Abdominal pain is the No. 1 reason people head to the doctor. But 'my stomach hurts' is a very nonspecific complaint, and this type of discomfort can be associated with a broad array of conditions, ranging from no big deal to life-threatening.
However, your doctor can narrow the list of possible causes by assessing your symptoms, doing a physical exam and checking laboratory and imaging test results.
Pain in the upper left abdomen, which is also known as left upper quadrant (LUQ) pain, can occur with myriad conditions affecting many organs, including the stomach, colon, spleen, pancreas, kidneys, lungs and heart. Here, we'll break down the most common culprits.
Stomach and Colon Conditions
The stomach is in a prime location for LUQ pain, as it sits just under the lower left ribs and extends toward the middle of the upper abdomen. Several disorders can cause discomfort in this region, including stomach ulcers, esophagitis and gastritis or inflammation of the stomach lining. Stomach cancer, fortunately, is a less common diagnosis.
A portion of the large intestine called the transverse colon crosses the upper abdomen, passing below the stomach on the left side — and this area can also be affected by LUQ pain. Examples include diverticulitis, inflammatory bowel disease, severe constipation, irritable bowel syndrome and, rarely, colon cancer.
Typical symptoms of these conditions may include stomach pain as well as bloating, indigestion, nausea and vomiting.
Diverticulitis may also include fever, tenderness in the belly and constipation, per the Mayo Clinic. "Diverticulitis can be treated with antibiotic medications, a liquid diet, pain medications or, in severe cases, surgery," Neha Vyas, MD, a family medicine specialist at the Cleveland Clinic, tells LIVESTRONG.com.
Irritable bowel syndrome (IBS) may also cause cramping, diarrhea, constipation, weight loss, fatigue and blood in the stool, according to the Mayo Clinic.
"Irritable bowel syndrome is a functional disorder, which means the structure of the bowel is normal, but the bowel doesn't work properly," she says. "Inflammatory bowel disease is a structural condition — and you'll notice inflammation and changes in your bowel, which can lead to ulcers, and in rare cases, colorectal cancer."
Heart, Lung and Chest Conditions
The left chest and LUQ of the abdomen are separated by the diaphragm, the large muscle that helps move air into and out of the lungs. Since they're located so close to one another, it's common for ailments involving the left chest to cause LUQ pain.
Don't ignore heart-related pain, particularly angina, which refers to pain caused by insufficient blood flow to the heart (it's the most common symptom of a heart attack), according to the American Heart Association. This pain, which typically has a crushing nature, usually occurs in the chest but can be felt in the LUQ. Angina treatment entails lifestyle changes, such as eating right, not smoking, taking certain medications, angioplasty and stent insertion or coronary bypass surgery, according to the Mayo Clinic.
"Depending on its severity, angina of the gut can be treated with medications or surgery, though it's important to treat the origin of the angina as it may have implications for other parts of the body," says Dr. Vyas.
Pneumonia of the left lower lobe of the lung, which sits atop the diaphragm, is another consideration in people with LUQ pain, according to the American Lung Association. Cough, fever and difficulty breathing are common symptoms of pneumonia, which is often treated with antibiotics, per the Mayo Clinic.
Pleurisy — inflammation of the tissues that surround the lungs and line the chest wall — can also cause sharp LUQ pain when the left lower lung is involved, per the National Heart, Lung, and Blood Institute. The pain occurs with deep inhalations, coughing and sneezing.
If your case of pleurisy is bacterial in nature, antibiotics are the treatment of choice — viral infections usually resolve without medication, per the U.S. National Library of Medicine.
The spleen sits high in the LUQ, near the top of stomach, just below the diaphragm and behind the lower rib cage. The spleen wards off infection, filters metabolic waste products and produces red and white blood cells. Disorders of the spleen cause pain in the upper left abdomen, which often radiates to the left shoulder.
