Update: December 2018
Severe pain in the left hypochondrium – its appearance is
symptom of a large number of various diseases and pathological
states. Since the left subcostal abdomen corresponds
part of the stomach, left part of the diaphragm, intestinal loops, pole of the left
kidneys, pancreas and the most obvious organ is the spleen,
therefore, the most common causes of this pain can be a violation
the functioning of these particular organs.
The nature of the pain from the side under the ribs
First you need to decide what the hypochondrium area means –
left upper quadrant located under the ribs (see figure). AT
depending on the nature of the pain, when it appears, after what
of events, it is possible to determine what caused it and to which doctor should
apply for an accurate diagnosis and treatment:
Stitching pains in left hypochondrium when loaded
If they occur only during strong physical exertion,
such as – running, brisk walking (on a treadmill), jumping, during
being a fitness workout and other physical activities is not
scary and happens in practically healthy people. Such painful
sensations pass quickly and speak only about insufficient warm-up
before occupation and too abrupt or excessive movement.
Without a thorough warm-up (20 minutes) the body does not have time
to adapt to a sharp increase in blood circulation. If pain
occurs only under load, there is no particular danger if
a person does not suffer from heart disease (cardiomyopathy, etc.).
Even if you are completely healthy, you should not test the body –
stop, relax your arms, shoulders, breathe deeply or during
a sharp exhalation, press the palm to the place of pain, while
sharply leaning the body forward, so repeat 2-3 times and you can
Also следует следить, чтобы дыхание при занятиях было
deep enough because shallow and frequent breathing
accompanied by small excursions of the diaphragm. Usually sharp piercing
pains to the left and even to the right when running occur if exercise
begins abruptly without a warm-up and after meals. After eating should
take at least 1-1.5 hours because the gastrointestinal tract
loaded with work, the body is not warmed up and not rebuilt, hence
double load and double pain.
Dagger cutting acute pain syndrome
It is quite another thing if a dagger cutter, sharp
pain in the left side under the ribs when it is not connected with the load and
appears suddenly – this is a reason to provide urgent medical
help. ATнезапные сильные боли в левом подреберье могут указывать
on the rupture of the renal pelvis, spleen, be the result of perforation
loops of the small intestine or the wall of the stomach. As well as
abdominal myocardial infarction or acute pancreatitis.
Acute, severe pain after injury
If pain возникает при вдохе после падения, травмы или
car accident – it could be a sign, a symptom
serious damage to internal organs, life-threatening.
Dull pain in left hypochondrium
Spilled, dull pain under the ribs on the left, if she periodically
occurs over a long time, is the reason for
anxiety, as it can be a symptom of sluggish
chronic diseases of the gastrointestinal tract. More often
In total, it is cholecystitis, gastritis, pancreatitis and others. To
confirm or exclude pathology data should refer to
a gastroenterologist, to do a series of laboratory tests,
instrumental studies, ultrasound and other procedures, analyzes.
Splenomegaly in various pathologies of the blood, autoimmune or
systemic diseases, sepsis, bacterial infections –
This is a reason for dull or aching chronic pain in the left in
It’s a dull pain
Constant pulling, aching pain on left side under ribs – symptom,
a sign of sluggish colitis or duodenitis, if this symptom
nausea, vomiting joins – it can be a manifestation of an ulcer
stomach. Not associated with the gastrointestinal tract such pain can be a sign
preinfarction state, coronary heart disease or
So, the pain in the left upper part
abdomen, can be caused by the following reasons, pathologies and
- Cardiomyopathy, heart attack, damage to the heart muscle
- Painшинство заболеваний желудочно-кишечного тракта — гастрит,
cholecystitis, pancreatitis, gastric ulcer, colitis,
- Intercostal neuralgia (symptoms)
- Splenic rupture (trauma) or enlargement of the spleen due to
- Infarction of the spleen with arterial thrombosis
- Tumors of internal organs
- Diaphragmatic hernia or diaphragm injury
- Rheumatic manifestations
- Left-sided pneumonia, left-sided pleurisy, which
arise in the lower part of the left lung
It is necessary to distinguish the pain in the hypochondrium by the mechanism
ATсе возможные боли в левом боку под ребрами также разделяют по
механизму occurrence, это может служить дополнительным
diagnostic indication to help determine pathology
this or that body or system.
