Pain under the left rib

Pain under the left rib is a symptom that cannot be considered specific without taking into account the accompanying clinical signs; in addition, in a diagnostic sense, it is important to know exactly the localization and nature of the pain, its dependence on food intake or other etiological factors.

In the left hypochondrium area there are many organs, nerve endings, vessels, lymph nodes, subcutaneous tissue, muscles - all of them can be a source that provokes pain. Pain under the left rib can be associated with the following organs:

• Left lung.
• Pancreas (tail).
• Heart and mediastinum (mediastinum).
• Upper part of the stomach (fundus).
• Upper pole of the left kidney.
• Left zone of the diaphragm.
• Left uterine appendages in women.
• Left-sided flexure of the colon.

For an accurate diagnosis of the pain symptom under the left rib, a combination of symptoms, instrumental and laboratory examinations are required, which, when combined into a clinical picture, help to establish the actual cause of the pain.

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Causes of pain under the left rib

From a pathophysiological point of view, pain is a signal of a disruption in the blood supply to a certain local area of an internal organ, changes in tissue trophism, nerve endings, swelling, etc. As a rule, the causes of pain under the left rib are closely related to the following types of provoking factors:

1. Tissue swelling due to an inflammatory process in a nearby organ.
2. Changes in the trophism of nerve endings and tissues due to poor blood supply and oxygen starvation (ischemia).
3. Mechanical cause – injury as a result of a fall, impact, accident.
4. Violation of the integrity of the tunica mucosa (mucous membrane) of hollow organs located in the left hypochondrium as a result of exposure to a bacterial, pathogenic factor (ulcer, erosion, perforation).
5. Postoperative pain as an objective symptom after surgical treatment of the pancreas, left kidney, spleen, stomach.
6. Radiating pain, the source of which is usually located above the painful area - in the aponeurosis, muscles of the intercostal spaces (intercostal neuralgia, osteochondrosis).

In clinical practice, the most common causes of pain under the left rib are considered to be the following:

• Acute or chronic inflammation of the pancreas, pancreatitis.
• Splenomegaly, splenitis, rupture of the spleen.
• Acute or chronic inflammation of the gallbladder, cholecystitis.
• An inflammatory process in the mucous membrane, in the wall of the stomach, gastritis.
• GU – gastric ulcer.
• Inflammatory process in the lower lobe of the left lung.
• DG – diaphragmatic hernia.
• Chronic myelogenous leukemia.
• Diverticulitis.
• Ischemic colitis (large intestine).
• Pyelonephritis, glomerulonephritis.
• Cardiopathy – myocarditis, pericarditis, angina pectoris, myocardial infarction.
• Vegetative crises.
• Rheumatoid inflammatory processes, osteochondrosis, intercostal neuralgia.
• Flatulence.
• Rarely – inflammation of the appendix.
• Expansion of the bronchopulmonary system during pregnancy.

Gastrointestinal pathologies:

