Symptoms, Causes, Treatment, and More

Your left ribs protect the organs that sit below them, like your heart and your stomach. Pain in this area can be caused by injury, infection, or an underlying condition.

If you have pain in your chest, you might worry about a serious condition, such as a heart attack. While it’s true that pain under your left ribs can be a heart attack symptom, discomfort in that area is not always related to your heart.

Depending on the cause, left rib pain might feel sharp and stabbing, or dull and aching. For many people, pain in this area is due to a benign (not harmful), treatable cause. But if you’re having chest pain, it’s best to see a doctor or healthcare professional to make sure it’s nothing serious.

Read on to learn about possible causes of left rib pain, diagnosis, and treatments.

Chest pain can sometimes signal a medical emergency, such as a heart attack. If you’re feeling pain in your left ribs, it’s best not to ignore it.

Heart attack symptoms include:

• pain, discomfort, or a heavy feeling in your chest, usually in the middle or on the left side
• pain or discomfort in your neck, jaw, shoulders, arms, back, or above your belly button
• shortness of breath
• sweating
• fatigue
• nausea and vomiting
• lightheadedness or dizziness
• fast or irregular heart rate

If you think you could be having a heart attack, call 911 or local emergency services right away.

Your rib cage consists of 24 ribs — 12 on the left and 12 on the right side of your body. Their function is to protect your organs that lie beneath them.

On the left side, this includes your heart, left lung, pancreas, spleen, stomach, and left kidney. When any of these organs are infected, inflamed, or injured, pain can radiate under and around your left rib cage. It’s also possible to injure your ribs themselves.

Costochondritis refers to inflammation of the cartilage that attaches your ribs to your breastbone. This condition doesn’t always have a clear cause. It can happen for several reasons, such as:

• an infection
• an injury
• severe coughing

Costochondritis causes a sharp, stabbing pain that’s usually felt on the left side of your rib cage. It may get worse when you cough, sneeze, or press on your ribs.

A forceful blow or injury to your chest is the most common cause of bruised or broken ribs.

If you have a bruised rib, you’ll usually feel pain in your chest that’s worse when you inhale or move.

When a rib is broken, the pain is likely to be severe. It may make you feel like it’s hard to breathe in all the way. Broken ribs can sometimes cause serious complications, such as:

• a collapsed lung
• injuries to your blood vessels or organs, such as your spleen
• flail chest, which is a medical emergency that happens when you have many fractures in your ribs

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two different digestive conditions. The causes of IBS and IBD aren’t fully known.

IBS and IBD both cause persistent, long-term pain in your abdomen, which is the area from your chest down to your hips. It’s possible for IBS or IBD to cause pain under your left ribs. These conditions also cause digestive symptoms, such as constipation, diarrhea, and gas.

Symptoms may come and go. IBS symptoms tend to improve after you have a bowel movement. IBD is a more serious condition that causes physical changes to your intestines. A doctor can see these changes using imaging tests.

Your pancreas is a gland located near your small intestine, on the left side of your belly. It makes insulin, which your body uses to turn sugar into energy. It also releases digestive juices into your small intestine to help break down food you’ve eaten.

Pancreatitis refers to inflammation of your pancreas. It can have many causes, including:

• injury
• long-term heavy alcohol use
• gallstones

Pain caused by pancreatitis can happen suddenly (acute pancreatitis), or it can slowly get worse over time (chronic pancreatitis). Additional symptoms of pancreatitis include:

• fever
• fast heart rate
• nausea
• vomiting
• weight loss
• jaundice

It’s important to treat pancreatitis to prevent serious complications.

Your spleen also sits in the left side of your body, near your rib cage. This organ is an important part of your immune system. It produces white blood cells that fight infection, and it processes other parts of your blood.

An enlarged spleen, also called splenomegaly, can cause symptoms such as:

• pain or discomfort
• bloating
• feeling full after eating only a small amount of food

Several things can cause an enlarged spleen, including:

• viral infections, such as mononucleosis
• bacterial infections, such as syphilis
• parasitic infections, such as malaria
• blood diseases
• liver diseases

Sometimes, your spleen can rupture, usually as a result of trauma. It’s a medical emergency, and you should get medical attention immediately.

