What Causes the Pain in My Left Side?

These past few days, I have been experiencing pain in my left side. Although the pain is tolerable, I am still wondering what causes it. Before visiting my physician, I have done some research and discovered that the pain can be caused by some health disorder.

The pain in the left upper abdominal area, specifically under the ribs, can be manifested in several ways. It can be stabbing and sharp, radiating and shooting, or simply unbearable pain. This can be worrisome since there are lots of major organs that is situated within the region: the left kidney, the spleen, portions of the colon, part of the liver, the stomach and the pancreas. Aside from the pain in the left side, there are other symptoms that might occur, such as bloating, nausea, bowel movement irregularities and cramps – all of these symptoms may give clues about the underlying condition.

What Causes the Pain in my Left Side
What Causes the Pain in my Left Side | Source

Generally, pain in this part can have several causes like:

  • Stomach and bowel disturbance - ulcers, irritable bowel syndrome, gas, and acid reflux
  • Structural trauma – broken ribs, collapsed lung, aortic aneurysm, and hernias
  • Infection and Inflammation – diverticulitis, pancreatitis, spleen irritation, costochondritis, instestinal infection, and pericarditis.

Some of the underlying causes can be treated easily. Mild inflammation can be treated with pain relievers or anti-inflammatory drugs. Problems with bowel movement can be treated with digestive aids. But there are some like broken ribs, aortic aneurysms, pancreatitis and collapsed lungs, that are very serious and need immediate attention.

Generally, Which side you will get pain?

  • Right Side
  • Left Side
  • Between Shoulders
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Other Causes of Pain in Left Side

During my research on what might have been causing the pain in my left side, I have found out that left iliac fossa pain or LIF pain is the same with pain in left side. The pain may occur due to a self-limiting condition but it could also be a sign of a surgical/medical emergency. The LIF is less common than right iliac fossa pain.

Parietal pain occurs where there is harmful stimulation of the parietal peritoneum due to ischaemia, stretching or inflammation. It is intense, localized, sharp, discrete and aggravated by movement or coughing. Visceral pain is experienced when harmful stimuli affect the viscus. Hindgut areas like the large intestine can cause lower abdominal pain. Referred pain is kind of pain felt in remote parts supplied by the same dermatone as the affected organ.

Causes of Chronic Pain in the Left Side
Causes of Chronic Pain in the Left Side | Source

Determining the Cause of Pain

The tests to be performed should be based on the patient's symptoms and the examination findings. In the general practice setting there are several bedside tests that can be done to aid in diagnosing:

Test urine for leukocytes, nitrites and/or pus cells, if a urinary tract infection is suspected. Every time I feel the pain in my left side, I always thought that it is caused by the bacteria that is accumulating in my urinary tract. If the test turns out negative, then you have to take different kinds of tests and continue with the investigation. The pregnancy test is carried out to determine if the pain is caused by ectopic pregnancy or in case if you are pregnant, a miscarriage is suspected.

In case of non-acute pain, further investigations can be requested:

  • Blood tests can be performed, this may include full blood count, liver function tests and renal function.
  • Further urological evaluations may be required.
  • Referral for further bowel analysis can be necessary.
  • Ultrasound scanning can confirm ovarian or other mass.
  • Vaginal swab tests can help to dismiss pelvic infection

For acute abdomen, the patient is referred to the hospital right away, to perform more diagnostic tests. CT scanning is done instead of ultrasound scanning except in cases of suspected cholecystitis. Abdominal x-ray can be done to dismiss ileus, perforation and bowel obstruction, where it may show dilated loops of bowel. The erect chest x-ray may confirm intraperitoneal air under the diaphragm. I hope the conditions mentioned above does not cause the pain in my left side.

Determining the Type of Left Side Pain

Left iliac fossa or pain in left side can be diagnosed as chronic/subacute or acute.

Will you do a regular health checkup?

  • Yes
  • No
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Causes of Acute Pain in Left Side

Gastrointestinal Causes

  • Constipation – acute constipation normally has an organic cause. This should be a diagnosis of exclusion.
  • Gastroenteritis – this commonly causes more generalized abdominal pain. Care should be taken since gastroenteritis particularly the one that causing pain in left side should be a diagnosis of exclusion.
  • Volvulus – the sigmoid volvulus is the most popular type of colonic volvulus. It can result to large bowel obstruction and may have a dangerous effect in elderly patients.
  • Diverticulitis – around 90% of diverticular disorder involves the sigmoid colon and thus this condition commonly involves LIF pain.
  • Appendicitis – Rarely, this can present a pain in left side, especially in patients with loose and redundant attached caecum.
  • Left Inguinal/ femoral hernia - A dangerous femoral hernia or left inguinal may involve pain in left side. There will be an irreducible swelling and tenderness over the hernia orifice, and symptoms and signs of bowel obstruction. This requires an immediate surgical referral.

Gynaecological Causes

  • Ectopic pregnancy in the left fallopian tube – there is pain in the left side with less vaginal bleeding. If it involves profuse bleeding and 2 or 3 liters are lost within a short period of time with continues hypovolaemic shock.
  • Abortion (threatened or complete) – if the pregnancy test is positive and there is bleeding, an ultrasound scan can be done to dismiss abortion. If there is pain and ectopic pregnancy is not causing it, then it might be a sign of threatened abortion.
  • Causes of pain in the left side in later pregnancy – placental abruption, premature labor, uterine rupture.
  • Pelvic Inflammatory Disease – normally, vaginal discharge is present. This is common if you have been with multiple sexual partners, a previous experience of PID.
  • Mittelschmerz – a sudden onset of mid-cycle pain.
  • Ovarian torsion – this normally happens when an ovary has a cyst. Diagnosis can be hard. There could be adnexal tenderness. An ultrasound scan may show any abnormalities in the ovary.
  • Pelvic tumor
  • Fibroid degeneration.

Causes of Acute Pain in Left Side
Causes of Acute Pain in Left Side | Source

Causes of Chronic Pain in the Left Side

Most of the time, the pain in my left side are relieved when I take an antispasmodic medicine. But, there are times the pain is persistent that even if I take medication it won't stop.

Gastrointestinal Causes

  1. Constipation – the pain associated with chronic constipation is usually felt in the left side.
  2. Irritable Bowel Syndrome – the pain may be caused by difficulty in bowel movement.
  3. Carcinoma of rectum or descending colon – a change in bowel movement due to rectal bleeding and weight loss. It could be signs of perforation and obstruction.
  4. Ulcerative colitis and Crohn's Disease – Inflammatory bowel disease can affect the colon. Diarrhea with mucus and blood is present.
  5. Other causes of LIF pain are ovarian tumor, endometriosis, hip pathology and others.

Managing Pain in Left Side

I have tried taking analgesic to get rid of the pain in my left side. The medication works, but after several days it reoccurs.

Here are some ways on how to manage the pain in left side:

  • The management of pain depends on the diagnosis and the underlying disorder.
  • An haemodynamically and acute abdomen unstable patient needs immediate referral to hospital to ask for further assessment. If ectopic pregnancy or abdominal aortic aneurysm is suspected, seek secondary care right away.
  • Breathing, circulation and airway should be evaluated and managed accordingly.
  • The traditional remedy for pain in the left side is taking analgesics. However, this should not be given to patients with an acute abdomen since it can suppress physical signs. NSAIDs or opiods are good analgesics.

After learning these things about LIF pain or pain in the left side, I decided to visit my physician first, before taking any medication for the pain in my left side.

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