Pain under the left rib

The pain under the left rib is a symptom that can not be considered specific without regard to the concomitant 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 on other etiological factors.

In the zone of the left hypochondrium there are a lot of organs, nerve endings, vessels, lymph nodes, subcutaneous tissue, muscles - all of which can be a source of pain. The pain under the left rib can be connected with such organs:

• Left lung.
• Pancreas (tail).
• Heart and mediastinum (mediastinum).
• The upper part of the stomach (bottom).
• The upper pole of the left kidney.
• The left diaphragm zone.
• Left appendages of the uterus in women.
• Left-sided bending of the colon.

To accurately diagnose the pain symptom under the left rib, a combination of symptoms, instrumental and laboratory examinations are required, which, combining into the clinical picture, help establish the actual cause of the pain.

[1]

Causes of pain under the left rib

From a pathophysiological point of view, pain is a signal of a violation of the blood supply of a certain local zone of the internal organ, changes in tissue trophism, nerve endings, puffiness, and so on. As a rule, the causes of pain under the left rib are closely related to such kinds of provoking factors:

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

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

• Acute or chronic inflammation of the pancreas, pancreatitis.
• Splenomegaly, splenect, rupture of the spleen.
• Acute or chronic inflammation of the gallbladder, cholecystitis.
• Inflammatory process in the mucous membrane, in the wall of the stomach, gastritis.
• YABZH - peptic ulcer of the stomach.
• Inflammatory process in the lower lobe of the left lung.
• DG is the 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 is an inflammation of the appendix.
• Expansion of the volume of the broncho-pulmonary system during pregnancy.

Gastrointestinal pathologies:

• Gastritis, in which there is a functional disorder or inflammation and, as a consequence, pain. The pain symptom is expressed in a burning sensation, heartburn, is aching and is associated with eating. Also, with gastritis, a person feels nausea, heaviness, pressure in the hypochondrium, often on the left, and general disorders can be weakness, increased sweating, cardiovascular system, anemia (B12 deficiency), atypical taste in the mouth.
• YABZH - peptic ulcer of the stomach, the symptoms of which can manifest in the left hypochondrium. The difference between the YBW and the ulcerative process in the duodenum is that the erosive stomach reacts with food, the pain occurs after eating, the "hungry" pain is not characteristic for it.
• Perforation of an ulcer is a condition considered urgent, requiring immediate medical attention. Symptoms of perforation are very specific - sudden arisen, sharp (dagger) pain, cyanosis of the skin, dizziness and often - loss of consciousness.
• Adenocarcinoma of the stomach, which in the initial stage does not have obvious clinical signs, but, growing, is felt as a constant pain, independent of the time and quantity of food taken. Also among the small signs of cancer may be loss of appetite, weight loss of the body, anemia, rejection of protein, especially meat foods, heaviness in the stomach. Clear signs of maligning the process are drawing pains that give under the right or left rib (at the location of the tumor), melena feces), vomiting, in consistence resembling coffee grounds.
• Constipation or constipation, especially secondary, caused by damage to the large intestine.
• Increased spleen (splenomegaly). Stretching of the organ capsule is most often provoked by infectious mononucleosis and manifests itself as weakness, headaches similar to migraine, joint pain and myalgia, increased sweating, lump in the throat, inflamed lymph nodes, herpetic eruptions and characteristic pains under the left rib.
• The rupture of the spleen capsule of a traumatic or infectious etiology manifests itself in the form of sharp, acute pain on the left under the rib that gives to the back, cyanosis of the skin around the navel, the left abdominal region. This condition is classified as urgent, requiring immediate hospitalization.
• An exacerbation of pancreatitis, which causes heaviness and severe pain on the left, shingles. Often the pain under the left rib irradiates in the back, accompanied by nausea, vomiting, hyperthermia.
• DG is a diaphragmatic hernia, which clinically in the initial period can signal itself with heartburn due to acid casting into the esophagus - esophagus, then by dull, constant aching pain in the left hypochondrium, sensation of nausea, gravity in the epigastrium. When the stomach is caught, sharp pains are possible.

