Pain in Lower left side of abdomen female – what are the causes of pain in the left lower abdomen?

The lower left abdomen is the end of the colon, and in some women, the left ovary. The slight pain in this area is usually nothing to worry about and may go away on its own within a day or two. However, if the pain persists, it may be a symptom of many serious ailments.

Pain in the left lower abdomen can be a sign of many diseases. Apart from its localization, the nature of the pain is also important, i.e. whether it is dull, acute, chronic, or radiates to another area of ​​the body, if so to what. In the case of pain on the left side of the abdomen, a number of diagnostic tests should be performed in addition to the physical examination to determine its cause and implement appropriate treatment.

Pain in the lower abdomen on the left side – what could be the most common causes?

Abdominal and lower abdominal pain are one of the most common complaints that patients report to GPs. The causes of these ailments are usually difficult to diagnose quickly. Lower abdominal pain can represent a wide variety of conditions, and for women, the range of possible causes is potentially increased by gynecological conditions.

The most common causes of pain in the lower abdomen on the left and right are minor digestive system diseases, functional intestinal cramps (depending on their work, motor skills) or simply indigestion. However, pain in the left side of the abdomen may be indicated by other gastrointestinal diseases.

A possible gastroenterological cause of pain in the left lower abdomen is irritable bowel syndrome (pain in the lower abdomen may be constant or recurrent, acute, spasmodic, harassing, does not wake patients up at night, may increase after a meal, decreases after a bowel movement).

Another moderately common cause of abdominal pain is ulcerative colitis, a type of chronic inflammation of the colon whose cause is not fully understood. Perhaps the development of the disease is influenced by environmental, genetic and immunological (related to the immune system) factors. Long-term inflammation in the intestine (most often in the rectum and colon) leads to ulceration. The first symptoms of the disease in the form of diarrhea, blood impurities in the stool occur between the age of 20 and 40. It happens that an acute relapse may have up to 20 bowel movements a day. If the diarrhea is severe, there is blood, pus or mucus in the stools, severe abdominal pain ( pain in the left lower abdomen )), the patient feels a painful pressure on the stool – think about ulcerative colitis.

Pain in the left side of the lower abdomen and intestinal diseases

Abdominal pain on the left side , which is also felt in the lower abdomen, is a common symptom of diverticula of the large intestine and diverticulitis of the large intestine. The presence of diverticula (small protrusions of the intestinal mucosa) in the large intestine is usually asymptomatic and is detected accidentally. Only about 20 percent. Of these cases, they are accompanied by clinical symptoms such as pain in the left lower quadrant, constipation, or painful diarrhea. It is a disease of civilization, it occurs in developed countries. Usually the disease begins around 4-5 decades of life. In people over 80 years of age, it is found in as many as 2/3 of the population. If acute diverticulitis develops, there is also a fever, leukocytosis (increased number of white blood cells in the blood count), increased pain in the left iliac palpation, physical examination can detect a tumor and muscle defense.

Pain in the lower abdomen on the left side and in the left hypochondrium can also be a sign of colon obstruction and colorectal cancer . Most often, mechanical obstruction in the large intestine (obstruction of the intestinal lumen) is caused by cancer. Colorectal cancer is the second leading cause of cancer deaths in Poland. Its incidence is influenced by many genetic and environmental factors (mainly diet, i.e. eating large amounts of fats and small amounts of vegetables and fruits). Most often, the cancer is located in the sigmoid colon and rectum (the end of the large intestine). If the cancer is in the left part of the colon, changes in bowel habits are predominant, often bloating, systolic pain on the left side of the lower abdomen and rectal bleeding may be seen.

Could lower abdominal pain and lower back pain mean kidney problems?

Pain may radiate from the back to the left lower abdomen near the renal colic . Colic pain is the first symptom of kidney stones (deposits in the urinary tract). Usually it is located in the lumbar region, but it radiates to the groin, to the genitals, so it can also be felt in the left iliac fossa (when urolithiasis affects the left kidney). Renal colic is described as sudden, paroxysmal and recurrent pain. The pain is related to the movement of the deposit in the urinary tract as it enters the ureter, which has a narrow lumen. It is accompanied by nausea and vomiting and a painful urge to urinate.

