Pain under your left rib cage isn't uncommon, but figuring out the culprit can take some trial and error. The left side under the ribs is home to several major organs, including your heart, left lung, pancreas, spleen, stomach and left kidney.
Determining which part might be affected — and whether the problem is serious — involves paying close attention to your symptoms, and in many cases, seeking medical attention, according to Julia Blank, MD, a family medicine physician at Providence St. John's Health Center in Santa Monica, California.
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Here's a list of some of the most likely causes of left side pain under the ribs (or pain in the LUQ — left upper quadrant — in medical lingo) and when to consider seeing a doctor.
1. Cardiovascular Problems
Because your heart sits under your left rib, upper left abdominal pain under the ribs could be a sign of a cardiovascular issue. According to Dr. Blank, the pain could be a sign of:
Heart attacks occur when a blood clot in an artery blocks the flow of blood to the heart. They're usually marked by chest pressure or tightness; pain that spreads to the shoulder, jaw or upper abdominal area; fatigue; a cold sweat; dizziness; nausea or shortness of breath, according to the Mayo Clinic.
How to treat it: A heart attack is an emergency that requires immediate medical attention. If you or someone you know is experiencing possible symptoms, call 911 immediately.
Angina is a type of chest pain caused by temporary reduced blood flow to the heart (due to one or more partially blocked blood vessels), and symptoms often feel similar to a heart attack. Like a heart attack, angina can develop from heart disease and should be treated seriously, as it can often progress to a heart attack. The difference is that symptoms of angina can come and go, and it can often be relieved with the right tools, per the Cleveland Clinic.
How to treat it: Rest or medications like nitroglycerin can often ease angina pain in the short term, while lifestyle changes or medication to lower blood pressure or cholesterol can help resolve the problem. You should call 911 for sudden angina that won't go away; it could be a sign of a heart attack.
Cardiovascular infections such as pericarditis or endocarditis occur when parts of the heart become inflamed. They're often caused by viral infections like bacteria or pneumonia. You might feel a sharp or stabbing pain in the upper left abdomen or chest that gets worse when you lie down, breathe deeply or cough.
How to treat it: Seek medical attention if you have signs of a heart infection. Depending on the infection and its cause, you may need to take high doses of anti-inflammatory medications to reduce inflammation around your heart or take antibiotics or antifungals to clear the infection, per the National Institutes of Health.
2. GI Problems
Because your stomach, pancreas and spleen all sit under your left rib, it's possible that left rib cage pain could stem from a GI issue, says Dr. Blank.
Indigestion is another word for upper abdominal discomfort, which can happen on your left or right side (or both) and is caused by overeating, anxiety, stomach infections and a number of other possible conditions. You might notice you feel uncomfortably full after eating just a little bit or have pain between your breast bone and bellybutton, nausea and a burning or bloating feeling, per the Mayo Clinic.
How to treat it: Eating smaller, more frequent meals, managing your stress and taking over-the-counter meds like antacids can help manage mild indigestion, which will typically clear up in a week or two max. But if your symptoms stick around beyond that, let your doctor know.
Gastroesophageal reflux disease or GERD occurs when stomach contents splash up into the esophagus, which can cause a burning feeling in the chest or back, especially when lying down. Over time, GERD can also lead to trouble swallowing, sore throat or coughing, according to Johns Hopkins Medicine.
It can be triggered by certain foods or medications or when there's increased pressure on the abdomen, like during pregnancy.
How to treat it: Start by avoiding possible triggers, like spicy or fatty foods, and avoiding eating large or heavy meals close to bedtime. If lifestyle changes aren't making a difference, talk with your doctor about taking an over-the-counter antacid.
IBS or IBD
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two distinct conditions. But both can cause sharp or dull abdominal pain and bloating that could extend up towards your left rib cage, along with gas, diarrhea or constipation.
Inflammatory bowel diseases like Crohn's disease and ulcerative colitis can also cause rectal bleeding and lead to weight loss, according to the Centers for Disease Control and Prevention (CDC). Untreated, they can lead to serious complications such as intestinal perforation, internal bleeding and colon cancer.
How to treat it: See your doctor if you suspect you could have IBS or IBD. IBS can usually be managed with lifestyle changes including paying attention to your diet, but IBD is a more serious disease that typically requires medication and sometimes surgery, per the CDC.
Pancreatitis happens when cells in the pancreas become irritated and inflamed. That can occur from problems like gallstones, drinking too much, infections, abdominal surgery, taking certain medications or, in some cases, pancreatic cancer.
It's marked by upper abdominal tenderness and pain that may feel worse after eating, and in some cases, fever, nausea, vomiting or weight loss according to the Mayo Clinic.
How to treat it: Pain medications and IV fluids can help get pancreatitis symptoms under control. Depending on the underlying cause of the inflammation, you may need additional treatment such as surgery or endoscopic procedures.
Because it sits directly under your left rib cage, an enlarged spleen can cause pain in your upper left abdomen that radiates to your left shoulder or back, per the Cleveland Clinic. You might also notice that you feel fuller sooner after meals. Enlarged spleens are always caused by an underlying condition — most often an infection or liver disease, but in some cases, cancer or blood disorders.
How to treat it: See your doctor if you're noticing symptoms of a possible enlarged spleen. Doctors may rule out spleen pain by examining your abdomen, doing a blood test or running a CT or MRI.