If your spleen ruptures, the area might feel tender when you touch it. In addition to pain, other signs and symptoms can include:

• low blood pressure
• dizziness
• blurry vision
• nausea

More rarely, a splenic infarct happens when a portion of your spleen necrotizes or “dies.” This happens when the blood supply is lowered or stopped, usually as a result of an injury or conditions that affect your blood.

Gastritis refers to inflammation of the lining of your stomach, which is also near the left side of your rib cage.

It doesn’t always cause symptoms, but possible symptoms include:

• pain in your upper abdomen
• feeling full after eating only a small amount of food
• nausea
• vomiting

The causes of gastritis include:

• Helicobacter pylori infection
• frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• long-term, heavy alcohol use

Your kidneys are part of your urinary tract. They’re located on either side of your spine, but when they become inflamed or infected, the pain can radiate to the front of your body. When your left kidney is involved, you might feel pain near the left side of your rib cage.

Kidney stones are hardened calcium and salt deposits that form into stones. They can cause a cramping pain as they move out of your kidneys and make their way toward your bladder. In addition to pain in your left rib cage, kidney stones can also cause:

• an urge to urinate, with little urine coming out
• bloody or cloudy urine
• pain in your side that radiates to the front of your body

Kidney infections occur when bacteria from your urinary tract make their way into your kidneys. This usually happens due to a bladder infection. Additional symptoms of a kidney infection can include fever and nausea.

If you’re having symptoms of a kidney problem, it’s important to see a doctor. You can get a diagnosis and start any treatment that may be needed.

Your heart is surrounded by a fluid-filled sac called the pericardium. Pericarditis refers to inflammation of this sac. This can cause a dull ache or a stabbing pain that’s usually worse when you’re lying down. Pericarditis can also cause a high fever.

Researchers aren’t sure why it happens, but it often occurs after you’ve had a viral infection.

Pericarditis can lead to complications if it is not treated.

Pleurisy happens when the tissue that surrounds your lungs becomes inflamed. Causes of pleurisy include:

• pneumonia
• blood clot in your lung
• injury
• cancer that has spread from another part of your body to the tissue surrounding your lungs
• cancers that specifically affect the tissue surrounding your lungs, such as mesothelioma

Pleurisy on your left side may cause pain under your left rib cage, but the main symptom is a sharp, stabbing pain when you breathe. Be sure to see a doctor if you experience any intense chest pain while breathing.

To figure out what’s causing pain in your left rib cage, a doctor will give you a physical exam that includes feeling the affected area. This will help them check for any signs of swelling or inflammation that might be caused by conditions such as costochondritis.

If they suspect the pain could be due to a heart problem, a doctor might use an electrocardiogram to measure the electrical activity in your heart. This will help to rule out any serious underlying condition.

Next, they may take blood, stool, or urine samples for testing. Analyzing these results can alert a doctor to signs of kidney problems, pancreatitis, or gastritis.

If the cause of your rib cage pain still isn’t clear, you may need an imaging test, such as:

• ultrasound
• CT scan
• X-ray
• endoscopy

This will give a doctor a better view of your bones, organs, and tissues.

What kind of doctor should I see for left rib pain?

There are many possible causes of pain around your left rib cage. A primary care doctor can usually help you determine the cause. If needed, they can refer you to a specialist, such as an orthopedic doctor who treats bones, muscles, and joints.

If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

If you think you could be having a heart attack or other medical emergency, call 911 or your local emergency services right away.

Treating your left rib cage pain depends on what’s causing it. If it’s related to any type of inflammation, a doctor will likely recommend you take NSAIDs to lower your pain and swelling. In some cases, you may need an antibiotic to clear up a bacterial infection.

Bruised ribs will likely heal with rest, as will broken ribs, if there are no complications.

In rare cases, you may need surgery. For example, if a kidney stone is too large to pass through your body on its own, a doctor may need to surgically remove it.

Given the number of organs in the upper left part of your body, it’s not uncommon to feel pain under the left rib cage. It may be caused be an easily treatable condition.

But if you have pain in this area that’s severe, worsens over time, lasts more than 24 hours, or is associated with any of the serious symptoms above, you should get medical treatment immediately to rule out any underlying conditions.

Symptoms, Causes, Treatment, and More

Your left ribs protect the organs that sit below them, like your heart and your stomach. Pain in this area can be caused by injury, infection, or an underlying condition.