• Gastritis, which is characterized by a functional disorder or inflammation and, as a consequence, pain. The pain symptom is expressed in a burning sensation, heartburn, is aching in nature and is associated with food intake. Also, with gastritis, a person feels nausea, heaviness, pressure in the hypochondrium, often on the left, and general disorders can be weakness, increased sweating, disruption of the cardiovascular system, anemia (B12-deficiency), an atypical taste in the mouth.
• PUD is a gastric ulcer, the symptoms of which may appear in the left hypochondrium. The difference between PUD and the ulcer process in the duodenum is that the erosive stomach reacts to food intake, pain occurs after eating, "hunger" pains are not typical for it.
• Ulcer perforation is a condition considered an emergency requiring immediate medical attention. The symptoms of perforation are very specific – sudden, sharp (stabbing) pain, cyanosis of the skin, dizziness and often – loss of consciousness.
• Adenocarcinoma of the stomach, which in the initial stage has no obvious clinical signs, but, growing, is felt as a constant pain, independent of time and amount of food consumed. Also among the minor signs of cancer may be loss of appetite, weight loss, anemia, intolerance to protein, especially meat food, heaviness in the stomach. Obvious signs of malignancy of the process are nagging pains, radiating under the right or left rib (at the site of tumor localization), melena (black feces), vomiting, the consistency of which resembles coffee grounds.
• Constipation, especially secondary to injury to the colon.
• Enlargement of the spleen (splenomegaly). Stretching of the organ capsule is most often provoked by infectious mononucleosis and manifests itself as weakness, headaches similar to migraines, joint pain and myalgia, increased sweating, a lump in the throat, inflamed lymph nodes, herpetic eruptions and characteristic pain under the left rib.
• Rupture of the spleen capsule of traumatic or infectious etiology manifests itself as a sharp, acute pain on the left under the rib, radiating to the back, cyanosis of the skin around the navel, left abdominal area. This condition is classified as urgent, requiring immediate hospitalization.
• Exacerbation of pancreatitis, which causes heaviness and severe pain on the left, of a girdle nature. Often the pain under the left rib radiates to the back, accompanied by nausea, vomiting, hyperthermia.
• DG – diaphragmatic hernia, which in the initial period can clinically signal itself with heartburn due to acid reflux into the esophagus – the esophagus, then with dull, constant aching pain in the left hypochondrium, a feeling of nausea, heaviness in the epigastrium. If the stomach is pinched, sharp pains are possible.

Causes of pain in the left side associated with cardiac diseases:

• All types of functional, structural pathology of the heart muscle - cardiomyopathy. Pain under the left rib is provoked by excessive physical exertion, less often - stress. Symptoms of cardiomyopathic diseases can be pain on the left, tachycardia, decreased motor activity, weakness.
• Ischaemia – IHD (ischemic heart disease), a condition in which blood flow, blood supply to the heart muscles is disrupted due to narrowing, obstruction of the coronary arteries. Symptomatically, IHD manifests itself as aching pain, burning in the left side, under the rib, heaviness, difficulty breathing, nausea.
• Infarctus, ischemic necrosis, myocardial infarction - a condition requiring emergency care and manifested in the form of heaviness spreading from the middle of the chest, most often to the left, under the rib, shoulder blade, under the jaw, into the neck, into the arm. Infarction may be accompanied by shortness of breath, tachycardia, a feeling of severe burning in the retrosternal space.

Bronchopulmonary diseases:

• Left-sided pneumonia, in which pain is provoked by an inflammatory process in the lower lobe of the lung, is felt as dull, vague, aching. The pain symptom intensifies with a cough reflex, then the pain is felt as stabbing.
• Dry pleurisy of the left lung. The disease is manifested by rapid breathing, hyperthermia, pain associated with persistent coughing, body turns, bends. If pleurisy occurs in an exudative form, the pain is aching, accompanied by a feeling of heaviness, pressure in the chest, cyanosis of the skin of the face, fingers.

Neurological diseases:

• Intercostal neuralgia caused by irritation of the nerve roots. It manifests itself as acute, severe pain in the acute stage; in chronic cases, clinical signs may include aching pain under the rib, associated with movements, changes in posture, and bending. The pain intensifies with intense physical activity, inhalation, sharp turns, and sneezing. Intercostal neuralgia is also characterized by certain pain points that respond to palpation. Pain often radiates and spreads to the shoulder blade and arm, which confuses the differentiation of diseases.
• Vegetative crises, which are not associated with cardiac diseases, but are symptomatically manifested by pain under the left rib, a feeling of pressure in the chest, increased pulse, sweating, a feeling of fear, panic.

Diseases of the musculoskeletal system, spine:

• Osteochondrosis of the thoracic spine.
• Rheumatoid inflammation of the textus connectivus – connective tissue, joints.
• Cervical-brachial radiculopathy.
• Rib injuries – bruises, fractures.

