Pain in the left hypochondrium. Aching pain in the left side under the ribs in front

Feelings of discomfort and pain in the left hypochondrium are a fairly common reason for patients to turn to medical care. Similar phenomena can be different in their manifestations (aching, cutting, sharp, etc.) and in intensity, as well as in duration. To establish their cause, one visit to the doctor is not enough; more additional examinations. This is due to the fact that in this segment of the body there are several organs, which, due to the pathological processes occurring in them, thus make themselves known.

Organs of the left hypochondrium

The left hypochondrium is the area located under the two lower ribs on the left side of the conditional middle of the abdomen. The following organs are located here:

spleen;

pancreas;

left side of the stomach;

aperture (left side);

small intestine;

colon;

the left kidney and its ureter, as well as ligaments.

Besides this, there are some other types pain in this area, not directly related to the above authorities. They are a consequence of diseases of the internal organs in other areas of the abdomen or parts of the body and spread along nerve fibers (see below).

Causes of pain in the left hypochondrium

The main causes of pain in the left hypochondrium are as follows:

stomach diseases, most often ulcers, gastritis;

pancreatic diseases - pancreatitis;

spleen diseases;

pathology of the left kidney;

diseases of the small and large intestines.

Also, no less rarely, pain in this area can be caused by:

inflammatory processes of the diaphragm, its hernias and tumors;

pneumonia of the left lung;

heart diseases, in particular angina pectoris, heart attack, coronary artery disease;

lumbar osteochondrosis, as well as thoracic spine;

inflammatory processes in the left appendages in women (adnexitis, etc.);

postoperative and post-traumatic consequences (hematomas, cuts, stitches, etc.);

Each of these reasons can pose a potential threat to human life. Therefore, for their timely elimination and treatment, immediate contact with a specialist is required.

According to the nature of pain in the left hypochondrium, there are the following types:

dull, aching;

• sharp, sharp;

In addition to these characteristics, to make a correct diagnosis, the doctor also takes into account indirect manifestations of pain. These include:

• development;

  character;

  duration;

  intensity;

  reasons for the increase;

  irradiation (where it gives off);

  reasons for relief.

A person who can competently describe the nature of the pain greatly helps and speeds up the process of identifying the causes of the disease.

Sharp, sharp pain

Sharp, acute pain usually indicates the presence of serious damage to internal organs, requiring immediate hospitalization. In this case, a person experiences a strong, almost unbearable pain reaction, often accompanied by loss of consciousness. If this does not happen, then the person tries to alleviate the condition by rushing about in search of a comfortable body position.

This pain occurs in the following cases:

renal colic;

perforated stomach ulcer;

acute pancreatitis;

intestinal perforation;

strangulated renal cyst;

injuries to internal organs - rupture or hematoma of the spleen, rib fractures, rupture of the kidney, rupture of the kidney ligaments.

To save the patient's life, surgical intervention is often inevitable in such situations.

Dull, aching pain

This type of pain can occur in many cases, most often associated with the chronic course of diseases of the organs of the left hypochondrium. These include chronic forms of gastritis, gastric ulcers, pancreatitis and pyelonephritis, colitis or duodenitis. Also, coronary heart disease and pre-infarction conditions often cause such pain syndrome.

With this type of pain, the patient often does not consult a doctor in time and adapts to them. As a result, the body long time without treatment, processes occur that lead to the destruction of organs or irreversible tissue degradation, which threatens the loss of functions of the entire organ and the need to carry out operations over time.

In medical practice People especially often complain of a dull, aching pain in cases of chronic gastritis. In this case, the patient especially experiences pain in the left hypochondrium on an empty stomach or after eating. His appetite decreases and fatigue occurs quickly. Timely treatment and following a certain diet helps to cope with the disease. If the disease is not a long period remains without taking adequate therapeutic measures, serious pathological processes leading to oncology.

In addition to these diseases, this type of pain is inherent in the following diseases:

enteritis (inflammatory bowel processes);

inflammatory processes of the appendages;

oncology of the pancreas or liver, spleen;

oncology of the left lung;

enlarged spleen due to leukemia, anemia, mononucleosis of an infectious nature, rheumatoid arthritis;

At intestinal pathologies And peptic ulcer stomach pain usually also occurs after eating or on an empty stomach, severe flatulence, bloating, and sometimes vomiting blood or nausea. These manifestations can be disturbing at night.

In any of the above cases, it is important to know that the sooner the medical examination about the reasons causing this type pain, the more effective the treatment will be and the faster the recovery period will begin.

The spleen is located on the left side of the abdomen under the ribs. This organ is difficult to palpate, but it is its lesions that can cause nagging pain. This is usually observed when it increases in size against the background of sluggish infectious (tuberculosis) and autoimmune processes (for example, lupus erythematosus).

Also, pain of this nature is observed in the case of hepatitis. With a long-term form chronic hepatitis Along with nagging, constant or periodic pain, both on the right (more often and more intensely) and on the left, a person experiences symptoms such as a complication of the condition when using fatty foods, heaviness inside the abdomen, increased liver size. If left untreated, this can lead to cirrhosis of the liver.

Stitching pain

Another type of pain that occurs in the left hypochondrium is stabbing pain. They are usually associated with various diseases of the left kidney. Usually these are the following ailments:

urolithiasis disease;

pyelonephritis.

Painful sensations appear in the back or side and can be transmitted to the hypochondrium area. In this case, there is an increase in body temperature, vomiting, nausea, frequent urge to urination and its pain, general weakness. Very severe stabbing pains may be associated with the presence of large stones in the organ or the beginning of their movement. In this case, surgery is necessary.

If the pain is not very pronounced, use conservative methods treatment. However, in any case, you need to contact a specialist.

Throbbing pain

This dangerous disease, as pancreatitis very often causes pain in the left hypochondrium and its character is similar to strong pulsation. Along with pain symptoms, vomiting of bile, fever, diarrhea, bloating, chills, sweating, and swelling in the extremities are observed. The patient tries to find a comfortable position that reduces pain. He leans forward or sits down. This disease is very dangerous and can become acute, requiring immediate medical attention.

Pain that occurs in women

Women during various physiological processes (pregnancy, premenstrual period) may also experience pain in the left hypochondrium area.

During pregnancy, especially in the 2nd -3rd trimester, when the fetus is already quite large, natural pressure occurs on the internal maternal organs. The result is periodic pain.

If a woman’s body produces increased amount female sex hormones in anticipation of the onset of menstruation, which affect the bile ducts, causing them to spasm. In this case, there may be a sensation of pain under the right rib, spreading to the left side of the abdomen, bitterness in the mouth and a feeling of nausea. In this case, a consultation with a gynecologist will help you choose correct measures to prevent such phenomena.

Pain caused by heart and vascular diseases

With diseases of the heart and vascular system, and in particular with vegetative-vascular dystonia and angina, pain also occurs in the left hypochondrium region. In the case of dystonia, this is due to a violation of the mechanism for maintaining the tone of blood vessels, and in the case of angina pectoris, heart pain is radiated to this area.

The nature of the pain in these cases can be dull, stabbing, or aching. Patients usually find it difficult to describe such phenomena, because they can be both prolonged and paroxysmal with unclear localization. When conducting research, typical diseases of the organs located in this area of ​​​​the hypochondrium are not detected and the person is sent for examination to a cardiologist or neurologist.

Sometimes completely healthy people or children experience pain in the left hypochondrium during active physical activity (sports, intense work). This usually happens when a person has low level preparation for these classes. The mechanism of this phenomenon is such that under the influence of load the level of blood circulation in the body increases sharply.

In response to all this blood vessels increase in diameter, including the right vena cava, which runs next to the liver and begins to put pressure on it. As a result, a stabbing pain appears on the right side, which is transmitted to the left hypochondrium. A short time after the cessation of exposure, the pain reaction goes away on its own and does not require any therapeutic measures. Many schoolchildren encounter such manifestations during cross-country competitions or passing sports standards.

Sometimes similar pain sensations can appear with sudden movements or bending of the body. This is due to the contact of internal organs with the surface of the rib and, accordingly, the body’s protective reaction in the form of pain.

Measures in case of pain

If a diagnosis has not yet been established, and the pain is bothersome, you need to seek help and advice from a therapist who will conduct initial research and determine the patient’s next steps.

Of course, each specific type of pain requires contacting a specific specialist:

• gastroenterologist;

  endocrinologist;

  cardiologist;

  gynecologist;

  urologist, etc.

There are cases that require emergency medical care with hospitalization. In other words, when an emergency ambulance call is required:

First of all, these are sharp, sudden pains.

Secondly, this aching character pain for an hour.

Thirdly, it is stabbing pain for more than 30 minutes that appears when moving.