If you have pain in your chest, you might worry about a serious condition, such as a heart attack. While it’s true that pain under your left ribs can be a heart attack symptom, discomfort in that area is not always related to your heart.

Depending on the cause, left rib pain might feel sharp and stabbing, or dull and aching. For many people, pain in this area is due to a benign (not harmful), treatable cause. But if you’re having chest pain, it’s best to see a doctor or healthcare professional to make sure it’s nothing serious.

Read on to learn about possible causes of left rib pain, diagnosis, and treatments.

Chest pain can sometimes signal a medical emergency, such as a heart attack. If you’re feeling pain in your left ribs, it’s best not to ignore it.

Heart attack symptoms include:

• pain, discomfort, or a heavy feeling in your chest, usually in the middle or on the left side
• pain or discomfort in your neck, jaw, shoulders, arms, back, or above your belly button
• shortness of breath
• sweating
• fatigue
• nausea and vomiting
• lightheadedness or dizziness
• fast or irregular heart rate

If you think you could be having a heart attack, call 911 or local emergency services right away.

Your rib cage consists of 24 ribs — 12 on the left and 12 on the right side of your body. Their function is to protect your organs that lie beneath them.

On the left side, this includes your heart, left lung, pancreas, spleen, stomach, and left kidney. When any of these organs are infected, inflamed, or injured, pain can radiate under and around your left rib cage. It’s also possible to injure your ribs themselves.

Costochondritis refers to inflammation of the cartilage that attaches your ribs to your breastbone. This condition doesn’t always have a clear cause. It can happen for several reasons, such as:

• an infection
• an injury
• severe coughing

Costochondritis causes a sharp, stabbing pain that’s usually felt on the left side of your rib cage. It may get worse when you cough, sneeze, or press on your ribs.

A forceful blow or injury to your chest is the most common cause of bruised or broken ribs.

If you have a bruised rib, you’ll usually feel pain in your chest that’s worse when you inhale or move.

When a rib is broken, the pain is likely to be severe. It may make you feel like it’s hard to breathe in all the way. Broken ribs can sometimes cause serious complications, such as:

• a collapsed lung
• injuries to your blood vessels or organs, such as your spleen
• flail chest, which is a medical emergency that happens when you have many fractures in your ribs

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two different digestive conditions. The causes of IBS and IBD aren’t fully known.

IBS and IBD both cause persistent, long-term pain in your abdomen, which is the area from your chest down to your hips. It’s possible for IBS or IBD to cause pain under your left ribs. These conditions also cause digestive symptoms, such as constipation, diarrhea, and gas.

Symptoms may come and go. IBS symptoms tend to improve after you have a bowel movement. IBD is a more serious condition that causes physical changes to your intestines. A doctor can see these changes using imaging tests.

Your pancreas is a gland located near your small intestine, on the left side of your belly. It makes insulin, which your body uses to turn sugar into energy. It also releases digestive juices into your small intestine to help break down food you’ve eaten.

Pancreatitis refers to inflammation of your pancreas. It can have many causes, including:

• injury
• long-term heavy alcohol use
• gallstones

Pain caused by pancreatitis can happen suddenly (acute pancreatitis), or it can slowly get worse over time (chronic pancreatitis). Additional symptoms of pancreatitis include:

• fever
• fast heart rate
• nausea
• vomiting
• weight loss
• jaundice

It’s important to treat pancreatitis to prevent serious complications.

Your spleen also sits in the left side of your body, near your rib cage. This organ is an important part of your immune system. It produces white blood cells that fight infection, and it processes other parts of your blood.

An enlarged spleen, also called splenomegaly, can cause symptoms such as:

• pain or discomfort
• bloating
• feeling full after eating only a small amount of food

Several things can cause an enlarged spleen, including:

• viral infections, such as mononucleosis
• bacterial infections, such as syphilis
• parasitic infections, such as malaria
• blood diseases
• liver diseases

Sometimes, your spleen can rupture, usually as a result of trauma. It’s a medical emergency, and you should get medical attention immediately.

If your spleen ruptures, the area might feel tender when you touch it. In addition to pain, other signs and symptoms can include:

• low blood pressure
• dizziness
• blurry vision
• nausea

More rarely, a splenic infarct happens when a portion of your spleen necrotizes or “dies.” This happens when the blood supply is lowered or stopped, usually as a result of an injury or conditions that affect your blood.