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

• All kinds of functional, structural pathology of the cardiac muscle - cardiomyopathy. The pain under the left rib provokes excessive physical exertion, less often - stress. Symptoms in cardiomyopathic diseases can be left pain, tachycardia, decreased motor activity, weakness.
• Ischaemia - CHD (ischemic heart disease), a condition in which blood flow is disturbed, blood supply to the muscles of the heart due to narrowing, obturation of the coronary arteries. Symptomatically CHD manifests aching pain, burning in the left side, under the rib, heaviness, shortness of breath, nausea.
• Infarctus, ischemic necrosis, myocardial infarction is a condition that requires urgent care and manifests itself in the form of gravity, spreading from the middle of the chest most often to the left, under the rib, scapula, under the jaw, in the neck, in the arm. An infarction can be accompanied by a lack of breathing, tachycardia, a feeling of severe burning in the vaginal space.

Broncho-pulmonary diseases:

• Left-sided pneumonia, in which pain is provoked by the inflammatory process in the lower lobe of the lung, is felt as a dull, implicit, aching. Pain symptom increases with cough reflex, then the pain is felt like a stitch.
• Dry pleurisy of the left lung. Diseases manifested by rapid breathing, hyperthermia, pain, which is associated with persistent coughing, body twists, slopes. If the pleurisy is exudative, 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. Is manifested acute, severe pain in the acute stage, with chronic clinical symptoms may be pain under the edge of the aching nature, associated with movements, changing postures, slopes. The pain intensifies with intense physical exertion, inspiration, sharp bends, sneezing. Also for intercostal neuralgia, there are certain painful points that react to palpation. Pain sensations often have an irradiating character and are given under the scapula, in the hand, which causes confusion in the differentiation of diseases.
• Vegetative crises that are not associated with cardiac diseases, but symptomatically manifested by pain under the left rib, a feeling of pressure in the chest, increased heart rate, sweating, a sense of fear, panic.

Diseases of the musculoskeletal system, spine:

• Osteochondrosis of the thoracic spine.
• Rheumatoid inflammation of the textus connectivus - connective tissue, joints.
• Cervico-shoulder radiculopathy.
• Injuries of the rib - 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 difficult to differentiate due to their nonspecificity. However, they can be combined according to the following on the grounds:

• Visceral symptoms that are typical of gastrointestinal pathologies. Symptoms most often appear in the form of cramping pains in colic, spasms, or as aching, dull pain in the chronic form of pathology. Also visceral pains are characterized by reflection, that is, they can irradiate to nearby zones, most often to the left or to the right.
• Localized peritoneal pains, typical of ruptures or perforations. Such a pain symptom is acute, harsh and intensified with exertion, movement, and breathing.
• Irradiating symptoms, characteristic for inflammatory processes in the broncho-pulmonary 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 in this way:

Pain under the left rib, accompanied by a feeling of raspiraniya, severity, nausea	Diseases of the bottom, cardial part of the stomach
Pulsating pain, aggravated by 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 region, intercostal neuralgia
Burning pain, pouring from the middle of the chest to the left, nausea, a reflection of pain in the arm, under the shoulder blade	Cardiological pathologies - IHD, myocardial infarction

Pain under the left rib in front

The pain symptom, which is localized in the left hypochondrium from the chest, can be indicative of diseases of the stomach or spleen. If the pain is dull, aching in nature and occurs periodically, regardless of food intake, it may be a sign of splenic splenomegaly in the initial stage. In addition, the pain under the left rib in front can signal a diaphragmatic hernia, an abscess, in such situations the symptom is sharp, acute, the pain grows rapidly, intensifies with bends, coughing, and breathing. It is necessary to differentiate the pain symptom from simple colitis, which can also manifest in the zone of the left hypochondrium, especially if they are associated with the upper loops of the intestine. In addition, thus can be felt myositis, inflammation of the gallbladder, shifted to the left and manifested by atypical signs. The most dangerous factor that provokes pain in the lower part of the left rib is myocardial infarction.