Fourth – dull pain with nausea and vomiting of blood.

Any self-medication measures for the left hypochondrium localization of pain, without establishing their diagnosis, are unacceptable, as they can aggravate the course of the disease and lead to complications. Such a popular procedure among people as warming is specially prohibited. You should also not use antispasmodics before consulting with a specialist. They are able to dull the pain and disrupt the clinical picture, as well as the symptoms of the disease.

The only thing that can be applied in the event of such pain manifestations is to apply cold to the area (ice or cold compress).

Strong pain in the left hypochondrium - its appearance is a symptom of a large number of different diseases and pathological conditions. Since the left hypochondrium region of the abdomen corresponds to part of the stomach, the left part of the diaphragm, intestinal loops, the pole of the left kidney, the pancreas and the most obvious organ - the spleen, therefore, most often the causes of such pain can be a dysfunction of these organs.

Character of pain on the side under the ribs

First, you should decide what the hypochondrium area means - this is the upper left quadrant, located under the ribs (see figure). Depending on the nature of the pain, when it appears, after what events, you can determine what caused it and which doctor you should contact for an accurate diagnosis and treatment:

Stitching pain in the left hypochondrium during exercise

If they occur only during intense physical activity, such as running, fast walking (on a treadmill), jumping, during fitness training, etc. physical activities- this is not scary and happens in practically healthy people. Such painful sensations pass quickly and only indicate insufficient warm-up before exercise and too sudden or excessive movement.

Without a thorough warm-up (20 minutes), the body does not have time to adapt to the sharp increase in blood circulation. If pain occurs only during exercise, there is no particular danger in this, unless the person suffers from heart disease (cardiomyopathy, etc.). Even if you are absolutely healthy, you should not test your body - stop, relax your arms, shoulders, breathe deeply, or while exhaling sharply, press your palm on the place where the pain is located, while sharply leaning your body forward, repeat this 2-3 times and you can run on.

You should also ensure that your breathing is deep enough during exercise, since shallow and frequent breathing is accompanied by small excursions of the diaphragm. Typically, sharp stabbing pains on the left and even the right when running occur if the workout starts abruptly without warming up and after eating. After eating, at least 1-1.5 hours should pass, since the gastrointestinal tract is overloaded with work, the body has not warmed up and has not rebuilt, hence double the load and double the pain.

Dagger cutting acute pain syndrome

It’s a completely different matter if a dagger-like, cutting, sharp pain occurs in the left side under the ribs, when it is not associated with stress and appears suddenly - this is a reason to provide urgent medical care. Sudden severe pain in the left hypochondrium may indicate a rupture of the renal pelvis, spleen, or be a consequence of perforation of the loops of the small intestine or the stomach wall. And also as an abdominal variant of myocardial infarction or acute pancreatitis.

Sharp, severe pain after injury

If pain occurs when inhaling after a fall, injury, or car accident- this may be a sign, a symptom of serious damage to internal organs that threatens life.

Dull pain in the left hypochondrium

Diffuse, dull pain under the ribs on the left, if it occurs periodically over a long period of time, is a cause for concern, as it may be a symptom of a sluggish chronic disease of the gastrointestinal tract. Most often these are cholecystitis, gastritis, pancreatitis and others. To confirm or exclude these pathologies, you should contact a gastroenterologist and do a series of laboratory tests, instrumental studies, ultrasound and other procedures and tests.

Splenomegaly in various blood pathologies, autoimmune or systemic diseases, sepsis, bacterial infections– this is a reason for dull or aching chronic pain on the left hypochondrium.

It's a dull pain

Constant nagging, aching pain on the left under the ribs is a symptom, a sign of sluggish colitis or duodenitis, if this symptom is accompanied by nausea and vomiting, this may be a manifestation of a stomach ulcer. Such pain not related to the gastrointestinal tract may be a sign of a pre-infarction condition, coronary heart disease or angina pectoris.

So, pain that occurs in the left upper abdomen can be caused by the following reasons, pathologies and diseases:

• Cardiomyopathy, heart attack, damage to the heart muscle
• Most diseases of the gastrointestinal tract - cholecystitis, gastric ulcer, colitis, duodenitis
• Splenic rupture (trauma) or enlarged spleen due to infectious diseases
• Splenic infarction due to arterial thrombosis
• Tumors of internal organs
• Diaphragmatic hernia or diaphragm injury
• Rheumatic manifestations
• Left-sided pneumonia, left-sided pleurisy, which occurs in the lower part of the left lung

Pain in the hypochondrium should be distinguished according to the mechanism of occurrence

All possible pain in the left side under the ribs are also divided according to the mechanism of occurrence, this can serve as an additional diagnostic sign to help determine the pathology of a particular organ or system.

Referred pain - these pain sensations appear as radiating from fairly distant organs, such as with a heart attack, left-sided pneumonia, pleurisy or other diseases.
Visceral pain- for intestinal spasms or impaired gastric motility, as well as their sprains muscle fibers. When there may be aching and dull pain, or cramping pain - when intestinal colic, which often radiate to nearby areas of the body.
Peritoneal pain- constant and clearly localized pain, which is caused by irritation of the peritoneum, such as with a perforated gastric ulcer. This pain intensifies with breathing and movement, it is cutting and sharp.

When there is pain in the left hypochondrium in front

If such pain is localized under the ribs in front, this most likely indicates diseases of the spleen or damage to the tissues of the stomach. In these cases differential diagnosis carried out with myocardial infarction, colitis of the upper intestinal loops,. If the pain shifts more towards the center, a combination of stomach disease with diseases of the gallbladder and duodenum.

When the pain is behind

Most often, when the left kidney is damaged, the pain is localized in the left hypochondrium at the back, it is quite strong and constant; to diagnose kidney disease, you should do an ultrasound, a general urine and blood test. In addition to the pathology of the left kidney, such pain can occur with thoracic and lumbar osteochondrosis; palpation of the paravertebral processes can give rise to this pain syndrome.

Girdle pain combined with pain on the left

If there is a girdle pain in the area under the left ribs, moving from behind to the anterior abdominal wall, this may be a sign of inflammation of the pancreas - pancreatitis. When inflammation begins, there is an unbearable burning pain that subsides a little when the person leans forward in a sitting position.

Pathologies of the diaphragm

Constant pain in this area can occur due to pathologies of the diaphragm, diaphragmatic hernia. The hole in the diaphragm, necessary for the esophagus, which connects to the stomach, separates the chest cavity from the abdominal cavity. And when the muscle tissue that regulates this hole weakens, the lumen expands, so upper section the stomach can extend beyond the abdominal cavity into the chest.

In this case, the stomach contents reflux into the esophagus, causing constant dull, aching pain on the left, with nausea and heartburn. Pregnancy, obesity, excessive physical activity can contribute to the development of a diaphragmatic hernia, and this pathology often occurs in older people with a general weakening of the entire muscular system. Sometimes this condition is aggravated by pinching of the stomach, then sharp, cutting, sharp pain appears in the left hypochondrium.

Cause: intercostal neuralgia

Various neurological diseases may cause compression or irritation of the intercostal nerves. Painful sensations with intercostal neuralgia have wide range manifestations:

• In the area of ​​the ribs, under the ribs - shooting, piercing, sharp or aching, burning or dull pain (see also).
• The pain may intensify with sudden movements, sneezing, inhaling, coughing, even when changing body position.
• Attacks of intercostal neuralgia are accompanied by stabbing pain on the left side, manifested by muscle twitching, pallor or redness of the skin, increased sweating.
• When pressing on certain points on the back, chest, between the ribs or along the spine, painful sensations also appear.

With neuralgia, pain can be localized not only in the left side, but also in the lower back, under the shoulder blade (as with heart disease). They can be at night, in the morning, and during the day, for quite a long time, in places of damage nerve pathways sometimes there is a feeling of numbness.

Heart pathologies

Aching pain in the left side in combination with shortness of breath during exertion and even at rest, nausea, rapid heartbeat, burning and heaviness in the chest occur with heart disease, such as coronary heart disease. When the coronary arteries are damaged, the blood supply to the heart muscle is disrupted, causing pathological condition like ischemia.

Also, similar pain under the ribs can occur with cardiomyopathy - these are several different diseases that lead to dysfunction of the heart muscle, but there is no pathology of the valve apparatus, arterial hypertension, diseases of the heart vessels. With cardiomyopathy, the heart muscle changes structurally. It shows up fatigue, pain in the left side during physical activity. .

