Left Upper Quadrant Pain - Diagnosis

Authored by Dr Mary Harding, 08 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 08 Jul 2017

Your doctor will narrow the (enormous) field of possible diagnoses by talking to you and by examining you. They may be able to find the cause simply from doing so. For example, if they find the typical rash of shingles, you will need no further tests to find the cause. If they find your spleen to be enlarged this suggests the problem is related to your spleen or blood. If examination is normal, that already rules out quite a few possible diagnoses. 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 and your chest.

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

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

  • Check the function of your pancreas, liver and kidneys.
  • Rule out any inflammation or infection in your system.
  • Screen for lymphomas and leukaemias and to look for anaemia.
  • Check your sugar level.

Next it will depend on what 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 indigestion, or constipation or shingles.

If a heart or lung problem is suspected, a heart tracing (electrocardiogram, or ECG) and/or chest X-ray might be required. If a problem with your stomach or upper bowel is suspected, you may need an examination with a tube with a camera put down into your stomach (an endoscopy). A computerised tomography (CT) scan or an ultrasound scan may be helpful to look at your spleen, pancreas or kidneys. In some cases an X-ray of the tummy may be useful. Further tests include other "scopes" (such as a colonoscopy or endoscopic retrograde cholangiopancreatography (ERCP) and other scans (such as a magnetic resonance imaging (MRI) scan).

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.

Hi guys, fairly new to this forum, here’s my story, about 5 months ago literally overnight I started to get abdominal pains cramp ect, it got to the point of feeling bloated waking up feeling sick...

matt38065
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