Gastritis refers to inflammation of the lining of your stomach, which is also near the left side of your rib cage.

It doesn’t always cause symptoms, but possible symptoms include:

• pain in your upper abdomen
• feeling full after eating only a small amount of food
• nausea
• vomiting

The causes of gastritis include:

• Helicobacter pylori infection
• frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• long-term, heavy alcohol use

Your kidneys are part of your urinary tract. They’re located on either side of your spine, but when they become inflamed or infected, the pain can radiate to the front of your body. When your left kidney is involved, you might feel pain near the left side of your rib cage.

Kidney stones are hardened calcium and salt deposits that form into stones. They can cause a cramping pain as they move out of your kidneys and make their way toward your bladder. In addition to pain in your left rib cage, kidney stones can also cause:

• an urge to urinate, with little urine coming out
• bloody or cloudy urine
• pain in your side that radiates to the front of your body

Kidney infections occur when bacteria from your urinary tract make their way into your kidneys. This usually happens due to a bladder infection. Additional symptoms of a kidney infection can include fever and nausea.

If you’re having symptoms of a kidney problem, it’s important to see a doctor. You can get a diagnosis and start any treatment that may be needed.

Your heart is surrounded by a fluid-filled sac called the pericardium. Pericarditis refers to inflammation of this sac. This can cause a dull ache or a stabbing pain that’s usually worse when you’re lying down. Pericarditis can also cause a high fever.

Researchers aren’t sure why it happens, but it often occurs after you’ve had a viral infection.

Pericarditis can lead to complications if it is not treated.

Pleurisy happens when the tissue that surrounds your lungs becomes inflamed. Causes of pleurisy include:

• pneumonia
• blood clot in your lung
• injury
• cancer that has spread from another part of your body to the tissue surrounding your lungs
• cancers that specifically affect the tissue surrounding your lungs, such as mesothelioma

Pleurisy on your left side may cause pain under your left rib cage, but the main symptom is a sharp, stabbing pain when you breathe. Be sure to see a doctor if you experience any intense chest pain while breathing.

To figure out what’s causing pain in your left rib cage, a doctor will give you a physical exam that includes feeling the affected area. This will help them check for any signs of swelling or inflammation that might be caused by conditions such as costochondritis.

If they suspect the pain could be due to a heart problem, a doctor might use an electrocardiogram to measure the electrical activity in your heart. This will help to rule out any serious underlying condition.

Next, they may take blood, stool, or urine samples for testing. Analyzing these results can alert a doctor to signs of kidney problems, pancreatitis, or gastritis.

If the cause of your rib cage pain still isn’t clear, you may need an imaging test, such as:

• ultrasound
• CT scan
• X-ray
• endoscopy

This will give a doctor a better view of your bones, organs, and tissues.

What kind of doctor should I see for left rib pain?

There are many possible causes of pain around your left rib cage. A primary care doctor can usually help you determine the cause. If needed, they can refer you to a specialist, such as an orthopedic doctor who treats bones, muscles, and joints.

If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

If you think you could be having a heart attack or other medical emergency, call 911 or your local emergency services right away.

Treating your left rib cage pain depends on what’s causing it. If it’s related to any type of inflammation, a doctor will likely recommend you take NSAIDs to lower your pain and swelling. In some cases, you may need an antibiotic to clear up a bacterial infection.

Bruised ribs will likely heal with rest, as will broken ribs, if there are no complications.

In rare cases, you may need surgery. For example, if a kidney stone is too large to pass through your body on its own, a doctor may need to surgically remove it.

Given the number of organs in the upper left part of your body, it’s not uncommon to feel pain under the left rib cage. It may be caused be an easily treatable condition.

But if you have pain in this area that’s severe, worsens over time, lasts more than 24 hours, or is associated with any of the serious symptoms above, you should get medical treatment immediately to rule out any underlying conditions.

Pain and heaviness in the left hypochondrium

What is the left hypochondrium

The left hypochondrium is the area of ​​the body that is located on the left under the breast and reaches an average of 10 centimeters in length and width.

The stomach, pancreas, spleen, loops of the small intestine, left lung, heart, kidneys can give pain in this area.

Doctors conditionally divide the abdominal wall into 9 regions: right and left hypochondrium, epigastric region, right and left lumbar region, navel region, right and left iliac region, hypogastric region.