Pathological conditions of the spleen

The spleen is a fragile, easily torn organ, so any pathological condition of it is reflected by pain. Its slight increase is difficult to recognize, especially in obese people, since it lies deep in the left hypochondrium. An enlarged spleen or splenomegaly occurs in some infectious diseases, for example, infectious mononucleosis. However, in addition to pain in the spleen area, this disease is characterized by bright severe symptoms such as fever, muscle pain, headache, increase lymph nodes, general intoxication, sore throat, liver enlargement. The spleen performs several important functions in organism:

• This is the thinnest blood filter
• This is the largest lymph node
• It is the largest conglomerate of reticuloendothelial tissue

With hypertrophy of the spleen, when it intensively performs immune, phagocytic and filtering functions, that is, against the background of diseases of immune complexes, hemolytic anemia, acute severe infections, it increases in size and can cause pain on the left. Other causes of pain and enlargement of the spleen include trauma, infiltration, tumors or defects in its development. Particularly acute sharp pain in the area under the ribs occurs during a blow or injury, leading to rupture of the spleen. In addition to pain, a sign of rupture is the bluishness of the skin around the navel, since it accumulates there. a large number of blood, and the pain radiates from the left hypochondrium to the back, if such symptoms appear, you should call an ambulance.

Diseases of the stomach, pancreas

• Gastritis

This disease affects the majority of the population, since the current state of the food industry, aimed at creating chemicalized products, contributes to the development of functional disorders of the stomach and the entire gastrointestinal tract. The gastric mucosa is quite sensitive to any irritants, which in our daily diet more than enough. Gastritis most often manifests itself as belching, aching pain in the hypochondrium, nausea, pain in epigastric region, vomiting, heartburn, heaviness, feeling of pressure. These symptoms appear soon after eating, and general disorders may also occur - pallor, weakness, irritability, sensory disturbances in the lower and upper extremities, signs of dyspepsia - diarrhea.

• Stomach ulcer

It has similar symptoms to gastritis and depends on the duration and severity of the disease, in contrast to duodenal ulcers, when pain occurs during periods of hunger, an empty stomach, pain with a stomach ulcer occurs after eating. This also causes heartburn, nausea, vomiting, sour belching, loss of appetite and body weight. With a perforated ulcer, the main striking symptom is dagger, sudden pain, pallor, general weakness.

• Pancreatic diseases

The most typical symptoms acute pancreatitis there is severe pain under the left hypochondrium, in the left side, and in the epigastric region, of a girdling nature, accompanied by vomiting with bile, nausea, increased body temperature, urine staining is also possible dark color and stool clarification. The pain can be so severe that the person is forced to sit bent over. With chronic pancreatitis, patients complain of a dull aching pain, especially after a magnificent feast. With cancer of the pancreas, it is very difficult to diagnose; this is a very small, hard-to-reach organ that is difficult to diagnose and treat, and the symptoms of cancer are practically invisible at the onset of the disease.

• Oncological diseases of the gastrointestinal tract

In our time of oncological tension, any manifestations of ailments, weakness, lack of appetite, anemia, aversion to certain foods, for example, meat, rapid satiety, periodic pain in the stomach, intestines, a series of constipation with diarrhea, should alert a person, especially with age. Oncology is dangerous due to its asymptomatic course in the early stages. For any persistent pain, you should consult a doctor to find out the cause and carry out timely treatment.

According to statistics, a large number of patients come to medical institutions for consultation with complaints of pain on the left side under the ribs. This is due to the fact that several organs, vessels, muscles and lymph nodes are localized in this area. If the normal functioning of the above systems and organs is disrupted, pain of a different nature may occur.

Only in some situations can pain occur due to simple reasons such as intense physical activity. In most cases, they are signs of serious pathologies.

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Possible causes of pain in the left hypochondrium

Pain in the left hypochondrium is characterized by:

• localization: front, side, left;
• by manifestation: pinching, sharp, constant, cutting, dull, etc.

First of all, it is necessary to consider possible diseases and pathologies with the nature of the pain and accompanying symptoms in order to determine the course of action to eliminate discomfort.

Splenic rupture

The spleen is the largest lymphatic organ located above the stomach. If the function of the spleen is impaired, constant aching pain occurs on the left side.



The spleen is not considered vital important bodies, but any deviations from normal functioning bring severe discomfort. Sharp pain may occur when the spleen ruptures due to its increase in size.

A splenic rupture can be recognized by the following symptoms:

• blue discoloration of the skin near the navel;
• the occurrence of headaches;
• nausea;
• increased sweating;
• dizziness.

The gap is provoked by the following reasons:

• trauma and bruises;
• kidney and liver diseases;
• bearing a child;

If the spleen ruptures, it is necessary to provide assistance to the patient:

1. 1. Place the person on his back gently and without sudden movements, ensure complete peace.
2. 2. Press on the sternum on the left side with your fist and maintain this position until the ambulance arrives.
3. 3. To reduce the intensity of bleeding, apply ice to the sore spot.



Pathologies of the cardiovascular system

Pain sensations arising from pathologies of the cardiovascular system can be different:

• stupid;
• sharp;
• piercing;
• penetrating;
• pulsating;
• burning;
• pressing;
• give to the shoulder area and to the shoulder blade on the left side.

This is due to the fact that there are a large number possible pathologies of cardio-vascular system. Almost all of them cause characteristic symptoms:

• fatigue;
• difficulty breathing;
• nausea;
• increased sweating;
• blueness of the face in the lip area;
• burning in the chest area at the front.

If the described symptoms appear, you must immediately call an ambulance. Pain concentrated in the upper left hypochondrium may be a signal of myocardial infarction. To relieve pain before the ambulance arrives, the patient can be given validol or another sedative.



Intercostal neuralgia

Due to pinching nerve endings When you turn your body, take too deep breaths and intense exercise, pain appears in the lumbar region. The duration of pain can vary:

• cutting;
• short-term;
• long lasting

Aching pain is accompanied by additional symptoms:

• weakness;
• malaise;
• headaches.

Treatment of intercostal neuralgia is carried out after a doctor’s prescription. To reduce the intensity of pain at home, you can use massage, acupressure, or place warm compresses on the painful area.

Progress of pregnancy

Nagging pain during pregnancy may occur due to the threat of miscarriage or ectopic development of the fetus. They are mainly caused by displacement of internal organs or compression of the ureter and renal pelvis.

In addition to the constant increase in size of the uterus, pain may occur due to the activity of the fetus. To relieve tension during sleep or rest, it is recommended to periodically change your position.

Urgent medical attention is required for prolonged pain lasting more than 15 minutes with increasing intensity, vaginal bleeding and weakness.

Endocrine system disorders

Pathological processes in the pancreas can cause a feeling of heaviness near the stomach, a bitter taste in the mouth and belching. Painful sensations in this case are of a girdling nature and are suppressed under the influence of sedatives containing enzymes.



In the absence of timely therapy, there is a risk of pain becoming chronic. Under these circumstances, pain under the left rib will be accompanied by:

• increased body temperature;
• flatulence;
• intoxication of the body;
• swelling.

With the development of oncological tumors in the pancreas, pain appears only after the tumors reach an impressive size. As a result, bursting pain occurs on the left side below the ribs, the eyes and skin acquire a yellowish tint.

Digestive system dysfunction

Often after eating a person experiences pain on the left side under the ribs. This may be a manifestation of gastritis, which is characterized by other accompanying symptoms:

• malaise and weakness;
• heartburn;
• nausea and vomiting;
• flatulence;
• increased sweating.

If a patient has colitis, he will experience bloating, rumbling and indigestion. The pain comes in attacks and is characterized by spasms that are transmitted to nearby areas.

With a peptic ulcer, the pain is sharp, dagger-like, which becomes more active after eating. It is often unbearable, radiating to the back, causing fever and intoxication.

Respiratory system diseases

Left-sided pneumonia with pleurisy causes dull, mild pain. Mainly provoked by deep breaths and exhales and severe cough.

Associated symptoms of pneumonia and other pathologies of the respiratory system:

• dyspnea;
• increased breathing;
• blue discoloration of the nasolabial triangle.

In case of respiratory system disorders, often turning over on the left side during sleep can eliminate pain.

Spinal diseases

Pain that occurs on the side and back on the left side may be signs of spinal diseases:

• osteochondrosis;
• arthrosis.

Pain is usually triggered by walking, physical activity, or after waking up due to an uncomfortable body position during sleep.

Gynecological disorders

In women, pain in the lower abdomen can be sudden, stabbing in nature, transmitted to the groin and radiate to the hypochondrium on the left side. These signs may indicate a ruptured ovarian cyst.

Associated symptoms:

• the appearance of intoxication;
• low blood pressure;
• increase in temperature;
• the appearance of uterine bleeding.

Classification of causes by nature of pain

When visiting a doctor, pain can be described by its nature, degree of intensity and location. Doctors divide all pain into several types of pain in the left hypochondrium. Pain happens:

• aching and dull;
• sharp and sharp;
• piercing;
• pulling;
• pulsating.