Symptoms of pain under the left rib

Symptoms of pain under the left rib depend on their pathogenetic mechanism (origin and development) and are quite difficult to differentiate due to their non-specificity. However, they can be combined according to the following signs:

• Visceral symptoms, which are typical for gastrointestinal pathologies. Symptoms most often appear as cramping pains with colic, spasms, or as aching, dull pains with a chronic form of pathology. Visceral pains are also characterized by reflection, that is, they can radiate to nearby areas, most often to the left or right.
• Localized peritoneal pain, typical for ruptures or perforations. This pain symptom is acute, sharp and intensifies with tension, movement, breathing.
• Irradiating symptoms characteristic of inflammatory processes in the bronchopulmonary system.

In addition, in a diagnostic sense, there are enough typical clinical descriptions, so the symptoms of pain under the left rib can be systematized as follows:

Pain under the left rib, accompanied by a feeling of distension, heaviness, nausea	Diseases of the fundus, cardiac part of the stomach
Throbbing pain that intensifies with coughing, deep breathing (inhalation)	Pleurisy, inflammation of the lower lobe of the lung
Constant, aching, dull pain	Diseases of the spleen, less often – the left kidney
Pain that increases with exhalation, periodic paresthesia of the hands	Osteochondrosis of the thoracic spine, intercostal neuralgia
Burning pain spreading from the middle of the chest to the left, nausea, pain reflected in the arm, under the shoulder blade	Cardiological pathologies – coronary heart disease, myocardial infarction

Pain under the left rib in front

A pain symptom that is localized in the left hypochondrium from the chest side may indicate diseases of the stomach or spleen. If the pain is dull, aching and occurs periodically, regardless of food intake, it may be a sign of splenitis, splenomegaly in the initial stage. In addition, pain under the left rib in front may signal a diaphragmatic hernia, abscess, in such situations the symptom is sharp, acute, the pain quickly increases, intensifies when turning, coughing, breathing. It is necessary to differentiate the pain symptom from simple colitis, which can also manifest itself in the left hypochondrium, especially if they are associated with the upper intestinal loops. In addition, myositis, inflammation of the gallbladder, displaced to the left and manifested by atypical signs, can be felt in this way. The most dangerous factor provoking pain in the lower part of the left rib is myocardial infarction.

Sharp pain under the left rib

Severe, sharp pain in the left hypochondrium may be a sign of perforation of the stomach wall or perforation of the upper loops of the small intestine. Such "dagger" pains are a reason for an immediate call for emergency care and urgent hospitalization. In addition, sharp pain under the left rib is often a signal of a rupture of the spleen capsule. If the pain is of a girdle nature, this may be evidence of an attack of pancreatitis, which begins acutely, suddenly, for such pains constancy is typical, they do not depend on coughing, changes in body posture, movements, and so on. Left-sided sharp pains in the hypochondrium may also manifest a gastralgic infarction, which is not often encountered in clinical practice, however, this type of ischemia indicates necrosis of the lower posterior part of the ventriculus sinister cordis - the left ventricle.

Pain under the left lower rib

Localization of the pain symptom under the lower left rib is most often associated with neuralgia. Intercostal neuralgia has many signs, often disguised as cardialgia, signs of ulcerative processes in the stomach, intestines. However, pain under the lower left rib, like many neurological symptoms, has its typical parameters:

• A sharp, piercing pain that makes a person “freeze.”
• Any movement increases the pain.
• The pain intensifies when inhaling.
• The pain is paroxysmal and lasts for several minutes.
• A painful symptom that cannot be relieved or treated, and that recurs more and more frequently.
• The pain is not relieved by taking cardiac medications.
• The pain is localized in the area from the 5th to the 9th rib on the left, reflected in the shoulder, left shoulder blade, and less often the arm.

Aching pain under the left rib

Aching pain under the left rib is usually constant and indicates a chronic, sluggish disease, most often inflammation. This symptom is typical for gastroduodenitis, colitis and the beginning of an ulcerative process in the stomach. If such pain is accompanied by vomiting, which relieves pain, then PUD (peptic ulcer) is almost indisputable. In addition, constant, aching pain in the left hypochondrium can signal developing angina, ischemia and even an atypical picture of a pre-infarction condition.