Pain, heaviness or other discomfort in the left hypochondrium can also occur with anemia, diseases of the spine, and as a variant of the so-called radiating (reflected) pain.

In most cases, the doctor can guess the cause of pain in the left hypochondrium by the nature of pain and accompanying symptoms. To confirm the diagnosis, laboratory blood tests are prescribed, as well as ultrasound (ultrasound), radiography, or endoscopic examination.

Varieties of pain in the left hypochondrium

Pain in the left hypochondrium may be sharp, dull, cutting or aching.

Acute pain in the left hypochondrium

Acute or so-called stabbing pain is not always a sign of a serious pathology. This happens if gases accumulate in the splenic angle of the large intestine.

In addition, such pain occurs with acute pancreatitis or injuries of the spleen. In addition to pain, accompanying symptoms can indicate the severity of the condition: vomiting, high fever, chills, increased heart rate and a sharp drop in blood pressure.

With the appearance of stabbing and acute pain in the left hypochondrium, an ambulance should be called immediately.

Acute pain may appear spontaneously or may be due to exercise, changes in body position, alcohol or fatty foods.

Acute pain in the left hypochondrium may indicate pancreatitis – inflammation of the pancreas

Dull pain or heaviness in left hypochondrium

Usually dull pain is characteristic of chronic or gradually developing diseases: pancreatitis, peptic ulcer, some infections. Patients often describe dull pain as heaviness, discomfort, a feeling of fullness in the left hypochondrium.

Such pain should not be ignored. Without treatment, the risk of disease progression and the development of severe complications increases.

Aching pain in the left hypochondrium

Aching pain is more often characterized by patients as mild, exhausting, as if spreading, which can spread to the entire abdomen.

Aching pain does not always have a serious cause. So functional dyspepsia, irritable bowel syndrome or infections that affect the gastrointestinal tract (enterovirus infection, salmonellosis) can manifest themselves.

Cutting pain in left hypochondrium

Cutting pain is characterized by patients as sharp, dagger, localized. As a rule, it comes from a certain organ, for example, an inflamed pancreas in acute pancreatitis.

If there is a cutting pain in the left hypochondrium, you should seek medical advice as soon as possible.

According to the nature of the course, pain in the left hypochondrium can be acute or chronic.

Causes of pain and heaviness in the left hypochondrium

Any pain syndrome begins in the same way: pain receptors of cells in the affected part of the body are excited. It is this excitement that the brain perceives as pain.

The peritoneum, as well as the internal organs, have good innervation (they have many nerve endings and receptors), so any inflammatory processes or organ malfunctions naturally manifest as pain.

In addition, pain can occur when organs are stretched and squeezed by them on the nerve endings of neighboring tissues. This happens with swelling of tissues after injury or due to stretching of the loops of the intestines by intestinal contents or gases.

Also, pain in the left hypochondrium may have physiological causes. Sometimes it appears after overeating, intense sports, during pregnancy. As a rule, this is not dangerous: pain and heaviness go away on their own when a person returns to the usual rhythm of life.

Pain on the left often has physiological causes: overeating, pregnancy or active sports

Diseases in which there is pain in the left hypochondrium

The most common diseases that lead to pain in the left hypochondrium include:

• pancreatitis,
• peptic ulcer of the stomach and duodenum,
• pathologies of the spleen,
• abdominal injuries,
• lung diseases,
• myocardial infarction,
• intercostal neuralgia.

In case of myocardial infarction, a person experiences severe pain in the region of the heart, radiating to the left arm or hypochondrium

Pancreatitis

Pancreatitis is inflammation of the pancreas.

There is acute and chronic pancreatitis. The first appears suddenly and is characterized by acute sharp pain in the left hypochondrium and the center of the abdomen. The second one develops gradually. In chronic pancreatitis, pain does not always occur, but only after overeating or alcohol abuse. As a rule, patients describe it as aching.

In addition to severe pain, acute pancreatitis may present with the following symptoms:

• nausea,
• diarrhea,
• high temperature,
• yellowing of the skin and whites of the eyes,
• rapid heartbeat.

People with chronic pancreatitis may lose weight for no reason, they may develop oily stools with an unpleasant odor.

Peptic ulcer of the stomach and duodenum

Peptic ulcer of the stomach and duodenum is a disease in which defects (ulcers) form in the stomach, as well as in the upper parts of the duodenum.

