What are the other possible causes?
Inflammatory bowel disease
Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease (IBD). IBD is not to be confused with irritable bowel syndrome (IBS) which is very different). These conditions cause the lining of the gut to become inflamed. Diarrhoea (sometimes with blood mixed in) is usually the main symptom.
- Crohn's disease:
- Any part of the gut can be affected and the pain depends on which part is affected.
- Ulcerative colitis:
- Diarrhoea is often mixed with mucus or pus.
- Blood mixed with the diarrhoea is common.
- The tummy pain is typically crampy.
- A feeling of wanting to go to the toilet but with nothing to pass (tenesmus) is also common.
- Sigmoid volvulus happens when the very last part of the large bowel, the sigmoid, twists on itself causing a blockage.
- Causes colicky pain and a very bloated tummy (abdomen)
- The people it affects are usually elderly and have often had long-term problems with constipation.
- It is dangerous and requires emergency surgery.
- Kidney stones are hard stones that can form in the kidney, in the tube (the ureter) draining urine from the kidney, or in the bladder.
- A stone that passes into the tube (the ureter) draining urine from your left kidney may cause pain that starts in your left loin and spreads (radiates) to your groin and left lower quadrant (LLQ), or into your testicle (testis) if you are a man.
- You may notice blood in your pee.
- In some cases you may have pain from shingles before a blistery rash appears.
- Pain tends to be sharp or burning.
- You may not feel quite yourself.
- The tummy is a common place for shingles rash.
Abdominal aortic aneurysm
- An abdominal aortic aneurysm is a swelling of the largest blood vessel in the body (the aorta) inside the abdomen.
- It doesn't usually cause any symptoms but can occasionally cause pain before it bursts. The pain is usually felt in your back or the side of your tummy (abdomen) but it can occasionally be felt in the left lower (or right) quadrant.
What else could it be?
These lists of possible causes for LLQ are by no means exhaustive and there are many other conditions that can cause pain in the LLQ. Problems in your spine or back could be 'referred'. Referred pain in this situation means that it is coming from your back but you are feeling it around the front. Muscular pulls and sprains can also affect you in the tummy area. If this is the case, moving the particular muscle would make the pain worse, whereas if you were to lie completely still, it wouldn't hurt.
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.
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