Each pain syndrome includes several possible violations. They can occur as a response of the body to disrupted vital processes.

Stitching pain

Stitching pain is usually provoked by physical activity and sports activities. Characteristic pain syndrome is that it can occur even in completely healthy people. This is explained by the fact that intense physical activity was applied suddenly without prior warm-up. The reason is the inability of the body to quickly rebuild and adapt to accelerated blood circulation.

To eliminate pain caused by physical activity, you must:

• relax;
• take a deep breath;
• bend over as you exhale and press your palm onto the painful area.

If stabbing pain occurs in the area under the left rib in the absence of physical activity, damage to the left kidney is suspected. The cause may be pyelonephritis or urolithiasis. These cases are characterized by pain from the back. Associated symptoms:

• frequent urination;
• feverish condition;
• weakness;
• elevated temperature.

When stones move in the kidneys, the stabbing pain becomes sharp and cutting. This is a signal that you need to urgently seek help from a doctor.

Blunt pain

An aching dull pain is a harbinger of heart attack, which indicates the development of coronary artery disease. In this case, pain often worsens at night and deprives a person of sleep.

In addition to a heart attack, there are suspicions of:

• cholecystitis;
• peptic ulcer;
• gastritis;
• colitis.

In addition to pain, there are other symptoms indicating the above-described diseases of the gastrointestinal tract:

• stool disorder;
• weakness;
• nausea;
• poor appetite;
• discomfort.

All these symptoms should not be ignored, because there is a risk of developing serious complications in the absence of drug treatment.

It's a dull pain

Constant aching pain is a likely consequence of the following conditions:

• intestinal pathologies (enteritis, colitis);
• lesions of the left lung (pleurisy, pneumonia);
• injury or rupture of the spleen;
• inflammation of the left appendage;
• development of malignant neoplasms in the liver or pancreas.

Aching pain is one of the symptoms of intercostal neuralgia, cardiomyopathy, heart attack and accompanies a diaphragmatic hernia.

Nagging pain

Nagging pain usually occurs during the course of infectious diseases or due to disruption of autoimmune processes. One possible cause is hepatitis, in which pain worsens after eating heavy and fatty foods.

Other possible reasons- enlargement of the spleen or chronic liver damage, which causes a feeling of heaviness in the abdomen. In the absence of drug therapy, splenic rupture or liver cirrhosis are possible, respectively.

Dagger pain

Acute pain may be a sign dangerous complications.The following are possible causes that require immediate help:

• strangulation of a renal cyst;
• perforation of small intestinal loops;
• exacerbation of pancreatitis;
• rupture of the renal pelvis or spleen;
• development of myocardial infarction;
• perforated stomach ulcer.

These pathologies cause unbearable pain in the patient, up to shock and loss of consciousness. Similar signs appear due to serious injury and rupture of internal organs.

Throbbing pain

In acute pancreatitis, throbbing pain occurs, radiating to the left hypochondrium. This condition is life-threatening. Accompanied by pancreatitis:

• increased temperature;
• swelling;
• bloating;
• vomiting bile;
• diarrhea.

To alleviate the condition, the patient is advised to bend over. This will reduce the intensity of pain.

If the patient does not take action, the throbbing pain becomes girdling, the urine darkens and the feces become discolored. If seizures occur, it is necessary to urgently call ambulance, because further treatment takes place only in a hospital.

Treatment

Due to the fact that pain in the left hypochondrium can be caused by various diseases, it is necessary to clinical examinations. Only after establishing the exact cause can we proceed to treatment of the pain syndrome.

Pain in the left hypochondrium can be a symptom of a number of diseases and pathological conditions. In a person, on the left under the ribs there is a spleen, pancreas, part of the stomach, the left part of the diaphragm, the upper pole of the left kidney and intestinal loops, so for correct diagnosis disease, it is important to know the nature of the pain and its location, the dependence of pain on food intake and other factors.

What can hurt in the left hypochondrium?

Pain in the left side under the ribs can be caused by organs, nerve endings and organs located in the neighborhood located in this area. The source of pain can be:

• pancreas (the left part of this organ is located in the left hypochondrium);
• stomach (the bottom of this hollow organ is adjacent to the ribs);
• colon (in the left part of the abdomen in the subcostal region there is a loop of transition from this part of the intestine to the descending part of the large intestine);
• spleen;
• left side of the diaphragm;
• left lung and pleura;
• heart and mediastinum (reflection of pain from organs chest);
• left kidney and ureters (the upper pole of this organ is located in the area under the ribs);
• left appendages of the uterus in women (pain of a radiating nature);
• ribs, muscles and nerves located in the left hypochondrium.

Pain in the left hypochondrium can occur both in the upper part (closer to the ribs) of this area and in its lower part. Determine the disease in each specific case using this nonspecific symptom It’s difficult even for a doctor, so it’s important to know the nature of the pain and the degree of its intensity.

Types of pain in the left hypochondrium

Painful sensations, according to their characteristics and mechanism of occurrence, are divided into:

• Visceral. This type of pain can be cramping or aching, occurs with spasms of the stomach or intestines, and manifests itself when the motility of these organs is impaired or their muscle fibers are stretched. May transmit to nearby organs.
• Peritoneal. They have a clear localization, are distinguished by constancy and intensity, arise suddenly and last for a fairly long period of time, and subside gradually. This type of pain is caused by irritation of the peritoneum. Develops with structural changes organs (perforation of a stomach ulcer, etc.) and accompanies a pathological condition called “acute abdomen” (peritonitis, acute pancreatitis).
• Reflected. They develop due to the irradiation of pain that arose as a result of the pathology of an organ distant from the location of the pain. Pain may radiate to the left hypochondrium in the presence of pulmonary diseases (left-sided pneumonia, pleurisy).

According to the nature of the pain, pain in the left side under the ribs can be:

• Sharp, cutting. It occurs suddenly, is intense, is associated with life-threatening situations, and therefore requires calling an ambulance (it is a symptom of splenic rupture, perforation of the stomach or intestinal wall, rupture of the renal pelvis). Acute pain in the left hypochondrium when inhaling is a sign of traumatic injury to internal organs as a result of an accident or fall.
• Dull, spilled. Dull pain in the left hypochondrium that has been present for a long period indicates the presence of a chronic disease (pancreatitis, gastritis, etc.).
• Aching. Constant aching pain on the left under the ribs is a sign of a sluggish inflammatory process (colitis or duodenitis). Exhausting aching pain in this area in the presence of vomiting indicates a stomach ulcer. Frequently occurring pain in the left hypochondrium can be caused by angina pectoris, coronary heart disease and pre-infarction conditions.
• Stabbing. It can occur during intense physical activity, passes quickly and is observed even in absolutely healthy people. Stitching pain on the left under the rib, which intensifies with coughing and deep breathing or is accompanied by nausea and vomiting, is a sign of inflammatory diseases. This type of pain can occur with diseases of the spleen, intestines, heart and vegetative-vascular dystonia.

In order to speed up the process of identifying the cause of pain, it is important to take into account indirect manifestations of pain. When describing pain in the left hypochondrium, you need to indicate:

• when did the pain begin?
• how the process developed;
• what is the nature of the pain under the rib;
• duration of pain;
• pain intensity;
• reasons for strengthening and relief;
• where does the pain go (irradiation).

Helps to establish the cause of pain and its location (pain can occur under the last left rib in the front, back and side).

Pain in the left hypochondrium anteriorly

Pain under the left rib in the front occurs when:

• . In chronic diseases of the gastrointestinal tract, pain during palpation intensifies. An acute inflammatory process is characterized by sharp, severe pain.
• Diseases of the spleen. The pain can be sharp or dull and pressing, depending on the nature of the disease.
• Heart diseases. The pain is burning or stabbing in nature.
• Lesions of the diaphragm, pleura and lung. The pain is sharp, rapidly growing, aggravated by deep breathing, coughing and turning.
• Diseases of the gallbladder with its atypical localization (the pain is aching in nature).
• Spinal diseases and musculoskeletal system.