Also, aching pain under the left rib can serve as one of the clinical signs of a diaphragmatic hernia, the initial stage of stretching of the spleen capsule.

Pain under the left rib at the back

Localization of pain behind the left hypochondrium may be a sign of kidney pathology and require complex diagnostics, including standard nephrological studies - general urine analysis, ultrasound, urography, etc. In addition, pain under the left rib behind is one of the manifestations of osteochondrosis of the lumbar, less often the thoracic spine. These diseases are diagnosed by palpation of the paravertebral zones, X-ray, general and biochemical blood tests, computed tomography. Often, pain that begins at the back becomes encircling and moves to the abdominal zone, which indicates an attack of pancreatitis. In this case, the pain is sharp, acute and does not depend on changes in posture, movements, turns.

Pain under the left rib at the back can be caused by the following reasons:

• Dry left-sided pleurisy.
• Oncologic process in the left lung.
• Pneumothorax.
• Atypical manifestations of myocardial infarction.
• Pericarditis.
• Atypical manifestations of renal artery thrombosis.
• Renal colic.
• An attack of pancreatitis.

Stabbing pain under the left rib

Most often, stabbing pain under the left rib is associated with the onset of stretching of the spleen capsule, this symptom is especially characteristic during physical exertion, active movements, overexertion. In addition, a stabbing symptom in this area can be associated with a life-threatening disease - myeloleukemia, which does not manifest itself clinically in the initial stage and can be determined randomly, during a blood serum test. With this disease, the spleen, responsible for the production of leukocytes, also suffers, splenomegaly develops, manifested by heaviness under the left rib, tingling after eating. In the terminal stage of myeloleukemia, a seal is clearly palpable under the left rib.

A more favorable prognosis is for osteochondrosis of the thoracic spine, which can also signal itself with stabbing pains in the left hypochondrium.

It should be noted that left-sided pleurisy, especially exudative, is manifested by sharp stabbing symptoms in the hypochondrium, the pain intensifies when coughing and breathing (exhaling).

Dull pain under the left rib

Dull, aching pain symptoms are characteristic of the onset of inflammatory processes. Dull pain under the left rib is typical for developing chronic pancreatitis, gastroduodenitis, and less often cholecystitis. In addition, a factor provoking dull pain sensations may be splenomegaly - stretching of the spleen capsule, in which the breakdown and utilization of red blood cells occurs during hemolytic anemia. Less often, dull pain under the left rib may be a sign of hemoblastic pathologies - lymphocytic leukemia, lymphoma. The spleen is sensitive to pathologies of the organs associated with it and can increase in size due to portal hypertension, liver cirrhosis, hepatitis, which often manifest clinically indirectly through the symptoms of spleen diseases. Also, nagging, dull pains can serve as a diagnostic sign of an acute infectious disease - mononucleosis, causing hypertrophy of the spleen up to its rupture. Less often, a dull pain in the left hypochondrium indicates chronic cardiac diseases - bacterial endocarditis, pericarditis.

Aching pain under the left rib

The pulling nature of pain indicates the following diseases:

• Osteochondrosis, which manifests itself as dull, aching pain that intensifies with arm movements, turns, and static tension.
• Inflammation of the left shoulder-scapular joint, in which the pain under the left rib is of a reflected nature.
• Myalgia is an inflammation of the chest muscles on the left, caused by physical overexertion and hypothermia.
• Inflammatory processes in the heart muscle not associated with ischemia or spasms of the coronary vessels.
• Cardioneurosis, vegetative attacks, in which a nagging pain under the left rib is caused by a dysfunction of the autonomic nervous system.
• Chronic inflammatory processes in the stomach, intestines, pancreas.

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Severe pain under the left rib

Severe, sharp pain in the left hypochondrium is most often associated with a serious condition, exacerbation of pathological processes, which requires emergency medical care.