In order to decide on the right treatment, your provider will need to determine what's causing the spleen to become enlarged.
3. Lung Problems
Your left lung sits inside your left rib cage, points out Dr. Blank. So if your rib pain is accompanied by changes in breathing or other related symptoms, it's possible it could be caused by a lung problem.
An infection that causes the air sacs in one or both lungs to become inflamed, pneumonia can develop from viral upper-respiratory infections like a cold, the flu or COVID-19 as well as certain types of bacterial infections. The symptoms can range from mild to severe and may include a cough with greenish or blood-tinged mucus, fever or chills, shortness of breath, fatigue and sharp or stabbing chest pain that gets worse when you breathe deeply, according to the American Lung Association.
How to treat it: Pneumonia treatment depends on whether the infection is caused by bacteria or a virus. Bacterial pneumonia typically requires antibiotics to get better. Viral pneumonia may clear up on its own with rest and fluids, but in some cases your doctor might also opt to prescribe an antiviral medication.
Pleurisy is an inflammation of the lung lining that can be caused by an infection or autoimmune disease. It's typically marked by sharp, stabbing chest pain that comes from one specific place and worsens when you breathe or cough. The pain can be so strong that you might find yourself trying to breathe carefully to minimize your discomfort, the Cleveland Clinic notes.
How to treat it: Pleurisy treatment depends on the underlying cause. Some infections will require antibiotics; in other cases, your doctor may recommend pain relievers or corticosteroids to ease your discomfort. If fluid is building up in your lungs, you may need to have it drained.
Trauma or injury to your left rib, like a pulled muscle or a broken rib, can cause intense pain that's concentrated in that area. If you have pain when pushing on your left rib or stretching, it may be due to an injury.
"You might experience sharp pain or pain with deep breathing or moving," Dr. Blank says. "Typically there is an inciting trauma or event that's associated with the start of the pain."
Most often, the cause is a fall, car accident or contact sports, the Mayo Clinic notes.
How to treat it: Broken ribs can heal on their own in about six weeks, but you'll need to rest and ice the area regularly to help it heal. Your doctor might also recommend breathing exercises to help you breathe more deeply, because avoiding deep breaths can increase the risk for pneumonia.
Oral medications like over-the-counter or prescription pain relievers can ease your discomfort as your rib heals.
5. Other Problems
Other issues can also trigger left upper quadrant pain near the rib cage. These include:
Ectopic pregnancies — when a fertilized egg implants outside the uterus — are first marked by light vaginal bleeding and pelvic pain. This can progress to pain in the shoulder (known as "referred pain," when a nerve causes a pain sensation in an area of the body not directly involved in the pregnancy), an urge to have a bowel movement and severe abdominal pain, lightheadedness or fainting, according to the Mayo Clinic.
How to treat it: Ectopic pregnancies can cause life-threatening complications and require immediate medical attention. Depending on how far along the pregnancy is, the ectopic tissue may be removed with medication or surgery.
Kidney stones are hard mineral or salt deposits that form inside the kidney. Because this organ is located high in the abdomen, a stone there can feel like upper abdominal pain under the ribs or back pain. The pain is usually sharp and comes with cloudy or bloody urine, fever or chills, and burning while urinating, notes the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
How to treat it: You may be able to pass a small kidney stone on your own without treatment; drinking plenty of fluids can encourage it to move along. If the stone is difficult to pass, you may need to have it removed or have it broken into smaller pieces so it can pass more easily.
How Can You Treat Discomfort or Pain Below Your Left Rib Cage?
There's no one-size-fits-all way to manage left upper quadrant pain. "Treatment depends on the cause of the pain," Dr. Blank says. If you're not sure what the underlying issue might be, make an appointment to discuss your symptoms with your doctor.
If you suspect your discomfort stems from an injury, you can start by resting, applying ice to the affected area and taking an over-the-counter pain reliever like acetaminophen or ibuprofen, recommends the Mayo Clinic.
When Should You Worry About Pain Under Your Left Rib?
Pain around the left rib cage isn't always cause for concern, and sometimes the problem will clear up on its own. But in other cases, the discomfort could be a sign of a serious problem.
According to Dr. Blank, you should contact your doctor for upper left abdominal pain if:
- The pain occurred after trauma or an injury
- The pain is severe and hasn't gotten better after 24 to 48 hours
- The pain is accompanied by other concerning symptoms like a fever, vomiting, shortness of breath, a rash or a mass that you can feel with your fingers
- Mayo Clinic: "Heart Attack"
- Cleveland Clinic: "Angina"
- National Institutes of Health: "Pericarditis"
- Mayo Clinic: "Indigestion"
- Johns Hopkins Medicine: "Gastroesophageal Reflux Disease (GERD)"
- Mayo Clinic: "Pancreatitis"
- Cleveland Clinic: "Enlarged Spleen"
- American Lung Association: "Pneumonia Symptoms and Diagnosis"
- Cleveland Clinic: "Pleurisy"
- Mayo Clinic: "Broken Ribs"
- Mayo Clinic: "Ectopic Pregnancy"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Kidney Stones"
- Centers for Disease Control and Prevention: "What is inflammatory bowel disease (IBD)?"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.