If You Feel Pain In Your Lower Left Abdomen, One Of These Reasons May Be To Blame
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It’s never a great feeling to have pain anywhere in your body. But it can be especially anxiety-inducing when you have pain in your lower left abdomen. After all, lots of important organs are housed in this area of the body.
You’ve got your intestines—both small and large—as well as your ureters, the little ducts that connect from the kidneys to the bladder. There's also the left ovary, left fallopian tube, left side of the uterus, and the surrounding muscles, like the rectus muscles. Yes, a lot going on.
If you’re feeling pain in the lower left abdomen, don’t freak—it’s not always a cause for concern. It could be something as simple as pain from constipation or even ovulation, says Tomas Luley, DO, an obstetrician-gynecologist and certified menopause practitioner at Novant Health in Charlotte, North Carolina. But if the pain is subtly worsening and you’re also losing weight, or have blood in your stools, for instance, those are signs to talk to your doctor (we'll get more into this!).
Meet the experts: Tomas Luley, DO, is an obstetrician/gynecologist and certified menopause practitioner at Novant Health in Charlotte, North Carolina. Henry Herrera, MD, is a gastroenterologist at DHR Health Gastroenterology in Texas.
Here are 12 possible reasons you might be experiencing pain in your lower left abdomen, according to medical experts.
1. Constipation
Constipation may cause abdominal discomfort in the left lower quadrant of your torso that feels like fullness, depending on how constipated you are, says Henry Herrera, MD, a gastroenterologist at DHR Health Gastroenterology in Texas. The pain can also come from the trapping of gas throughout the colon as the organ tries to move the stool along. To treat the pain, the constipation has to be treated.
If constipation gets worse, you can develop a fecal impaction, where your stools become so hard in the rectum that the stool behind it doesn’t have anywhere to go, so it’s a blockage, Dr. Herrera says. (This is more often seen in older patients who are immobile or bedbound, or in patients on chronic pain medications.)
Constipation can cause nausea and vomiting if it’s severe enough. In some cases, the fecal matter has to be removed manually, with your fingers. If you pass the stool and it’s large, rectal bleeding can also develop from the trauma of the stool passing through the anal canal, he says. Similarly, hemorrhoids can also develop from the straining, or a small tear called an anal fissure.
If you're backed up for longer than usual and it's causing pain, bleeding, and/or interfering with your daily life, reach out to your physician.
2. Ovulation
It’s totally possible to experience ovulation pain in the lower left abdomen around the time you’re ovulating, which is often referred to as mittelschmerz (German for "middle pain"), says Dr. Luley.
During ovulation, fluid will release from the dominant follicle, which can cause irritation to the pelvic cavity, causing pain. The pain may feel dull and cramp-like, but sometimes sharp, and it usually just happens for a day or two, he says. In addition to the lower left abdomen pain, you might also feel nauseous, discomfort in the lower back, or have vaginal discharge or even bleeding.
It's usually self-resolving, so no further treatment beyond rest is needed. However, you can always use a heating pad or take Motrin or Tylenol to relieve the pain.
3. Diverticulosis
Diverticulosis is the “outgrowth of the of the large intestine,” says Dr. Luley. In other words, the inside layer of the digestive tract pushes through the outer layer. It is common in people over 60, according to the National Library of Medicine.
The pain may feel dull, and it can be constant or intermittent, but overall, it’s more chronic. If you have diverticulosis, you could also experience pain in the right lower abdominal region too, he adds, and you might have excess bloating too.
In order to treat it, you usually have to work with your doctor to change your diet. Diverticulosis has been connected to eating a low-fiber diet.
4. Diverticulitis
Diverticulitis is related to diverticulosis, but it’s more specifically when those bulges that happen in the intestine lining become inflamed or infected. This may happen when the muscles weaken in your colon from dealing with constipation, says Dr. Herrera.
The lower left abdomen pain in this case can initially be described as a mild discomfort and is typically first connected with constipation. But after 24-48 hours, it may become more severe, sharp, and painful to the touch, he says.
If diverticulitis is uncomplicated, it can be treated with 10-14 days of antibiotics. If it becomes recurring, surgery may be necessary to avoid complications.
5. Endometriosis
Endometriosis is when the inside lining of the uterus, called endometrium, somehow makes its way on the outside of the uterus, says Dr. Luley. From there, it can implant in different areas in the pelvic cavity, along the ovary, or on the outside of the ovary. This disorder, which can be hereditary, can give you dull or sharp pain that might feel similar to cramping. Other symptoms beyond pain can be lower-back discomfort, nausea, and painful intercourse, he adds.
Endo can be treated with medications to decrease the pain, such as ibuprofen, Tylenol, and Motrin. If those don’t help, birth control pills, which regulate hormones can may help decrease endometriosis pain, Dr. Luley explains.
6. Adenomyosis
Similar to endometriosis, the endometrium is also involved in adenomyosis, except that the tissue actually grows into the muscular wall of the uterus. The pain—which usually feels like dull and intermittent, or like cramping—is unilateral but can also be felt throughout both sides of the public region, and it’s usually associated with the occurrence of the menstrual cycle, Dr. Tuley notes. Women with adenomyosis might have heavier cycles or cycles that last longer than usual. Other symptoms include lower-back discomfort, nausea, even vomiting.