Sharp pain under the left rib

Strong, sharp pain in the left hypochondrium can serve as a sign of perforation of the stomach wall or perforation of the upper loops of the small intestine. Such "dagger" pains are the reason for the immediate call of emergency care and urgent hospitalization. In addition, the sharp pain under the left rib is often a signal about the rupture of the spleen capsule. If the pain is shrouded in nature, perhaps this is evidence of an attack of pancreatitis that begins acutely, suddenly, for such pains it is typically constancy, they do not depend on coughing, changes in body posture, movements and so on. Left-sided sharp pains in the hypochondrium can be manifested as a heart attack in gastralgic form, which in clinical practice is not common, however, this variant of ischemia indicates necrosis of the inferior part of the ventriculus sinister cordis - left ventricle.

Pain under the lower left rib

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

• Sharp, piercing pain, in which a person "freezes".
• Any movement increases the pain.
• Pain is worse when inhaled.
• The pain is paroxysmal and lasts for several minutes.
• The pain symptom, which does not stop, is not treated, is repeated more often.
• The pain is not removed by the intake of cardiac drugs.
• The pain is localized in the zone from the V to IX rib on the left, it is reflected in the shoulder, the left shoulder blade, and more rarely the arm.

Aching under the left rib

The aching pain under the left rib, as a rule, is of a permanent nature and indicates a chronic, sluggish disease, most often inflammation. Such a symptom is characteristic of gastroduodenitis, colitis and the beginning of an ulcerative process in the stomach. If this pain is accompanied by vomiting, which relieves pain, then YABZH (peptic ulcer disease) is virtually indisputable. In addition, persistent, aching pain in the left hypochondrium can signal about developing angina pectoris, ischemia and even an atypical picture of the pre-infarction state.

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

Pain under the left rib behind

The localization of pain behind the left hypochondrium may be a sign of kidney pathology and require a comprehensive diagnosis, including standard nephrological studies - general urine analysis, ultrasound, urography and so on. In addition, the pain under the left rib behind is one of the manifestations of lumbar osteochondrosis, less often of the thoracic spine. These diseases are diagnosed by palpation of paravertebral zones, X-ray, general and biochemical blood analysis, computed tomography. Often the pain that starts from behind gets a girdling character and passes to the abdominal zone, which indicates an attack of pancreatitis. The pain in this case is sharp, acute and does not depend on the change in the posture, movements, turns.

The pain under the left rib from behind can be provoked by such reasons:

• Dry left-sided pleurisy.
• Oncoprocess in the left lung.
• Pneumothorax.
• Atypical manifestations of myocardial infarction.
• Pericarditis.
• Atypical manifestations of thrombosis of the renal artery.
• Renal colic.
• Attack of pancreatitis.

Stitching pain under the left rib

Most often, the stitching pain under the left rib is associated with the beginning of sprain of the spleen, this characteristic is especially characteristic for physical activity, active movements, overstrain. In addition, a piercing symptom in this zone can be associated with a life-threatening disease - myeloid leukemia, which does not appear clinically in the initial stage and can be determined randomly, when examining serum. This disease also affects the spleen responsible for the production of leukocytes, develops splenomegaly, manifested by the severity of the left rib, tingling after eating. In the terminal stage of myeloid leukemia, under the left rib, the compaction is clearly palpable.

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

It should be noted that left-sided pleurisy, especially exudative, is manifested by sharp stitching symptoms in the hypochondrium, pain is aggravated by coughing, breathing (exhalation).

Dull pain under the left rib

Dull, aching pain symptoms are characteristic for the onset of inflammatory processes. Dull pain under the left rib is typical for developing chronic pancreatitis, gastroduodenitis, less often - cholecystitis. In addition, a factor that provokes dull pain sensations may be splenomegaly - sprain of the spleen capsule, in which the erythrocyte decays and utilization during hemolytic anemia occur. Less often, dull pain under the left rib can be a sign of hemoblastic pathologies - lymphocytic leukemia, lymphoma. The spleen sensitively reacts to the pathology of its associated organs and may increase due to portal hypertension, liver cirrhosis, hepatitis, which often manifest clinically indirectly through the symptoms of spleen diseases. Also, pulling, dull pain can serve as a diagnostic sign of an acute infectious disease - mononucleosis, which causes hypertrophy of the spleen until its rupture. Less often the stupid character of pain in the left hypochondrium testifies to cardiological chronic diseases - bacterial endocarditis, pericarditis.

