Abdominal pain is among the most common reasons for medical office and emergency room visits. Numerous conditions and diseases can trigger abdominal pain. Although many causes are medically inconsequential, some are serious and potentially life-threatening. The location of abdominal pain is one of the first ways doctors begin narrowing the list of possible causes. Front lower left abdominal pain is known medically as left lower quadrant (LLQ) pain. A digestive system condition is most frequently to blame for LLQ pain, but problems outside the gastrointestinal system can also cause pain in this location.
An intestinal problem tops the list of causes of LLQ pain. Mild or temporary discomfort in this location is often due to constipation or gas pains. Diverticulitis is another leading culprit, especially among older adults. Diverticula are small outpouchings of the intestinal wall. They most commonly occur in the left colon, which is situated in the lower left abdomen. Diverticula cause no symptoms unless they become inflamed, a condition called diverticulitis. Pain most often occurs in the LLQ accompanied by other symptoms, such as bloating, nausea, vomiting, fever, and diarrhea or constipation.
A colon infection caused by bacteria such as E. coli or Salmonella often provokes LLQ along with diarrhea, which may be bloody. Among people with a left-sided groin hernia, LLQ may signal strangulation of the hernia -- meaning part of the bowel is trapped in the hernia sac and has lost its blood supply. This condition is a medical emergency. People with inflammatory bowel disease, including ulcerative colitis and Crohn disease, may develop LLQ pain during a disease flareup. Irritable bowel syndrome (IBS) is another possible culprit.
Reproductive System Causes
Conditions involving the reproductive system can cause LLQ pain, especially in women. Left-sided ovarian cysts, tumors or twisting of the ovary can trigger pain in this location. In some women, ovulation triggers brief, one-sided lower abdominal pain known as mittelschmerz. Other possible culprits include endometriosis, pelvic inflammatory disease, uterine fibroids, miscarriage and ectopic pregnancy -- implantation of the pregnancy outside the uterus, often in the tube between the ovary and uterus.
Testicular, scrotal and prostate conditions can lead to pain in the lower left abdomen in males. Testicular torsion, or twisting of the testicle within the scrotum, causes severe testicular pain and tenderness that may be accompanied by LLQ pain. Infection or inflammation of the prostate or the related seminal vesicles, which produce seminal fluid, can also trigger lower abdominal pain that may be left-sided.
Urinary Tract and Other Causes
A stone in the left kidney or ureter -- the tube connecting the kidney to the bladder -- provokes left-sided pain that may be felt in the lower abdomen, back and groin. A kidney infection might also be to blame. Accompanying symptoms may include fever, chills, increased urinary frequency and pain with urination.
Bruising of the left lower abdominal wall due to an accident or forceful blow may cause local tenderness and pain. An abdominal aortic aneurysm is also a possibility. This life-threatening condition involves progressive ballooning of the aorta, the main artery that supplies blood to the lower body. Rupture of an aortic aneurysm is potentially fatal. Although other causes are more likely, an abdominal blood clot or inflammation of the abdominal blood vessels may be responsible for LLQ pain.
Warnings and Precautions
Mild, short-lived pain in the lower left abdomen that goes away on its own typically does not require medical evaluation. However, LLQ pain that persists, recurs, progresses or is severe should never be ignored as this symptom might signal a serious medical problem. Seek immediate medical care if you experience pain in your lower left abdomen along with any alarm symptoms, including: -- fever, chills or clammy skin -- dizziness, lightheadedness or fainting -- nausea, vomiting or the inability to pass gas or stool -- abdominal tenderness -- bloody or tarry stools -- vaginal bleeding unrelated to a menstrual period -- testicular or scrotal pain
Reviewed by: Tina M. St. John, M.D.
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- American Family Physician: Left Lower-Quadrant Pain: Guidelines from the American College of Radiology Appropriateness Criteria
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