Typically, pyelonephritis occurs as a complication of incorrectly treated urethritis or cystitis (ascending pathway). Pain in the lumbar region, chills, fever, nausea and vomiting predominate. There is also increased tenderness in the lower abdomen (left – if the left side of the urinary tract is involved).

Pain in the left lower abdomen in women

The diagnosis of pain in the left lower abdomen is extremely important in women, because apart from gastroenterological diseases (related to the digestive system), it can be caused by various gynecological diseases. One of the causes of pain in the left lower abdomen may be pain in the left ovary and a cyst in the left ovary . It is most common in women of reproductive (menstrual) age. Initially, it is asymptomatic and can be detected on a follow-up ultrasound. When it reaches a large size, it can cause chronic pain in the left lower abdomen, constipation, a feeling of pressure on the bladder, nausea and vomiting. If it ruptures, the pain is sudden, sharp, stabbing, and there may be peritoneal symptoms.

The torsion of the left ovary causes a sharp, stabbing pain in the left lower abdomen. The pain is located above the changed ovary and can often radiate to the back. Torsion most often occurs in the ovaries enlarged, e.g. as a result of ovarian cysts, during pregnancy and also in young girls before puberty.

Inflammation of the appendages on the left side causes pain in the left side of the abdomen . Acute adnexitis very often causes serious diagnostic problems due to non-specific symptoms and often atypical course. Most often, the patient experiences pain in the lower abdomen (in the case of inflammation of the appendages on the left, the pain is felt in the left iliac fossa). It is very severe pain, gradually increasing, accompanied by fever and increased heart rate. During the gynecological examination, the patient experiences severe uterine pain when the examiner moves it sideways.

An ectopic pregnancy is a condition in which a fertilized egg implants outside the uterine cavity. Symptoms of an ectopic (ectopic) pregnancy are not very characteristic. In addition to delayed menstrual bleeding, there may be periodic abdominal pain, most often one-sided, and irregular uterine bleeding.

What tests should be performed for pain in the lower abdomen?

Any abdominal pain requires diagnosis, especially if it is strong, sharp, stinging and increasing. Many different tests are used to find a cause.

• Rectal examination – should be performed if colon cancer is suspected.
• Contrast rectal enema – enables the diagnosis of diverticula of the colon and colorectal cancer.
• Computed tomography of the abdominal cavity and small pelvis may be useful in suspecting acute diverticulitis and in the diagnosis of colorectal cancer, its advancement and possible metastases.
• Colonoscopy with taking a sample for histopathological examination – enables macroscopic and microscopic evaluation (thanks to the possibility of taking samples during the examination) of colorectal cancer, it is possible to exclude or confirm the presence of additional neoplastic foci in the intestine, assess the extent of ulcerative colitis lesions (not in the acute phase of the disease) ) and differentiate it from Crohn’s disease.
• Abdominal ultrasound – is used to assess other organs in the case of bowel cancer (possible metastasis).
• Abdominal X-ray – in the case of suspected toxic distension of the colon in the course of ulcerative colitis, it is the examination of choice, as the contrast infusion is contraindicated.
• Chest X-ray – it will help to assess the stage of bowel cancer and possible metastases to the lungs.
• Overview X-ray – will visualize impermeable stones in the course of renal colic.
• Urine general examination and culture – in the case of renal colic, hematuria is very common, while high leukocyturia and high bacteriuria may indicate pyelonephritis.
• A gynecological examination is necessary in the case of suspected diseases of the reproductive system in women.
• If an ectopic pregnancy is suspected, the concentration of beta-hCG should be determined and a transvaginal ultrasound should be performed.
• The ultrasound of the appendages is necessary in the diagnosis of ovarian cysts and ovarian torsion.