Related pain may affect the lower mid quadrant area of your core, where the bladder sits, and the right lower quadrant region too. After a formal diagnosis from your physician, opting for Motrin or ibuprofen first is the move, he says. If that’s not helpful, birth control pills or the Mirena IUD may be worth exploring with your provider.
7. Hernia
A hernia is when there is a weakness in a muscle and an organ or tissue bulges through the opening. It's possible to have an anal hernia that may cause pain in the lower left quadrant region, notes Dr. Luley.
An anal hernia is when either the small or large intestines push through fascia and form a bulge in the area near your pelvic organs. It’s usually a dull, chronic, long-term pain that is progressive, so it’ll worsen over time, as will the bulge and other possible symptoms, like coughing or straining the bulge.
They’re typically treated surgically, which can be done with a minimally invasive laparoscopy, or with a skin incision over the hernia to support this area where there’s a weakening within the pelvic cavity.
8. Ovarian Cyst
Cysts, also known as little fluid-filled sacs that can form on the ovaries, are decently common, Dr. Tuley says. “About one third of women will experience a cyst at some point in their life,” he says.
Fortunately, most cysts will resolve on their own with time—some in several days, while others in more like six to eight weeks. They can be monitored with imaging and ultrasounds. However, some cysts may need further evaluation or even surgical treatment.
Ovarian cyst pain may fluctuate and be sharp at times, but for many, it stays constant and feels like a dull discomfort or pressure. With the pain, you may experience nausea, abdominal bloating, and back discomfort.
If the cyst hasn’t gone away after a few weeks, various forms of hormonal birth control can help lead to fewer cysts, Dr. Tuley says. If BC doesn't help, surgery to remove the cyst(s) may be the next step via a minimally invasive laparoscopy.
9. Ovarian Torsion
An ovarian torsion is when the ovary and part of the fallopian tube twist, causing the ovary to lose its blood supply. “It's almost like if you're hanging like an ornament on a Christmas tree and you kind of spin an ornament around a little bit,” explains Dr. Tuley. “Imagine if the blood flow back and forth is that thread attached to the branch, that Christmas tree.” The supply would be cut off, causing acute, sudden, sharp pain that's mostly constant.
Ovarian torsion most commonly happens from having a cyst on the ovary, as the cyst can cause an imbalance and cause the ovary to twist on itself, according to Yale Medicine. The pain is mostly on the side where the ovaries are affected. You might also experience nausea, vomiting, bloating, or back pain.
Ovarian torsion can be diagnosed with an ultrasound, and it’s treated surgically with a minimally invasive laparoscopic procedure to untwist the pedicle of the ovary so blood can flow back into it.
10. Osteoarthritis
This form of arthritis can affect people with a “wear and tear on the hips,” says Dr. Herrera. Because your hip extends up into your lower abdomen, people who have osteoarthritis pains also have lower abdominal pain, either on the left or the right, depending on which hip is involved. The feeling of the pain varies—it can be sharp if you’re in a position that triggers the pain, but generally, if you’re walking around, it’s more of an underlying discomfort. If you’ve been sitting down or immobile for a while, like in the morning when you first wake up, the area tends to be more sore. Usually, the pain gets worse with exercise, but also with certain movements.
For treatment, do a physical exam where you move your leg in different directions to see which ones cause pain, and it can be treated with anti-inflammatory medicines, he adds.
11. Ovarian Cancer
More rarely, pain in the left lower quadrant pain is a sign of an ovarian tumor. The pain might feel more like tenderness or discomfort if you press down in that area, but if you don’t push on it, you might not feel any pain at all, says Dr. Herrera. This type of pain is long-term and steadily worsening, lasting weeks to months, but it doesn’t usually cause pain in neighboring areas.
Ovarian cancer might also cause symptoms of weight loss, loss of appetite, and nausea. It can be diagnosed with imaging, like a transvaginal ultrasound or a CT scan of the abdomen and pelvis.
12. Colon Cancer
This type of pain may start off as a feeling of discomfort, then trouble using the restroom. As a cancerous growth in the colon grows, the space in the colon shrinks, preventing stool from passing as easily. At that point, the pain may be more severe, especially if there’s a blockage of the colon and the stool has nowhere to go.
Along with abdominal pain, an individual might experience rectal bleeding, abnormal weight loss if it’s severe enough, nausea, vomiting, and bloating or the feeling of fullness. This cause of abdominal pain, too, is more rare—but all the more reason not to hesitate to see your doctor if you're unsure of the cause of pain.
When To Talk To Your Doctor
While most lower left abdomen pain is not an emergency, “look out first and foremost for any red flag symptoms,” says Dr. Herrera. These could look like: rectal bleeding, abnormal weight loss, a change in bowel habits, or worsening pain. If the pain doesn’t resolve in a few weeks, see your primary care provider, or a gastroenterologist or gynecologist.
Depending on the cause, the pain can also become intense quickly—and sharp, acute pain should not be ignored. “The intensity of the pain is probably the most important thing, and especially if this is pain that's never been present before,” Dr. Luley notes. Therefore, if the pain is suddenly very severe, go to the emergency room or try to get an appointment that day with your doctor.
If you’re pregnant and having pain that isn’t relieved within an hour by a warm bath or shower or taking Tylenol, reach out to your physician. If you’re looking to become pregnant and struggling, some of the causes above could be interfering with conception—so that’s another reason to bring it up with your doctor sooner rather than later, Dr. Luley says.
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