Diseases of the digestive system

The causes of pain in the left hypochondrium in front can be:

• Pancreatitis is an inflammation of the pancreas, which in the acute form of the disease is accompanied by intense pain, nausea, loss of appetite, weakness, fever, chills and vomiting with bile impurities (vomiting can be indomitable character and not bring relief). The feces acquire a mushy consistency and there are particles of undigested food. If inflammation affects the head of the pancreas, obstructive jaundice may develop. The chronic form of the disease is characterized by dull, aching pain in the left hypochondrium, which intensifies with dietary errors. May be shingles in nature. There is bitterness in the mouth, heaviness in the upper abdomen, nausea, and possible vomiting. With pancreatitis, pain can radiate to the lower back, be constant or paroxysmal.
• Pancreatic tumors. The appearance of tumors in this organ in the later stages of the disease is accompanied by prolonged and intense pain in the left hypochondrium and in the center of the abdomen. The pain intensifies if the patient lies on his back, so he is forced to take a semi-bent position.
• Acute duodenitis (inflammation of the duodenum), which is accompanied by bursting, paroxysmal pain in the stomach area, radiating to the area of ​​the lower left rib (may radiate to the right hypochondrium or be girdling), nausea, rumbling and bloating, bitter belching or vomiting with bile , intestinal disorders and general weakness.
• Duodenal ulcer, in which severe pain occurs in the left side of the epigastrium several hours after eating, radiating to the left hypochondrium. Pain occurs when you feel hungry, as well as at night. Heartburn, sour belching, vomiting and constipation are observed. When pressing, there is pain in right side epigastrium.
• Gastric ulcer, in which pain in the upper abdomen and in the left hypochondrium can be different character(dull, aching, sharp, burning). It occurs when you feel hungry and at night, and lasts for a long period of time. May occur immediately after eating or long after eating. Accompanied by a feeling of heaviness in the stomach, heartburn, nausea, vomiting, loss of appetite and noticeable weight loss.
• Gastritis (inflammation of the stomach lining). Dull, aching pain in the left side under the rib that occurs after eating is characteristic of gastritis with low acidity. Accompanied by a tendency to diarrhea and decreased appetite. Vomiting relieves the patient's condition. With normal and high acidity, heartburn is present, pain occurs several hours after eating, and is felt under the ribs closer to the center.
• Inflammation of the mucous membrane of the upper intestinal loops (colitis), which is accompanied by a dull, aching pain that intensifies when walking. Pain under the rib and in the navel area is accompanied by increased gas formation, rumbling stomach, diarrhea is often present.

Intense, sudden, dagger-like pain is a symptom of a perforation of a stomach ulcer. This life-threatening condition is accompanied by general weakness, sudden pallor, and possible loss of consciousness. A patient with these symptoms requires emergency hospitalization.

If there is constant pain in the left side under the ribs, and the pain is in no way related to eating, it is necessary to exclude tumor diseases of the digestive organs.

Spleen diseases

If the left side hurts under the ribs in front, the cause may be diseases of the spleen:

• Enlarged spleen (splenomegaly), which is observed in infectious, autoimmune and myeloproliferative diseases, hematological disorders and metabolic disorders (most often causes this pathology Infectious mononucleosis). Accompanied by pallor of the skin, decreased appetite and performance. With the inflammatory nature of the disease, the body temperature rises to febrile levels, severe weakness, nausea, vomiting, and diarrhea are observed. The pain in the left hypochondrium is sharp and cutting in nature. Non-inflammatory pathology is characterized by normal or low-grade fever body, intoxication is mild or absent, moderate pain is dull, pressing or aching in nature.
• Spleen abscess, which develops as a result of infectious diseases, inflammatory diseases of other organs, injuries and bruises. Accompanied by high body temperature, fever and enlarged spleen. The pain intensifies with deep inspiration and can be felt in the shoulder and left side of the chest.

Heart diseases

Pain in the left side under the rib in front occurs when:

• Cardiomyopathies. This is a group of diseases characterized by structural and functional changes in the heart muscle in the absence of arterial hypertension, pathology of the coronary arteries and lesions of the valve apparatus. May arise from an unknown cause (idiopathic or primary) or develop due to various diseases ( secondary cardiomyopathy). The disease is accompanied increased fatigue and increased heart rate. The nature of the pain is aching, stabbing or pressing.
• Coronary heart disease. The disease is caused by a disruption of the blood supply to the heart muscle as a result of damage to the coronary arteries. Manifested by aching, pressing or burning pain varying degrees intensity. Painful attacks last from 30 seconds to 15 minutes, are provoked by emotional factors or physical stress, go away on their own at rest, and are quickly relieved by taking nitroglycerin. Accompanied by shortness of breath, rapid heartbeat, there may be a feeling of burning and heaviness in the chest, and possible nausea. The pain may radiate to the scapula and left arm.
• Myocardial infarction (a gastrological form that occurs in 2-3% of cases), in which necrotic processes affect the lower or infero-posterior part of the left ventricle of the heart. This life-threatening condition is accompanied by acute pain in the left hypochondrium, rapid heartbeat and difficulty breathing. The feeling of heaviness under the heart spreads under left rib and shoulder blade, in the neck and in the left arm. There may be a burning sensation in the chest area, profuse sweating, nausea, vomiting, severe hiccups and diarrhea. There is a puffiness of the face, a pale bluish tint to the skin and lips. If these symptoms appear, immediate emergency care is required.

Respiratory diseases

Pain in the left side under the ribs in front occurs when it irradiates from the retrosternal space with:

• Lower lobe left-sided pneumonia. The pain is dull, mild, aching, intensifies when coughing and can become stabbing in nature. Accompanied by a dry cough, a slight increase in temperature, severe weakness, increased sweating, shortness of breath, rapid breathing and symptoms that resemble ARVI (headache, etc.).
• Left-sided pleurisy (inflammation of the membrane that covers the lungs). May be primary (the inflammatory process develops directly in pleural cavity) and secondary ( infectious process spreads from the lungs). When fibrin protein falls out on the surface of the pleura, a dry form develops of this disease, and if there is any accumulation in the pleural cavity biological fluid(serous, purulent or hemorrhagic exudate) an exudative form of pleurisy develops. With dry pleurisy, there is increased sweating, rapid shallow breathing, increased temperature, pain in the left hypochondrium with persistent coughing, turning the body and bending over. Patients try to lie on their side, trying to reduce the pain that occurs when coughing. The exudative form is accompanied by aching pain, a feeling of heaviness and compression in the chest, pallor of the skin and limbs, and a forced position of the body. The neck veins swell, the affected half of the chest lags behind during respiratory movements, and the intercostal spaces protrude. Relief comes from the intervention of a specialist who pumps out the collected fluid.
• Cancer of the left lung with metastases affecting the pleural cavity and adjacent organs. Accompanied by impaired appetite and digestion, sudden weight loss, decreased immunity and lack of oxygen.

Pathologies of the diaphragm

It hurts under the left rib and with pathologies of the muscle that separates the chest and abdominal cavities (diaphragm). Pain can be caused by:

• Diaphragmatic hernia. This defect (hernial opening) can be congenital, traumatic or neuropathic. Through the hernial opening, the cardiac part of the stomach or its fundus, and sometimes intestinal loops, penetrate into the chest cavity. Small hernias are asymptomatic, but if large hernial sacs form, the patient experiences bloating, heartburn, sour belching, persistent cough, burning sensation in the chest and rapid heartbeat after eating. The pain is dull, aching, constant, and may be accompanied by nausea. If the stomach or intestines are pinched, the left hypochondrium hurts intensely, vomiting, stool retention occurs, and the general condition worsens. If a diaphragmatic hernia is strangulated, urgent medical attention is required, as this condition is life-threatening due to the risk of developing peritonitis.
• Relaxation of the diaphragm. With this pathology, the diaphragm becomes thinner and moves into the chest cavity along with the adjacent peritoneal organs. It can be congenital or acquired (develops as a result of damage to the phrenic nerve), total or limited. On the affected side, the lung is compressed, and volvulus of the stomach or splenic flexure of the colon is possible. With left-sided relaxation of the diaphragm, the symptoms coincide with a diaphragmatic hernia, while the right-sided one is asymptomatic.

Neurological diseases

Defeats peripheral nerves may cause severe pain in acute stage diseases and aching - with chronic course diseases.

Pain under the left rib in front with intercostal neuralgia, which occurs when the nerves passing between the ribs are damaged or compressed.

Intercostal neuralgia can be:

• radicular (occurs when nerve roots are pinched in the spine);
• reflex (occurs when muscles spasm in the intercostal space);
• one-sided;
• bilateral.

It is not life-threatening, but the pain is intense, stabbing or burning. Pain increases with inhalation, physical activity, coughing or sneezing, and can radiate to the arm, epigastric region, collarbone, lower back or under the shoulder blade.

A distinctive feature of intercostal neuralgia is the presence of pain points that respond to palpation of the intercostal spaces. The disease is accompanied by increased sweating, loss of sensation at the site of nerve damage, muscle twitching, swelling and changes in skin color in the affected area.

Stitches in the left side under the ribs due to irritation of the nerve passing in the area of ​​the last rib (the pain resembles hepatic colic). The cause of intercostal neuralgia may be injury, uncomfortable body position or flip flop, osteochondrosis, hypothermia, etc.