The first sign of a stomach ulcer is usually a burning pain in the left hypochondrium and upper abdomen, which is especially strong on an empty stomach and is slightly relieved after eating or taking heartburn medications.

Burning pain in the left hypochondrium and upper abdomen is one of the symptoms of peptic ulcer disease

Common symptoms of gastric and duodenal ulcers:

• fullness in the abdomen,
• bloating,
• belching,
• nausea,
• frequent feeling of hunger.

Pathologies of the spleen

Spleen is an organ that is located on the left just below the ribs. Its main function is to deposit blood. Platelets accumulate in the spleen, which, if necessary, are released into the bloodstream and close the damaged vessels. In addition, old erythrocytes are destroyed in it and immune cells – lymphocytes – are formed.

The spleen is like an oval about 12 cm long and not more than 8 cm wide

The most common pathologies of the spleen, in which it can hurt in the left hypochondrium:

• abscess,
• spleen injury,
• splenomegaly.

Abscess , or suppuration of the spleen, may develop after infectious diseases (endocarditis, typhoid fever, and others). As a rule, the abscess resolves on its own, but while healing is in progress, aching or dull pain may be felt in the left side.

Injury to the spleen dangerous organ rupture. This can happen due to a blunt blow to the side, such as in a car accident or during a fight. A ruptured spleen can lead to pain shock and death.

Splenomegaly is a condition in which the spleen is enlarged.
One of the causes of splenomegaly can be infectious mononucleosis, the causative agent of which is the Epstein-Barr virus. Also, other infections can be the culprits of splenomegaly: parasitic, viral, bacterial.

Cirrhosis, some types of anemia, autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus) can also lead to splenomegaly.

Enlargement of the spleen in size is usually accompanied by aching pain and a feeling of fullness in the left hypochondrium.

Abdominal injuries

Abdominal injuries are potentially life-threatening injuries that may be accompanied by massive internal bleeding. Such injuries can be open (eg, stab or cut wounds) or closed (internal bruising from a car accident or impact).

As a rule, pain in severe abdominal injuries is acute and is caused by the accumulation of blood between the tissue of the internal organs.

An abdominal injury, accompanied by a sharp deterioration in well-being, is an indication for urgent hospitalization and emergency surgical treatment.

Diseases of the lungs and pleura

Pleuropneumonia is an inflammation of the lungs and pleura caused by a viral, bacterial or fungal infection.

The main symptoms of pleuropneumonia are shortness of breath, chest pain, excruciating cough, fever. In some patients, pleuropneumonia is manifested by dull pain in the left hypochondrium.

In general, the disease is mild and successfully treated with a course of antibacterial, antiviral or antifungal drugs. In rare cases, severe complications develop, such as respiratory failure.

Myocardial infarction

Myocardial infarction (heart attack) is a condition in which the heart suddenly stops receiving blood (partially or completely).

Most often, a heart attack occurs due to atherosclerosis – the accumulation of cholesterol plaques in the walls of blood vessels. Sometimes plaques rupture, and blood thickens around them – blood clots form, which can block the artery. Because of this, not enough blood and oxygen will flow to the heart, so its tissues will begin to die.

Despite the fact that a heart attack is an acute condition, its symptoms develop gradually (over several hours, days or even weeks).

Common symptoms of a heart attack:

• severe pressing pain in chest;
• pain on the left under the ribs, in the neck, jaw, back;
• shortness of breath;
• weakness;
• dizziness;
• cold sweat;
• nausea or vomiting.

If you suspect a myocardial infarction, you should immediately call an ambulance.

Intercostal neuralgia

Intercostal neuralgia is a condition when a person experiences acute burning or shooting pain in the area to which the intercostal nerve is responsible for sensitivity.

Intercostal nerves entangle each rib like threads and attach to the spine and sternum

As a rule, pain in intercostal neuralgia girdles from the back to the abdomen, may disturb constantly or comes in waves, aggravated by deep inspiration, coughing or sharp turns of the body.

Which doctor to contact if there is pain in the left hypochondrium

If there is aching or dull pain in the left side, you should contact a therapist as soon as possible or immediately make an appointment with a specialized specialist who treats gastrointestinal problems – a gastroenterologist.

At the consultation, the doctor will conduct a survey and examination and, possibly, refer you to a narrow specialist – a nephrologist, gynecologist, endocrinologist, surgeon or neurologist.