Because of its location, the spleen is susceptible to injury. Blunt-force trauma can rupture the spleen and may result from a car crash, physical assault or a sports-related injury, per the Cleveland Clinic.
Common signs and symptoms associated with a ruptured spleen include pain and tenderness in the left upper abdominal quadrant. Because a ruptured spleen can cause extensive internal bleeding, a person with this condition may also experience reduced blood pressure, lightheadedness and confusion. A ruptured spleen requires immediate surgery, per the Mayo Clinic.
Enlargement of the spleen, or splenomegaly, can also cause left upper quadrant pain, which is often described as a feeling of fullness. Splenomegaly can occur with a variety of conditions, including sickle cell disease, leukemia or lymphoma, hepatitis or cirrhosis and infectious mononucleosis. The Mayo Clinic says treatment may require antibiotics or removal of the spleen if complications develop.
The pancreas is an elongated organ that sits deep in the abdomen and crosses the midline, with the head to the right and the tail extending into the LUQ.
Because of its location, diseases of the pancreas can cause pain centrally or on either side of the upper abdomen. Pancreatic pain can also radiate to the back. Pancreatic tumors and inflammation of the pancreas, or pancreatitis, can trigger LUQ pain.
"Pancreatitis is treated with bowel rest, which means nothing by mouth, as well as pain medications, fluids, a change in diet and in some cases, surgery," says Dr. Vyas.
The kidneys sit in front of the rear abdominal wall on each side of the spine. The upper end of each kidney is housed within the lower end of the rib cage at the rear of the body.
An infection or stone involving the left kidney typically causes moderate to severe pain, commonly extending into the LUQ and left groin. A tumor of the left kidney is another, less common possibility. Small stones can be passed with medications or by drinking enough water, while larger ones require surgery, per the Mayo Clinic.
Other Potential Causes
Several other disorders can sometimes provoke upper left abdominal pain under the ribs, usually along with other symptoms. For example, tearing or the rupture of an aortic aneurysm — a ballooning weakness of the largest artery of the body — can cause pain in various sites of the abdomen and back, according to MedlinePlus.
"And pain in the upper left quadrant might also point to something like herpes zoster, also called shingles," adds Dr. Vyas.
Certain conditions of the spine or spinal nerves can also cause pain in the LUQ. Abdominal bleeding, infection or inflammation that irritates the diaphragm merits consideration if other causes of LUQ have been ruled out.
When to See a Doctor
Mild left upper quadrant pain that goes away quickly may not be cause for concern. Persistent or recurring pain in this location, however, warrants a visit with your doctor to determine the cause and appropriate treatment.
Seek urgent medical care if your abdominal pain is severe or accompanied by other alarming symptoms, including:
- Vomiting or coughing up blood
- Persistent nausea and vomiting
- Black or bloody stools
- Fever, chills or night sweats
- Abdominal distention or tenderness
- Shortness of breath or difficulty breathing
- Dizziness, lightheadedness or fainting
- Mayo Clinic: "Diverticulitis"
- American Heart Association: "Angina"
- American Lung Association: "Pneumonia Symptoms and Diagnosis"
- National Institutes of Health, National Heart, Blood and Lung Institute: "Pleurisy and Other Pleural Disorders"
- Cleveland Clinic: "Ruptured Spleen"
- U.S. National Library of Medicine, MedlinePlus: "Aortic Aneurysm"
- Cleveland Clinic: "Neha Vyas, MD, Family Medicine"
- Mayo Clinic: "Irritable Bowel Syndrome"
- Mayo Clinic: "Inflammatory Bowel Disease"
- Mayo Clinic: "Angina"
- Mayo Clinic: "Pneumonia"
- U.S. National Library of Medicine, MedlinePlus: "Pleurisy"
- Mayo Clinic: "Ruptured Spleen"
- Mayo Clinic: "Enlarged Spleen (Splenomegaly)"
- Mayo Clinic: "Kidney Stones"