Reflected pains – these painful sensations appear as
radiating from far enough organs, such as with
heart attack, left-sided pneumonia, pleurisy, or other
diseases. Visceral pain – with intestinal cramps or
violation of gastric motility, as well as stretching of their muscular
fibers. With flatulence, aching and dull pains may occur, or
colic pains – with intestinal colic, which are often
give to nearby areas of the body. Peritoneal pain – permanent
and clearly localized pain caused by irritation
peritoneum, such as with perforated gastric ulcer. Such pain
amplified by breathing, movement, it is cutting, sharp.
When pain in left hypochondrium in front
If such pain is localized under the ribs in front, it is more likely
indicates a disease of the spleen or damage to the tissues of the stomach.
In these cases, the differential diagnosis is carried out with a heart attack.
myocardium, colitis of the upper loops of the intestine, myositis. If pain
moves more towards the center, perhaps a combination of stomach disease with
diseases of the gallbladder and duodenum.
When the pain is behind
Most often with the defeat of the left kidney, pain is localized in the left
hypochondrium behind, it is strong enough, constant, for
Diagnosis of kidney disease should be done ultrasound, pass the general
urine and blood test. In addition to the pathology of the left kidney, such pain can
occur with thoracic and lumbar osteochondrosis, palpation
paravertebral processes can give this pain.
Girdle pain with left pain
If there is a surrounding pain in the area under the left ribs,
going back to the anterior abdominal wall, it could be
a sign of pancreatic inflammation – pancreatitis. With
pancreatitis, a symptom of the onset of inflammation is
an unbearable burning stinging pain that subsides a little
when a person leans forward in a sitting position.
Pathology of the diaphragm
Constant pain in this area may occur in pathologies.
diaphragm, diaphragmatic hernia. Hole in the diaphragm required
for the esophagus that connects to the stomach, separates the chest cavity
from the abdominal. And with the weakening of the muscle tissue that regulates it
opening – the lumen expands, so the upper section of the stomach
may extend beyond the abdominal cavity into the chest.
With этом происходит заброс содержимого желудка в пищевод,
causing constant dull, aching pain on the left, with nausea, heartburn.
Contribute to the development of diaphragmatic hernia can – pregnancy,
obesity, excessive exercise, and often this
pathology occurs in older people with a general weakening of all
muscle apparatus. Sometimes this condition is aggravated by pinching
stomach, then sharp, cutting, sharp pains appear in the left
Withчина — межреберная невралгия
Various neurological diseases can cause pressure.
or irritation of the intercostal nerves. Pain when
intercostal neuralgia have a wide range of manifestations:
- In the area of the ribs, under the ribs – shooting, piercing,
acute or aching, burning or dull pain (see also pain in
- The pain may increase with sudden movements, sneezing, inhaling,
coughing, even when changing position.
- Withступы межреберной невралгии сопровождаются колющей болью в
chest, left side, manifest muscle twitching,
pallor or redness of the skin, increased perspiration.
- With надавливании на некоторые точки на спине, грудной клетке,
between the ribs or along the spine – painful ones also appear
With невралгии боль может локализоваться не только в левой
side, but also in the lower back, under the scapula (as with heart
diseases). They can be at night, and in the morning, and in the afternoon, it is enough
for a long time, in places of nerve damage sometimes
there is a feeling of numbness.
Aching pain in the left side in combination with shortness of breath with exertion and
even rest, nausea, palpitations, burning and heaviness in
Breasts are associated with diseases of the heart, such as ischemic
heart diseases. With поражении коронарных артерий нарушается
blood supply to the heart muscle, causing such a pathological
condition as ischemia.
