What are the common causes of left upper quadrant pain?
There are a lot of possible causes for pain in the left upper quadrant (LUQ) area. The following are some of the possibilities, not in order of how common they are.
Problems with the spleen
Your spleen is just behind your stomach, under and behind the lower ribs on your left. Its main functions are to filter your blood, create new blood cells and store platelets. It is also a key part of your body's immune system. It may cause pain:
- When it becomes enlarged, which can happen in certain blood-related cancers such as leukaemias and lymphomas. This tends to be a vague ache which may gradually get worse. It can also become enlarged during infections such as glandular fever, in which case a very mild pain would be associated with tiredness and repeated bouts of a sore throat and sometimes high temperature (fever).
- If it bursts (ruptures) following an injury, such as in a road traffic accident. This causes a sudden severe pain shortly after trauma to the tummy (abdomen.
- If it is damaged as part of a crisis in sickle cell disease.
Problems with your guts (bowels)
All sorts of common and uncommon problems to do with the upper and lower part of your guts can give you pain in this area. For example:
- Stomach ulcers. Stomach ulcers tend to give you pain in the middle of your tummy just under your ribs. The pain may be worse after eating or when you are lying down at night. Antacids may ease the pain. See separate leaflet called Stomach (Gastric) Ulcer for more information.
- Indigestion (dyspepsia). You can get some pain in the upper part of your tummy associated with heartburn and acid reflux. Again this tends to be worse lying flat or after meals. You may get some bloating. See separate leaflet called Indigestion (Dyspepsia) for more information.
- Gastroenteritis. Infections in your guts tend to cause pain all over your tummy, which is crampy and which is usually accompanied by diarrhoea and/or being sick (vomiting). See separate leaflet called Gastroenteritis in Adults for more information.
- Diverticulitis. This is an inflammation of a pouch or pouches which people who have diverticular disease have in their guts. Usually the pain from diverticulitis is lower in the abdomen, but sometimes it can be felt higher up. It usually comes with a temperature and an altered bowel habit. See separate leaflet called Diverticula (including Diverticulosis, Diverticular Disease and Diverticulitis) for more information.
- Crohn's disease and ulcerative colitis. These are long-term conditions which can cause pain anywhere in the tummy at times. They usually cause loose stools, sometimes with blood. See separate leaflets called Crohn's disease and Ulcerative Colitis for more information.
- Constipation. If your guts are full of poo, this can cause discomfort anywhere in your tummy. You will normally be aware that you are not opening your bowels as often, and that your poo is hard. See separate leaflet called Constipation in Adults for more information.
- Irritable bowel syndrome. This tends to cause pain lower down but can give pain anywhere in the tummy, especially as it often causes bloating which can make you feel uncomfortable higher up. It comes and goes and may be associated with diarrhoea and/or constipation. See separate leaflet called Irritable Bowel Syndrome for more information.
In some cases you can get the pain from shingles before the rash appears. You may have pain for a few days before a blistery rash appears. The pain tends to be quite sharp or burning, and you may feel not quite right in yourself. The tummy is a common place for a shingles rash.
Other people find they continue to get a pain long after the shingles rash is gone. This is called postherpetic neuralgia (PHN).
Kidney stones and infections
Problems with the left kidney tend to give you pain more around the left-hand side of the abdomen, or in your back (loin), but the pain may spread and involve the front of the tummy area. Kidney stones can cause a severe pain (usually round the back) which occurs in spasms lasting from a few minutes to several hours. There may be also be blood in your wee. A kidney infection can cause pain anywhere along your urinary tract. So this could be anywhere from the loin in your back, round to the front, the LUQ, or down to the lower part of your tummy. It may be associated with a fever, pain when you wee, or going to the loo more frequently.
See separate leaflets called Kidney Infection (Pyelonephritis) and Kidney Stones for more information.
Pain coming from the aorta
Your aorta is the main blood vessel of your body, carrying blood from your heart, and passing through the middle of your tummy, taking blood down to your legs and elsewhere. In some people this can swell, making it more vulnerable to leaking or bursting. If it develops a leak, you can get a tummy pain which you may feel in your back. If it bursts (ruptures), you will get a very severe pain in your tummy, back or chest and feel very unwell indeed. This is a major medical emergency and needs instant treatment. See separate leaflet called Abdominal Aortic Aneurysm for more information.
Pain coming from the pancreas
Your pancreas is in the middle of the upper part of your tummy. Chemicals (enzymes) made by cells in the pancreas pass into the guts to help digest food. The hormones insulin and glucagon are also made in the pancreas and help to regulate the blood sugar level. It can become inflamed in the conditions acute pancreatitis and chronic pancreatitis, causing upper tummy pain, usually with feeling sick (nausea) and/or being sick (vomiting). In acute pancreatitis there is usually also a fever and you may feel very unwell in yourself. Tumours of the pancreas can also cause upper tummy pain.
What are the common causes of left upper quadrant pain in pregnancy?
Any of the above conditions can cause pain in the LUQ area, whether you are pregnant or not, so you should always get checked out. However, in pregnancy a common cause of discomfort is the sheer pressure of the womb pressing on other organs, and pressing them into the diaphragm. Also problems with indigestion tend to be common in pregnancy, again at least partly due to the pressure on the stomach. Urinary tract infections are also more common in pregnancy.
What are the common causes of left upper quadrant pain in children?
In young children it is often quite difficult for them to show exactly where the pain is. If this is the case, the field of options widens to almost any cause of tummy ache. In children common causes include:
- Mesenteric adenitis. In children with infections such as colds, glands within the tummy commonly become inflamed giving them tummy ache.
- Appendicitis. Usually this gives pain in the lower right part of the tummy, but if a child can't show you exactly where the pain is, or if the appendix has burst (ruptured), appendicitis may be a possible diagnosis to consider.
- Pneumonia. Infections in the lower parts of the lungs can cause pain in the tummy.
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.
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