Pain on the left under the ribs in front can occur during vegetative crises - paroxysmal states of a non-epileptic nature, which are manifested by polymorphic vegetative disorders. These conditions are not associated with heart pathologies, but are symptomatically manifested by increased heart rate, arrhythmia, increased sweating, anxiety and panic, trembling of the limbs, a feeling of pressure in the chest, as well as pain in the stomach and under the left rib. The pain can be dull, sharp, stabbing, aching, or encircling, but usually the patient is not able to determine its exact location. Subjective symptoms in this disease do not correspond to objective studies (severe organic pathology is not detected).

A rare cause of pain in the left hypochondrium is abdominal migraine, in which painful spasms in the area of ​​the left rib and abdomen are accompanied by paleness of the skin, nausea, vomiting and muscle cramps of the abdominal wall are possible.

Diseases of the musculoskeletal system and spine

The cause of pain on the left side under the ribs may be:

• Osteochondrosis of the thoracic spine. This degenerative-dystrophic disease develops with incorrect posture, worsening metabolic processes in tissues and improper distribution of load on spinal column. Changes in the intervertebral discs of the thoracic vertebrae cause compression nerve fibers, which leads to pain. The pain can be mild and long-lasting or sharp and sharp, causing difficulty breathing and limiting muscle movement. Pain can be felt in the interscapular region, in the left half of the chest, in the area of ​​internal organs and along the intercostal nerves. Osteochondrosis is accompanied by numbness in the affected area and decreased mobility in the thoracic region.
• Fibromyalgia, which is diffuse, predominantly symmetrical musculoskeletal pain of a chronic nature. Can affect any part of the body. The affected area has hypersensitivity, after waking up, the body feels stiff, swelling and increased fatigue are observed, temperature surges, convulsions and spasms are possible.
• Tietze syndrome. This rare pathology is characterized by the development of aseptic inflammation of the costal cartilages (left or right, several cartilages may be affected at the same time). It manifests itself as local pain, which intensifies when you press on the affected area and take a deep breath. The pain increases over time, the pain radiates to the forearm and shoulder on the affected side, and in most cases is permanent. There are periods of exacerbation and remission.
• Rib injuries. When one or more ribs are fractured on the left side, there is sharp pain, aggravated by breathing movements, pale skin, difficulty breathing, hemoptysis (in case of rib fractures, internal organs in the sternum area are affected), shortness of breath, weakness, fever and cyanosis of the skin in the affected area. A crack in the rib is accompanied by excruciating pain in the affected area, which intensifies when inhaling and coughing, there is anxiety, shortness of breath, a feeling of suffocation and fatigue, swelling and blue discoloration of the tissues in the area of ​​injury are observed. A rib bruise is accompanied by swelling of the soft tissues in this area and pain, which intensifies with coughing, inhaling and movement.

Pain in the left hypochondrium behind

Pain under the left rib behind occurs when:

• Kidney diseases. The pain is pronounced and has a paroxysmal character.
• Retroperitoneal hematoma, which develops with abdominal injuries. The intensity of pain varies, the pain intensifies with movements of the hip joint.
• Diseases of the spleen. It can be acute when the integrity of this organ is violated and painful when its tissues become inflamed or die.
• Diseases of the respiratory system.
• Heart diseases.
• Acute pancreatitis.
• Thoracic and lumbar osteochondrosis.

Kidney diseases

If it hurts on the left under the rib and behind, and the pain is paroxysmal in nature, you can suspect renal colic.

At renal colic pain:

• occurs suddenly;
• very intense, acute, paroxysmal;
• does not subside at rest (the patient cannot find a position in which it will be easier for him);
• radiates to the lower back, spreads along the ureter, can radiate to groin area, in the area of ​​the external genitalia and on inner surface hips;
• accompanied in many cases by pain in the urethra and frequent urination;
• lasts from several minutes to several days.

After the attack has stopped, a dull pain remains in the lower back, but the patient is able to return to a normal lifestyle.

Retroperitoneal hematoma

If there is pain on the left under the ribs in the back, and the patient has recently had serious injury, there may be a retroperitoneal hematoma (limited accumulation of blood). This hematoma can form when the organs of the genitourinary system, esophagus, pancreas, or rectum are damaged.

The pain syndrome causes compression of the surrounding tissues by the hematoma (the more blood is shed, the more intensely the tissues are compressed and the more intense the pain is). Signs of acute blood loss may be present (low blood pressure, increased heart rate, pallor, weakness, thirst, dizziness and fainting).

Since this condition threatens the patient’s life, urgent hospitalization and additional examinations are necessary, and, if necessary, emergency surgery.

Spleen diseases

Pain under the left rib from the back can occur with:

• Traumatic damage to the spleen and disruption of the integrity of the tissue of this organ. Sharp pain is felt in the lower part of the peritoneum (on the left) and in the area of ​​the scapula, accompanied by pale skin, decreased blood pressure, nausea, vomiting, and unquenchable thirst. Cold sticky sweat appears.
• Splenic infarction. A nagging pain radiates to the lumbar region of the back and intensifies with inhalation, sweating increases, blood pressure decreases, pallor, nausea, vomiting, and thirst appear.
• Splenic cyst. When a relatively large cavity is formed in the parenchyma of the spleen, which is delimited by a capsule and filled with fluid, a dull, constant pain occurs in the left hypochondrium in the back area, which radiates to the scapula and left arm (a small cyst is asymptomatic). There is itching of the skin (hives may appear), belching, nausea and vomiting may occur, and the general condition worsens. The cyst can be congenital or form after a heart attack or abscess of the spleen. Also, a cyst occurs when affected by pork tapeworm, echinococcus, as a result of operations on the spleen and when it is traumatically damaged.

Dull pain in the back and left under the ribs occurs when:

• inflammatory processes in the body, since the spleen, as an organ of the immune system, is involved in the fight against various diseases;
• formation in the spleen of benign and malignant tumors(accompanied by decreased activity, loss of appetite and increased temperature).

Respiratory system diseases

Back pain under the left rib can cause:

• Dry left-sided pleurisy. Pain is felt when breathing or coughing and can affect the chest area, neck or radiate to the shoulder. It intensifies when trying to make any movement, is intense, and has a stabbing or cutting character.
• Oncological process in the left lung. Excruciating and persistent pain that does not respond to pain relief occurs when a tumor grows into the pleural tissue (tumors that do not affect the pleura do not cause pain, regardless of their size). The disease is accompanied by shortness of breath, followed by a cough that can last several hours, and an increase in body temperature.
• Pneumothorax is an accumulation of gas in the pleural cavity that occurs when lung damage and causes its tissue to collapse. Pneumothorax leads to a displacement to the healthy side of the mediastinum, compression of its vessels, drooping of the dome of the diaphragm and disorders of blood circulation and respiratory functions. It can occur spontaneously (after strong physical exertion, etc.) or as a result of injury. The pain on the affected side is piercing, radiates to the arm, neck and behind the sternum, intensifies when coughing, inhaling and with any movement. The severity of the resulting shortness of breath depends on the degree of collapse of the lung. There is pallor of the skin, a dry cough is possible, and there may be a fear of death.

Heart diseases

Pain in the left side of the back under the ribs can be:

• Atypical manifestations of myocardial infarction (ischemic necrosis of part of the left ventricular muscle, which is caused by blockage coronary artery). Persistent, wave-like sharp pain can last from 15-20 minutes to several hours. The pain radiates to the left arm (a tingling sensation occurs), neck, shoulder girdle, jaw, and is localized in the interscapular space mainly on the left.
• A consequence of dry pericarditis, which is inflammation of the pericardial sac (pericardium). It can be infectious, rheumatic or post-infarction, manifested by a dull pressing pain in the heart area, radiating to the left shoulder blade, shoulders and neck. Pain in most cases is moderate, but severe pain, reminiscent of an angina attack, is also possible. Pain with dry pericarditis gradually increases, lasts from several hours to several days, is not relieved by nitroglycerin, and intensifies with deep breathing, coughing, swallowing, and changing body position. There is shortness of breath, palpitations, weakness, chills, dry cough.

Attack of pancreatitis

Pain in the left side of the back in the hypochondrium can be caused by an acute form of pancreatitis - inflammation of the pancreas, which does not have a clear clinical picture and can be accompanied by various symptoms.

The severity of pain in the pancreas affects the severity of pain and the location of pain.

Constant, intense pain in the left side of the back occurs when:

• damage to the tail of the pancreas (the lumbar region and chest are affected);
• general damage to the organ, necrosis of its tissues or the development of edema (the pain is severe, has a girdling nature and affects the abdominal cavity and back).