Drawing pain under the left rib

Drawing the nature of pain indicates such diseases:

• Osteochondrosis, which manifests itself with dull, aching, painful pains, with the movements of the hands, bends, static tension.
• Inflammation of the left humeroscapular joint, in which the pain under the left rib is reflected.
• Myalgia - inflammation of the muscles of the breast on the left, caused by physical overload, hypothermia.
• Inflammatory processes in the cardiac muscle, not associated with ischemia, spasms of the coronary vessels.
• Cardioneurosis, vegetative seizures, in which the pulling pain under the left rib is caused by a violation of the functions of the autonomic nervous system.
• Chronic inflammatory processes in the stomach, intestines, pancreas.

[2]

Severe pain under the left rib

Strong, sharp pains in the region of the left hypochondrium are most often associated with a serious condition, exacerbation of pathological processes, which requires urgent medical care.

The severe pain under the left rib can be provoked by such factors:

• Inflammation of the lower lobe of the left lung in the acute stage.
• Injury of the left ribs (lower) - bruise, fracture.
• Splenomegaly caused by infection, cancer.
• Traumatic injury of the spleen capsule.
• Spleen cyst.
• Rupture of the spleen.
• Abscess of the spleen.
• Pathological expansion and splitting (aneurysm) of the artery of the spleen.
• Adenocarcinoma of the stomach in the terminal stage.
• Exacerbation of gastroduodenitis.
• Exacerbation of stomach ulcers.
• Perforation of the wall of the stomach.
• Acute pyelonephritis.
• Exacerbation of pancreatitis.
• Onkoprotsess in the tail of the pancreas.
• Pancreatic cyst.
• Colic of the left kidney.
• Tumor of left flexure of the colon.
• Attack of angina pectoris.
• Myocardial infarction.

Severe pain under the left rib, as a rule, is unbearable, even if it is stopped by spasmolytics, cardiopreparations 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 the pathological process in organs and systems associated with the zone of the left hypochondrium.

The constant pain under the left rib can be associated with a sluggish, latent disease of the stomach, intestines, kidneys, pancreas, lymphatic system and many other organs. In addition, persistent pain is characteristic of intercostal neuralgia, the symptomatology of which is "masked" under the signs of cardiac diseases. Pain discomfort, which does not stop, is also a cause for concern, since the pre-infarction state often has such signs. Despite the fact that aching, persistent pain is quite tolerable, they must be presented to the treating doctor for differentiation, diagnosis and treatment. Only in this way it is possible to avoid the transformation of the implicit pain symptom into acute, intolerant, and prevent the development of the disease.

Pulsating pain under the left rib

Pulsation, tingling is a typical clinic of the developing pathology of many organs covered with a membrane. Pulsating pain under the left rib may indicate a violation of tissue trophism and changes in blood supply in the spleen, in addition, the extension of its capsule is most often manifested in the form of periodic, blunt, pulsating pain. The spleen can both expand (splenomegaly), and decrease in size, atrophy with anemia, all changes in its parameters signal themselves with characteristic pulsating symptoms in the left hypochondrium. Diagnosis of diseases of the spleen is standard, as a rule, the relationship of pulsation with the state of the peritoneal vessels is determined, ultrasound examination of the abdominal cavity is performed, angiography of the aorta to exclude or confirm the aneurysm

Pain below the left rib

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

Nevertheless, such manifestations are well studied and are systematized in clinical practice in this way:

Diseases of the spleen, caused by the following reasons:

• Injuries - bruises, falls, accidents.
• Inflammatory process.
• Infectious mononucleosis.
• Ischemia and spleen infarction.

Diseases of the stomach:

• Gastroduodenitis.
• Dyspepsia.
• YABZH - peptic ulcer of the stomach.
• Tumor process, adenocarcinoma of the stomach.

Diseases of the pancreas:

• Pancreatitis.
• Pancreas cancer.

Pathologies of the diaphragm:

• Hernia.
• Congenital anatomical anomalies of the diaphragm.

Cardiological diseases:

• IHD is ischemic heart disease.
• Angina pectoris.
• Myocardistrophy.
• Pericarditis.
• Myocardial infarction.