Severe pain under the left rib can be caused by the following factors:

• Inflammation of the lower lobe of the left lung in the acute stage.
• Trauma to the left ribs (lower) – contusion, fracture.
• Splenomegaly caused by infection, cancer.
• Traumatic injury to the spleen capsule.
• Spleen cyst.
• Rupture of the spleen.
• Splenic abscess.
• Pathological dilation and dissection (aneurysm) of the splenic artery.
• Terminal stage gastric adenocarcinoma.
• Exacerbation of gastroduodenitis.
• Exacerbation of gastric ulcer.
• Perforation of the stomach wall.
• Acute pyelonephritis.
• Exacerbation of pancreatitis.
• Oncologic process in the tail of the pancreas.
• Pancreatic cyst.
• Colic of the left kidney.
• Tumor of the left flexure of the colon.
• Attack of angina pectoris.
• Myocardial infarction.

Severe pain under the left rib is usually unbearable, even if it is relieved by antispasmodics, cardiac drugs or other means, it is necessary to consult a doctor as soon as possible to avoid life-threatening conditions.

Constant pain under the left rib

The constant nature of pain indicates the development of a pathological process in the organs and systems associated with the left hypochondrium area.

Constant pain under the left rib may be associated with a sluggish, latent disease of the stomach, intestines, kidneys, pancreas, lymphatic system and many other organs. In addition, constant pain is characteristic of intercostal neuralgia, the symptoms of which are "masked" by signs of cardiac diseases. Painful discomfort that is not relieved is also a cause for concern, since a pre-infarction condition often has such signs. Despite the fact that aching, constant pain is quite bearable, it must be presented to the attending physician for differentiation, diagnosis and treatment. Only in this way is it possible to avoid the transformation of an implicit pain symptom into an acute, intolerable one, and prevent the development of the disease.

Throbbing pain under the left rib

Pulsation, tingling - this is a typical clinical picture of developing pathology of many organs covered with a membrane. Throbbing pain under the left rib may indicate a violation of tissue trophism and a change in blood supply in the spleen, in addition, stretching of its capsule most often manifests itself in the form of periodic, dull, pulsating pain. The spleen can either expand (splenomegaly) or decrease in size, atrophy with anemia, all changes in its parameters signal themselves with characteristic pulsating symptoms in the left hypochondrium. Diagnosis of spleen diseases is standard, as a rule, the connection of pulsation with the state of the vessels of the peritoneum is determined, an ultrasound examination of the abdominal organs is carried out, angiography of the aorta is performed to exclude or confirm aneurysm

Pain below the left rib

The etiology of symptoms in the left area of the body can be varied, since pain below the left rib is not a specific sign of a particular disease.

However, such manifestations are well studied and in clinical practice are systematized as follows:

Diseases of the spleen caused by the following reasons:

• Injuries – bruises, falls, accidents.
• Inflammatory process.
• Infectious mononucleosis.
• Ischemia and infarction of the spleen.

Diseases of the stomach:

• Gastroduodenitis.
• Dyspepsia.
• GU – gastric ulcer.
• Tumor process, gastric adenocarcinoma.

Diseases of the pancreas:

• Pancreatitis.
• Pancreatic cancer.

Diaphragm pathologies:

• Hernia.
• Congenital anatomical anomalies of the diaphragm.

Cardiological diseases:

• IHD – ischemic heart disease.
• Angina pectoris.
• Myocardiostrophy.
• Pericarditis.
• Myocardial infarction.

Neurological conditions:

• Vegetative attack.
• Fibromyalgia.
• Intercostal neuralgia.
• Osteochondrosis, radiculopathy

Pain below the left rib is a symptom that should not be overlooked, since important organs are located in the left hypochondrium, the condition of which often affects human life.

Pain under the left rib on the side

Most often, pain in the left side is associated with heart disease, but such a symptom can indicate many other reasons. In the area of the left rib, there are digestive organs - the stomach (bottom, cardiac part of the stomach), part of the intestine, colon, as well as the spleen, left kidney, ureter, uterine appendages. In addition, pain under the left rib may indicate dry left-sided pleurisy, which manifests itself as stabbing pains on the side, on the left. Indeed, left-sided pain radiating to the jaw, neck, arm, back, often to the side is a signal of an attack of angina pectoris, but more often everything is a symptom of a pre-infarction condition or infarction. Any discomfort in the left hypochondrium should be a reason to consult a doctor who can differentiate the signs of the disease, make an accurate diagnosis and begin symptomatic and basic treatment.