In acute pancreatitis, the following are possible:

• nausea and vomiting that does not bring relief;
• bloating;
• intoxication causing dehydration;
• hemorrhagic spots of a bluish or yellowish tint on the left side wall of the abdomen;
• spots in the navel area.

During exacerbation chronic pancreatitis back pain is moderate, reminiscent of pain associated with diseases of the spine.

Spinal diseases

Pain in the left hypochondrium of the back can cause osteochondrosis of the thoracic or lumbar region. With this degenerative disease, as a result of compression and irritation of the nerve roots, discomfort occurs in the ribs, both from the back and in the sternum.

Aching pain intensifies with movement, physical activity, staying in one position for a long time, or with hypothermia. Accompanied muscle weakness and a feeling of numbness in the upper extremities.

Pain in the left hypochondrium on the side

Pain in the left side under the ribs occurs when:

• An increase in the size of the spleen, which occurs with various infectious diseases (infectious mononucleosis, etc.). Unbearable, sharp pain occurs with tuberculosis of the spleen (in this disease, the spleen is so enlarged that it can be felt in the right side of the peritoneum).
• Chronic pancreatitis. Pain in this disease of the pancreas does not have a clear localization; it is cramping and of varying degrees of intensity. They usually occur half an hour after eating, as they are associated with the consumption of provoking foods (spicy, fatty, fried).
• Shingles, which is associated with damage to nerve endings. The pain at the initial stage of the disease is aching in nature, then the pain becomes acute and rashes appear on the skin in the affected area.
• Inflammation of the kidneys (pyelonephritis). It can be acute or chronic, accompanied by aching, dull pain, which becomes intense and paroxysmal when the ureter is blocked by a stone. General weakness, fever, chills, loss of appetite are observed, nausea and vomiting are possible.
• Inflammation of the ureters (urethritis). It occurs in acute and chronic form, can be infectious and non-infectious, gonorrheal and non-gonorrheal. Accompanied painful urination and discharge from the urethra.
• Ulcerative colitis - chronic inflammation mucosa of the large intestine, which is manifested by cramping moderate pain in the left side of the abdomen, frequent diarrhea, false urge to defecate, fever, loss of appetite and weight, weakness and pain in the joints (not all symptoms may be present).
• Obstruction of the large intestine, which develops for mechanical or functional reasons. It manifests itself as spastic sharp pain in the abdomen, which is first localized in the left side and then spreads to the entire abdominal area. Accompanied by vomiting, nausea, bloating, constipation and gas retention.
• Inflammations of the genitourinary system, which cause sexually transmitted infections.

Pain on the left side under the ribs can occur with injuries to this area, as well as with inflammation of the ovary in women.

Pain in the left hypochondrium in women

Pain in the left hypochondrium on the side, closer to the lower abdomen, in women can be caused by:

• Adnexitis (salpingoophoritis) is an inflammation of the ovaries and fallopian tubes, which is caused by various types of bacteria that enter these organs through the bloodstream or sexually. The disease is characterized by sharp, spasmodic or dull and aching pain in the lower abdomen, which spreads to the lumbar region. There is a rise in temperature, chills, failure menstrual cycle, heavy discharge, pain when urinating and during sexual intercourse.
• Torsion and rupture of the left ovarian cyst. With torsion, severe pain is localized in the lower abdomen, is characterized by an aching or pulling character, is accompanied by an increase in temperature, a drop in blood pressure, and a violation general condition body, vomiting is possible. When a cyst ruptures, the pain becomes intense, radiates throughout the abdomen and rectum, nausea and vomiting occur. These conditions require emergency medical attention.
• Ectopic pregnancy, which can manifest itself as a rupture of the fallopian tube during the 6th to 10th week of pregnancy (the early stage of an ectopic pregnancy is no different from normal pregnancy By clinical signs). At 5-8 weeks, aching, cutting or cramping pain may appear on the affected side, which becomes almost unbearable if the fallopian tube ruptures. When blood enters the abdominal cavity, pain spreads to epigastric region, shoulders and anus, urination and bowel movements are painful. At large blood loss pallor appears, decreased blood pressure, weak rapid pulse and loss of consciousness. This condition requires urgent hospitalization.
• Allen-Masters syndrome is a disease that causes rupture of the uterine ligaments (can occur after a complicated birth or after an abortion). It manifests itself as periodic stabbing or cramping pain in the left side, which sometimes radiates to the anus, accompanied by increased fatigue, painful periods and an increase in the size of the uterus.
• Endometriosis is a disease characterized by the proliferation of cells in the inner layer of the uterine wall (endometrium) outside the endometrial layer. It manifests itself as menstrual irregularities, stabbing pain in the affected area, pain during sexual intercourse, heavy discharge during menstruation, and infertility.

Pain in the left hypochondrium in a child

Pain in a child under the left rib can be caused by:

• Gastritis (inflammation of the stomach lining). The acute form in children is accompanied by severe pain in the epigastric region, belching, nausea, vomiting and diarrhea, salivation and dry mouth. In the chronic course of the disease, the pain is moderate, loss of appetite, intoxication and indigestion are observed.
• Appendicitis (in most people the appendix is ​​located on the right, but sometimes the pain radiates to the left side of the abdomen, an abnormal location of the organ is also possible).
• Coprostasis (accumulation of feces in the intestines), which occurs with constipation of various etiologies (organic, functional, nutritional, endocrine, conditioned reflex and medicinal). Abdominal pain is observed (the child cannot accurately indicate its location), bloating, pain during bowel movements, and there is a feeling incomplete emptying intestines. May cause intestinal obstruction.
• Volvulus - obstruction of intestinal patency due to constipation, trauma, strangulation, adhesions, hernia hiatus, which often occurs in young children. With this pathology, periods of rest in the child alternate with attacks of sudden pain. During an attack, the baby cries and presses his legs to his stomach. The body temperature rises, vomiting appears, and mucus or blood may appear in the stool. This condition requires urgent medical attention.
• Inguinal hernia strangulation. Inguinal hernia is a pathological but painless protrusion of the hernial sac in the groin, which increases with walking or crying and disappears at rest. The strangulation is accompanied by sharp pain, the hernia cannot be reduced into the abdominal cavity, and the area of ​​the protrusion is tense. At further development pathology, intestinal obstruction develops, which is accompanied by bloating, failure to pass gas and vomiting. The child requires urgent medical attention.

Which doctor should you contact for pain in the left hypochondrium?

Since not only the spleen, but also other organs are located on the left under the ribs, and the pain can be radiating, it is very difficult to independently determine the cause of the pain.

If pain appears in the left hypochondrium region, you need to contact a therapist, who will listen to the patient’s complaints and conduct an initial examination, and then tell you which specialist you need to contact in a particular case.

The therapist may refer the patient to:

• if you suspect diseases of the gastrointestinal tract (gastritis, peptic ulcer, colitis);
• a cardiologist if you suspect heart disease (cardiomyopathy, coronary heart disease, myocardial infarction);
• if you suspect infectious diseases(infectious mononucleosis, etc.);
• for diseases of the spleen;
• if pleurisy and pneumonia are suspected;
• to a neurologist if intercostal neuralgia and osteochondrosis are suspected;
• to a traumatologist if rib injuries are suspected;
• an oncologist if the presence of malignant processes is suspected;
• surgeon for conditions requiring emergency medical care (splenic rupture, etc.)

Indications for urgent hospitalization are:

• suddenly appeared sharp, acute pain in the left hypochondrium;
• aching constant pain that does not subside within an hour;
• stabbing pain that occurs when moving and does not subside within 30 minutes;
• dull pain accompanied by vomiting of blood or undigested food particles;
• any pain that is accompanied by pallor, rapid heartbeat, decreased blood pressure, dizziness and difficulty breathing.

Pain in the left side under the ribs is a serious syndrome that should not be ignored under any circumstances. Pain is a normal reaction of the body to injury, physical stress, sudden movements, physiological changes, for example, during pregnancy. But, besides this, they can talk about more serious hidden phenomena that occur in the body. Pain syndrome can be associated with an inflammatory process or with pathologies of internal organs and systems. When identifying the main cause that caused painful spasms, it is important to take into account their nature, duration and exact location. If pain occurs, an examination of the body is necessary.

Character of pain on the side under the ribs

Depending on the characteristics of the pain and the situations in which it manifests itself, you can guess which doctor you should see to make an accurate diagnosis.

