Left Lower Quadrant Pain - Diagnosis

Authored by Dr Jacqueline Payne, 08 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Helen Huins, 08 Jul 2017

Your doctor will narrow the (enormous) field of possible left lower quadrant (LLQ) pain diagnoses by talking to you and examining you. They may be able to find the cause simply by doing so. For example, if they find the typical rash of shingles, you will need no further tests to find the cause. The doctor will certainly need to feel your tummy (abdomen) in the area you have the pain, but may also need to examine other parts too, such as the rest of your tummy. Your doctor may also need to examine your bottom (rectal examination).

You will probably be asked to provide a sample of urine, to rule out kidney problems.

You may well have to go for blood tests. These might include tests to:

  • Check the function of your liver and kidneys.
  • Rule out any inflammation or infection in your body.
  • Look for anaemia.
  • Check your sugar level.

Next it will depend on what the examination and the tests above have suggested. In some cases no further tests will be needed - if, for example, your doctor is confident you have constipation or shingles.

If a problem with your large bowel is suspected, you may need an examination with a tube with a camera put into your large bowel (a colonoscopy). A computerised tomography (CT) scan or an ultrasound scan may be helpful to look for diverticula and to look at your kidneys. These tests are also used in women to look at the ovary and tubes. In some cases an X-ray of the tummy may be useful. Further tests include other 'scopes' (such as a sigmoidoscopy), a barium enema and other scans (such as a magnetic resonance imaging (MRI) scan).

If it is thought you might have an ectopic pregnancy - women - or a torsion of your testicle (testis) - men, you may only have one or two of these tests before having emergency surgery to treat your problem.

Nobody will need all these tests, and some people may not need any.

Further reading and references

  • Cartwright SL, Knudson MP; Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008 Apr 177(7):971-8.

  • Kim JS; Acute Abdominal Pain in Children. Pediatr Gastroenterol Hepatol Nutr. 2013 Dec16(4):219-224. Epub 2013 Dec 31.

  • Cartwright SL, Knudson MP; Diagnostic imaging of acute abdominal pain in adults. Am Fam Physician. 2015 Apr 191(7):452-9.

  • Manterola C, Vial M, Moraga J, et al; Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011 Jan 19(1):CD005660. doi: 10.1002/14651858.CD005660.pub3.

Hello, I am new here and need some help with an ongoing issue. It started months ago with just bloating, distension mainly in upper abdomen to which I was told ibs. I tried fodmap, buscopan,...

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