It should be noted that pain on the left side is not a specific symptom indicating the nature of the pathology, much less its etiology. All clarifications and confirmations should be based only on laboratory, instrumental and hardware diagnostic studies.

Sharp pain under the left rib

The acute nature of the pain indicates a serious, life-threatening condition, possibly due to perforation of the ulcer of the duodenum or stomach. Acute pain under the left rib in such cases is cyclical, most often it develops suddenly at night and is seasonal - spring or autumn. The pain radiates from the left rib to the back, less often to the lower back. A typical body position during ulcer perforation is the "fetal" pose, when the patient presses his knees to his stomach or clasps the sore spot with his hands. In addition, an acute pain symptom is characteristic of exacerbation of gastritis, the so-called severe "hunger" pains occur with an ulcer of the duodenum.

Acute pain in the left side can be a symptom of developed gastric adenocarcinoma in the terminal stage, when the tumor compresses nearby tissues and organs. The pancreas, affected by a malignant tumor in the body and tail, can also hurt in the left hypochondrium, and the pain most often occurs at night and radiates to the back.

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Diagnosis of pain under the left rib

In order to specify the etiology, to find the cause of the symptom in any painful condition, complex diagnostic measures are required. An accurate description of the pain, a detailed definition of its nature, dependence on food intake or other factors helps to narrow the list of disease variants in which a pain symptom appears in the left hypochondrium. In addition, the diagnosis of pain under the left rib involves the following actions:

1. Clarification of the localization of the pain symptom (above, below, behind, in front).
2. Find out the nature and intensity of pain.
3. Specify whether there is pain irradiation, the path, and the place of reflection.
4. Identify factors that provoke pain – food, tension, coughing, stress.
5. Determine what relieves the symptom – vomiting, body position, taking medications.
6. Assess associated symptoms.

Further diagnostics are carried out depending on the information received and may include:

1. General and biochemical blood analysis.
2. X-ray, computed tomography of the spine.
3. Ultrasound of abdominal organs.
4. Coprogram.
5. FGDS.
6. Angiography.
7. Cardiogram and ultrasound of the heart.
8. A biopsy may be possible.

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Treatment of pain under the left rib

Treatment of pain under the left rib directly depends on the severity of the symptoms

Acute conditions requiring emergency care are treated on the spot, then therapy is carried out in a hospital setting.

It should be noted that patients with a history of chronic diseases should know the methods and techniques for relieving acute pain symptoms, that is, have the necessary “first aid” medications with them, this is especially true for cardiac diseases, stomach ulcers, and intestinal ulcers.

In addition, symptomatic treatment should be the prerogative of a doctor, self-medication sometimes only aggravates the severity of the process and can lead to serious complications, including death. Any left-sided pain is a direct indication of a timely visit to a doctor and receiving adequate, professional help. It is completely inappropriate, even dangerous to look for ways to treat pain under the left rib in the media, from friends, using online resources, since such symptoms require diagnostics, often therapy in a hospital setting, and possibly resuscitation measures.

How to prevent pain under the left rib?

Preventive measures to prevent pain in the left hypochondrium include regular medical examinations, i.e. scheduled check-ups and visits to the attending physician. Prevention of pain under the left rib is especially important for the elderly, when the risk of developing heart disease and digestive system pathologies increases. Also, you should not let the disease take its course with latent pain sensations, which can serve as the first signal of a possible development of the disease. Almost any disease can be treated quite quickly and effectively if it is determined at an early stage. In addition, prevention of pain in the left rib area is associated with adherence to healthy eating and lifestyle standards, since most often painful discomfort in this area is caused by inflammatory or erosive processes in the digestive tract. Giving up bad habits, trusting modern, high-tech medicine, and timely preventive examinations will help to avoid not only serious complications, but also to extinguish the source of the disease at its very beginning.