• Stitching pain in the left side under the ribs, if they occur after serious physical activity, such as long running, walking at an accelerated pace, jumping, intense aerobic and strength exercise, do not pose a serious danger at all and occur in almost all healthy people. Typically, pain in this case is associated with insufficient warming up before exercise or with too intense movement. Without a good warm-up lasting at least 15-20 minutes, the body cannot prepare for a strong acceleration of blood circulation. Of course, there is no danger in this, but there is no benefit either, therefore, if such a situation arises, you need to stop doing the exercise, relax your arms and shoulders, start deep breathing and, during maximum exhalation, press on the painful area, bending forward, repeat this procedure several times , after which it is possible to continue playing sports. It may also start to sting on the side during cardio exercise if exercise occurs after a recent meal. After eating, you need to wait at least two hours, since the digestive system is loaded with digesting food, which is where pain occurs.
• Dagger, cutting, sharp pain in the left side under the ribs, which occurs unexpectedly and is not related to physical activity, requires immediate medical intervention. It may be a symptom of rupture of the renal pelvis, spleen, perforation of small intestinal loops or stomach walls. In addition, such pain syndrome can be caused by the abdominal variant of the myocardium or acute.
• Strong pain after injury, in the event of its aggravation during inhalation, which appears after a fall, blow or car accident, may indicate the presence of severe damage to internal organs, which can be life-threatening. With this option acute pain needed urgent help doctors
• Blunt pain in the left hypochondrium, if it sometimes bothers you for a long period of time, is also a reason for concern, because it can be caused by sluggish chronic pathology organs digestive system. In such a situation, a person may be sick, etc. To determine the presence of pathology, you need to visit, undergo various examinations, take tests, and do an ultrasound.
• Aching pain in the left side under the ribs may be a symptom of slow-flowing or duodenitis, but if a feeling of nausea and vomiting is added to this symptom, this may indicate a gastric ulcer. When nagging pain not related to food system, then it may indicate diseases such as pre-infarction condition, ischemic pathology hearts and .

Causes of pain in the left side under the ribs, depending on the location

When there is pain in the left side under the ribs in front, this often indicates an illness related to the spleen or stomach. In this case, differential diagnosis is made with diseases such as myocardium, upper intestinal loops, myositis. If pain is shifted closer to the center, this may be due to a combination of pathologies of the stomach and gallbladder or duodenum.

With pain localized in the back, the left kidney is often affected; to diagnose this pathology, you need to do an ultrasound and donate urine and blood for analysis. In addition to kidney disease, pain in this place can be caused by palpation of the paravertebral processes.

If you experience girdle pain, this may be a symptom of a pathology in the pancreas - pancreatitis. During attacks of this disease, a sign initial stage the inflammatory process is strong burning pain, passing from the back to the anterior abdominal wall, which subsides a little when bending forward in a sitting position.

Causes of pain in the left hypochondrium and symptoms of possible diseases

According to statistics, pain under the ribs on the left is one of the most pressing reasons for visiting medical institution. But it is not always caused by heart disease. In this area there are many organs, nerve fibers, lymph nodes, blood vessels and muscles, if they are damaged normal functioning, then pain appears. As already mentioned, pain varies depending on the disease, it can ache, pinch, be sharp or cutting, strong or tolerable, constant or periodic with attacks of exacerbation, but any of its manifestations requires immediate reaction and action. Let's consider the pathologies that can cause pain in the left hypochondrium and what additional symptoms you need to pay attention to.

Spleen

The spleen is the largest lymphoid organ located above the stomach. Pain under the ribs on the left, which occurs constantly and is aching in nature, may be a consequence of the development of a disease in this organ. Of course, the spleen is not one of the organs without which it is impossible to live, but any deviations from it normal operation may cause severe discomfort. An increase in the size of the spleen can lead to its rupture and severe pain. The following symptoms indicate a splenic rupture:

• bluish skin in the navel area;
• nausea;
• occurrence;
• increased sweating;
• dizziness.

What can cause a breakup:

• injuries and bruises;
• liver and kidney diseases;
• excessive physical activity;
• bearing a child and labor.

The cardiovascular system

Pain due to problems with the heart and blood vessels is typical different manifestations: they can be dull, sharp, piercing, stabbing, pressing, pulsating, burning and radiate to the shoulder and shoulder blade area on the left side. Almost all heart diseases cause a decrease in the supply of oxygen to the heart muscle, so a person quickly gets tired, has difficulty breathing, and often the burning sensation and nausea become unbearable. At the moment of myocardial infarction, a person’s heart begins to beat intensely and he lacks air; the pain is localized in the left side. Added to the described symptoms is that the person sweats a lot, hiccups and vomiting are possible, the face and lips become pale and take on a bluish tint, the pain in this case is concentrated in the upper left hypochondrium. When these symptoms appear, a person needs urgent hospitalization with intensive care.

Intercostal neuralgia

Characterized by pain under the shoulder blade and in the lumbar region different strengths and duration from sharp and short-term to aching and long-lasting. This disease begins due to pinched nerve endings, which can occur with sharp turns of the body, inhaling too deeply, coughing for a long time and forcefully, or during intense exercise. Additional symptoms are a feeling of general weakness and malaise, pain in the head.

During pregnancy

If there is a nagging pain syndrome under the ribs in a woman in position, you should make sure that there are no pathologies such as pancreatitis, as well as a threat or ectopic pregnancy. In other cases, pain may occur due to displacement of internal organs or compression of the ureter and renal pelvis by an enlarged uterus. Also, increased fetal activity can cause pain. To relieve tension, the “kitty cat” exercise helps, which temporarily reduces compression by changing position.

Note! In case of acute, sudden pain that lasts more than 15 minutes, with increasing intensity, which is accompanied by bleeding, weakness and dizziness, prompt medical attention is necessary.

Endocrine system

Pathological processes in the pancreas are often accompanied by a feeling of heaviness in the abdomen, a bitter taste in the mouth and belching, and the pain is girdling in nature and decreases after taking medications containing enzymes. If therapy is not started in time, the disease can become chronic, which, in addition to acute pain in the left hypochondrium, is manifested by general intoxication of the body, edema, and elevated body temperature.

Symptoms of cancer in the gland for a long time may not manifest itself, but when the neoplasm becomes impressive in size, a strong bursting pain is felt on the left side under the ribs, and the skin and eyes become yellow color, as in .

Digestive system

In diseases of the gastrointestinal tract, pain from the left side and abdomen often disturbs a person and appears mainly after a meal.

• presence of intoxication;
• state of weakness and malaise;
• increased sweating;
• nausea and vomiting.

With colitis, rumbling occurs, digestive disorders occur, pain in this case occurs in attacks, manifests itself in the form of spasms and colic and can spread to nearby areas. With a peptic ulcer of the stomach and duodenum, a person feels a sharp dagger pain, which begins after eating food, becomes unbearable, radiates from the back, is accompanied by high fever and the occurrence of intoxication. Whenever listed symptoms Immediate hospitalization and surgical therapy are necessary, as this condition seriously threatens human life.

Respiratory system

In left-sided cases with pleurisy, a dull, mild pain is felt in the left side under the ribs. When inhaling and exhaling deeply, coughing, or making sudden movements, the pain becomes more intense and is accompanied by tingling. The patient also experiences shortness of breath, rapid breathing, a bluish color of the nasolabial triangle, hyperthermia, relief occurs after the person lies down on the left side.

Spinal diseases

Pain syndrome that appears in the left side under the ribs at the back when walking may be a consequence of diseases of the spine: intervertebral hernia. In case of uncomfortable body postures, after waking up or physical activity the pain often gets worse.

Gynecology

At gynecological diseases in females, the pain is usually localized in the lower abdomen, but sometimes it can occur suddenly, stabbing pain in the groin, extending under the ribs on the left side, which most likely indicates a ruptured ovarian cyst.

Other symptoms are:

• the appearance of intoxication;
• an increase in temperature that cannot be brought down by medications;
• the appearance of uterine bleeding;
• low arterial.

If the listed signs are present, the injured woman requires urgent hospitalization and surgical care.

Treatment of pain in the left side under the ribs

If you experience any pain, you immediately want to take a painkiller. Many people try to drown out the pain and put off visiting a doctor, not taking the body’s calls seriously. To relieve pain, you can drink or nitroglycerin, but the data medicines provide only short-term relief. In case of constant pain, as well as incessant attacks, it is important to immediately see a therapist, who, based on data on the location, the nature of the pain and accompanying symptoms, will refer you to a specialist. Further examination and treatment are carried out by surgeons, gastroenterologists, traumatologists, endocrinologists, cardiologists and neurologists.

Important! In the event of sudden acute pain or pain lasting more than an hour, it is necessary to call an ambulance as quickly as possible in order to hospitalize the patient, since there is a high probability that he will need surgical intervention.

If there are serious pathologies, for example, myocardial infarction, acute pancreatitis or splenic rupture, you need to undergo treatment in a hospital. In all other cases, therapy can be carried out at home under the supervision of the attending physician.