Also similar pains under the ribs may occur when
cardiomyopathy is a number of different diseases that lead to
impaired function of the heart muscle, with no pathology
valve apparatus, arterial hypertension, diseases
heart vessels. With кардиомиопатии сердечная мышца изменяется
structurally. This is manifested by fatigue, pain in the left
side during physical exertion. More on symptoms and treatment.
Pathological conditions of the spleen
The spleen is a fragile, easily torn organ, so any
pathological condition is reflected by pain.
Its insignificant increase is difficult to recognize, especially in the full
людей, поскольку она залегает глубоко в левом hypochondrium
An enlarged spleen or splenomegaly occurs in some
infectious diseases, for example, in infectious mononucleosis.
However, apart from pain in the spleen, this inherent in the disease
pronounced symptoms, such as fever, muscle aches,
headache, swollen lymph nodes, general intoxication,
angina, enlarged liver. Spleen performs several
important functions in the body:
- This is the thinnest blood filter.
- It is the largest lymph node.
- It is the largest conglomerate of reticuloendothelial tissue.
With гипертрофии селезенки, когда она в усиленном режиме
performs an immune, phagocytic and filtering function, that is, on
the background of diseases of immune complexes, hemolytic anemia, acute
severe infections – it grows in size and can cause
pain on the left. Other causes of pain and spleen enlargement
include injuries, infiltration, tumors or defects in its development.
Especially acute sharp pain in the area under the ribs occurs when
shock, trauma, leading to rupture of the spleen. In addition to pain, a sign
rupture is the cyanosis of the skin around the navel,
since there accumulates a large amount of blood, and the pain gives
from left hypochondrium in the back, with the appearance of similar symptoms
should call an ambulance.
Diseases of the stomach, pancreas
The majority of the population suffers from this disease because
the current state of the food industry aimed at
the creation of chemical products, contributes to the development
functional disorders of the stomach and gastrointestinal tract. Gastric mucosa
sensitive enough to any irritants that are in our
daily diet is more than enough. Gastritis чаще всего
manifested by belching, aching pain in the hypochondrium, nausea, pain in
epigastric region, vomiting, heartburn, heaviness, feeling
pressure. These symptoms appear shortly after eating, as well as
common disorders can occur – pallor, weakness,
irritability, dry mouth, burning, disturbance
sensitivity of the lower and upper extremities, signs of dyspepsia –
- Stomach ulcer
It has similar symptoms with gastritis and depends on
duration and severity of the disease, unlike ulcers
duodenum, when pain occurs during the famine,
empty stomach, stomach ulcer pain occurs after eating. Also
this causes heartburn, nausea, vomiting, belching sour, reducing
appetite and body weight. With прободной язве основным ярким симптомом
is dagger, sudden pain, loss of consciousness, pallor,
- Pancreatic diseases
The most typical symptoms of acute pancreatitis are severe.
pain under left hypochondrium, in left side, and in the epigastrium,
hernia character, accompanied by vomiting with bile,
nausea, bitterness in the mouth, fever, also
possible staining of urine in a dark color and brightening feces. Pain
it happens so strong that a person is forced to sit bent over.
With хроническом панкреатите пациенты жалуются на тупую ноющую боль
especially after a magnificent feast. With онкологическом поражении
the pancreas is very difficult to diagnose, this
очень маленький, труднодоступный орган, который тяжело
amenable to diagnosis and therapy, and the symptoms of cancer are almost not
noticeable at the onset of the disease.
- Oncological diseases of the digestive tract
In our time of oncological tensions, any manifestations
malaise, weakness, lack of appetite, anemia, aversion to
some kind of specific food, such as meat, fast satiety,
recurrent pains in the stomach, intestines, a series of constipations with diarrhea,
should alert the person, especially with age. Oncology
dangerous for its low-symptom course in the early stages. With
any persistent pain should consult a doctor for clarification
reasons and timely treatment.