Neurological conditions:

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

The pain below the left rib is a symptom that should not be overlooked, since in the zone of the left hypochondrium there are important organs, on the condition of which human life often depends

Pain under the left rib on the side

Most often, pain in the left side is associated with heart disease, but this symptom may indicate many other reasons. In the zone of the left rib there are digestive organs - the stomach (the bottom, the cardiac part of the stomach), part of the intestine, the large intestine, as well as the spleen, left kidney, ureter, and uterine appendages. In addition, the pain under the left rib can testify to dry left-sided pleurisy, which is manifested by stitching pains from the side, to the left. Indeed, left-sided pain radiating to the jaw, neck, arm, back, often sideways is a signal about a stroke of angina, but more often everything is a symptom of a pre-infarction condition or a heart attack. Any uncomfortable sensation in the left hypochondrium should be the reason for contacting a doctor who can differentiate the symptoms of the disease, make an accurate diagnosis and begin symptomatic and basic treatment.

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

Acute pain under the left rib

The acute nature of the pain speaks of a serious, life-threatening condition, possibly in the perforation of an ulcer of the duodenum, stomach. Acute pain under the left rib in such cases is cyclic, most often it develops suddenly at night and has a seasonal character - spring or autumn. The pain radiates from the left rib in the back, less often in the lower back. The typical position of the body in the perforation of an ulcer is the posture of the "embryo", when the patient presses the knees to the stomach, or grips the sore spot with his hands. In addition, an acute pain symptom is typical for exacerbation of gastritis, so-called severe "hungry" pains occur with duodenal ulcer.

Acute pain in the left side can be a symptom of developed adenocarcinoma of the stomach at the terminal stage, when the tumor squeezes nearby tissues, organs. The pancreas, affected by a malignant tumor in the body and tail, can also hurt in the left hypochondrium, with pain manifested most often at night and gives in the back.

[3],

Diagnosis of pain under the left rib

In order to specify the etiology, to find the cause of the symptom in any morbid state requires complex diagnostic measures. To narrow down the list of variants of the diseases in which the pain symptom in the left hypochondrium manifests itself, an accurate description of the pain, a detailed definition of its character, dependence on food intake or other factors helps. In addition, the diagnosis of pain under the left rib suggests such 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. To specify, whether there is an irradiation of a pain, a way, a place of reflexion.
4. Identify factors that provoke pain - food, stress, cough, stress.
5. Determine what removes the symptom - vomiting, body position, taking medications.
6. To assess the concomitant symptomatology.

Further, the diagnosis is carried out depending on the information received and may include:

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

[4]

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 stopped on site, then therapy is performed in a hospital setting.

It should be noted that patients who have a history of chronic diseases should know the methods and methods of removing acute pain symptoms, that is, they must have the necessary "first aid" preparations, especially for cardiological diseases, stomach ulcers, intestines.

In addition, symptomatic treatment should be the prerogative of a physician, self-medication sometimes only aggravates the severity of the process and can lead to a serious complication, up to lethal outcomes. Any left-sided pain is a direct indication of a timely call to a doctor and getting adequate, professional help. It is completely inappropriate, even dangerous, to seek ways to treat pain under the left rib in the media, from acquaintances, through network resources, since such symptoms require diagnosis, often therapy in hospital settings, and possibly resuscitation.

How to prevent pain under the left rib?

Preventive measures to prevent pain symptoms in the left hypochondrium - this is regular medical examination, that is scheduled check-ups and visits to the attending physician. Especially relevant is the prevention of pain under the left rib for the elderly, when the risk of developing heart diseases, pathologies of the digestive system increases. Also, one should not let the disease into its own accord with implicit pain sensations, which can serve as the first signal about the possible development of the disease. Virtually any disease is quickly and effectively treated if it is determined at an early stage. In addition, the prevention of pain in the region of the left rib is associated with compliance with the norms of healthy nutrition, lifestyle, since most often the painful discomfort in this zone is caused by inflammatory or erosive processes of the digestive tract. Rejection of bad habits, confidence in modern, high-tech medicine, timely preventive examinations will help to avoid not only serious complications, but also to extinguish the focus of the disease at its very beginning.