially in people who do not have enough roughage and fibers in their diet, the muscle of the inner wall of their large intestine things out at points of entry of blood vessels into the large bowels, creating finger-like outpouchings, referred to as diverticulum or diverticular disease.

The lumen of these unnatural out-pouching of the wall of the colon could then become blocked with feces and overtime, the trapped bacteria in the feces causes inflammation of the wall of the of the diverticulum, leading to what is referred to as diverticulitis.

• About half of everybody over the age of 60 in many western countries do have diverticular disease and may go on to develop diverticulitis of varying degree
• Most diverticulitis (more than 90%) occurs in the sigmoid colon which is the s-shaped part  of our large intestine found on the left lower abdomen
• Symptoms of diverticulitis include moderate to severe lower left sided abdominal pain (though diverticulitis could also occur on the right side of the abdomen or any part of the gut), mild to moderate fever, poor appetite, change in bowel habit and sometimes passage of blood in stool.
  
• If you are 50 years or older, suffering with a left side lower abdominal pain, made worse by pressing on the left side of the abdomen, have mild to moderate fever, you are suffering with an acute attack of diverticulitis until proven otherwise.
• Diagnosis of diverticulitis is usually by means of the story, findings on examination and supported with a CT scan finding.
• Treatment of diverticulitis is by means of a combination of antibiotics. The first choice is usually a combination of Amoxi-Clav (also called Augumentin, which contains 500mg amoxicillin and 125mg of Clavulinic acid) at a dose of 1 tablet three times a day and Metronidazole (Flagyl) at a dose of 500mg three times a day. If you are allergic to penicillin, your doctor may opt to use a combination of Ciprofloxacin 500mg twice daily with Metronidazole, 500mg three times daily.
  
• If you have had diverticulitis once, it is likely that you would continue to have recurrence.
• You can prevent this cause of left side abdominal pain by including more fruit and vegetables in your diet to provide rich fibers.
  

5. Left Sided Ovarian Cyst Rupture Or Twisting

The left ovary could develop ball like cysts. if these cysts twist along their long axis on the stalk that attaches them to the ovary, or worse still ruptures, they could cause immense pain in the left side of a woman's abdomen.

The symptoms of ovarian cyst problems include sudden or gradual onset left side lower abdominal pain, continuous, radiates to the lower back on that side and sometimes also spreads to the hip and upper thigh on the same side.

Most women may notice symptoms occurring within two weeks of their last period, though an ovarian cyst can occur at any time, depending on the actual underlying trigger.

Diagnosis is usually by means of a simple pelvic ultrasound scan or laparotomy.

Treatment is by means of emergency surgical correction or removal of the offending ovary.

When To Seek Medical Advice

It is important to remember that left sided abdominal pain is very common. Like pain in other parts of the abdomen in most instances it is caused by a condition that isn’t life threatening. However, causes of pain in this part of the abdomen can be serious and it is important to analyse your symptoms.

If you have severe pain in any part of your abdomen lasting more than one hour which is not going away despite use of pain medication, it is important that you seek medical advice.  You should also seek urgent medical advice if this sudden onset of left sided abdominal pain is accompanied with one of the following symptoms:

• Vomiting
• Vomiting of coffee coloured material/ blood
• Diarrhoea
• Passage of dark or black tarry stool
• Inability to pass urine
• Passing urine frequently
• Jaundice (yellowing of the skin and whites of eyes)
• Fever
• Feeling faint
• Shoulder pain
• Lower back pain
• Sweating/ cold sweats

If you have been suffering with pain in the left side of your abdomen for days or months, and you suffer one of the following symptoms, you should also see your doctor as soon as possible.

• Recent change is bowel habit e.g. looser or harder stools
• Unintended weight loss
• Loss of appetite
• Reduced energy levels
• Fatigue
• Bloating after eating, which is relieved with a bowel movement
• Blood or mucus in your stools

Understanding Your Pain And Symptoms

When thinking about your pain, you need to consider the nature of your condition and think about:

• Where exactly on the left side the pain focuses
• When the pain started
• The scale of the pain between 1 and 10, with one being mild discomfort and ten the most severe pain you have experienced
• Whether there are any other symptoms associated with the pain

Do You Have Pain Elsewhere?

If the pain is in the upper left side of the abdomen, in other words, above the belly button, then click here too find out more about possible causes of upper left side abdomen pain.

If the pain is in the lower left side of the abdomen, in other words, below the belly button, click here too find out more about possible causes of lower left side abdomen pain.

References

• Oxford Hand Book of General Practice. Large Bowel Conditions. 3rd Edition. 2010. Pages 408 and 409.
  
• NHS Stomach ache and abdominal pain, http://www.nhs.uk/conditions/stomach-ache-abdominal-pain/Pages/Introduction.aspx (Accessed: September 2016).

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