You should also seek medical advice if:

• pain persists for more than one or two days or worsens;
• in addition to pain, fever, nausea, vomiting or diarrhea;
• people lose weight for no reason;
• weakness appeared, blood pressure decreased.

If there is a sharp acute pain in the left hypochondrium, an ambulance should be called as soon as possible.

In addition, call an ambulance immediately if:

• vomiting of blood or bloody stools;
• pain radiates to chest, neck or shoulders;
• pain accompanied by shortness of breath;
• developed severe bloating.

Diagnosis for pain and heaviness in the left hypochondrium

To distinguish the suspected disease from other similar pathologies and confirm the diagnosis, the doctor may prescribe laboratory and instrumental studies.

Laboratory research methods

To evaluate a patient’s general health, a doctor may order a complete blood count.

Clinical blood test with leukocyte formula and ESR (with microscopy of a blood smear when pathological changes are detected) (venous blood)

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Based on the results of a clinical blood test, one can suspect an inflammatory process, determine its severity and suggest a possible cause.

For the diagnosis of pancreatitis, laboratory tests are used that allow you to evaluate the work of the pancreas, identify violations and start treatment in a timely manner. As a rule, three indicators are determined: the level of glucose, the content of pancreatic amylase and lipase in the blood.

Pancreas

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Lipase

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Also, the doctor may prescribe a coprogram (a comprehensive analysis of feces). The analysis shows how well food is digested under the influence of pancreatic juice. If there are not enough enzymes, fat residues, muscle fibers and other components are found in the feces, which should not normally be present.

Coprogram

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To diagnose gastric and duodenal ulcers, a doctor may prescribe a general and biochemical blood test, a test for C-reactive protein – a marker of the acute phase of inflammation, as well as blood tests for liver enzymes – alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Biochemistry 21 indicators (extended)

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Aspartate aminotransferase (AST)

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In addition, tests for Helicobacter pylori are mandatory, because depending on whether a person is infected or not, the choice of drugs for treatment will also differ.

Helicobacter, DNA (Helicobacter pylori, PCR) scraping, count.

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If a perforated ulcer is suspected, your doctor may order a fecal occult blood test to check for bleeding.

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To detect Payr’s syndrome, doctors look at changes in the parameters of a clinical blood test (as a result, there will be a high level of leukocytes, an increase in ESR, a decrease in hemoglobin and red blood cells). In addition, blood tests for creatinine and urea may be ordered.

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Diagnosis of pathologies of the spleen is carried out using a clinical and biochemical blood test: a clinical analysis reveals a significant increase in ESR (more than 20 mm/h), a sharp decrease in the number of red blood cells and hemoglobin. In biochemical – a decrease in the amount of total protein due to albumin, an increase in urea.

The doctor also evaluates the results of the hemostasiogram: in case of pathologies of the spleen, the results will show an increase in blood clotting ability.

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To confirm the diagnosis of intercostal neuralgia caused by herpes zoster, PCR tests and tests for antibodies to the causative agent of herpes, the varicella-zoster virus, are prescribed.

Diagnosis using PCR tests allows you to identify the genetic material (DNA) of the virus in the blood, urine or discharge from the rash.

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Antibody tests help clarify the stage of the disease. So, with herpes zoster, an increased titer of antibodies of class G and class M is detected in the blood.

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Instrumental methods of examination

Depending on the nature and localization of pain, different instrumental examination methods are used, including:

• ultrasound examination of the pelvic organs, kidneys, liver;
• computed or magnetic resonance imaging;
• radiography for suspected inflammation of the lungs and pleura;
• endoscopic examinations of the gastrointestinal tract (gastroscopy, colonoscopy).

Treatment of pain in the left hypochondrium

Treatment will depend on the cause of the pain.

For the treatment of pancreatitis , as a rule, drugs are used that reduce the production of hydrochloric acid by the stomach, as well as enzymes, antispasmodics, and for severe pain, analgesics and non-steroidal anti-inflammatory drugs.

The main goal of treating gastric and duodenal ulcers is to reduce the production of hydrochloric acid with the help of drugs (proton pump inhibitors). They block the release of acid in the stomach and help the ulcer heal.

In addition, treatment may be supplemented depending on the cause that provoked the mucosal lesion. As a rule, it includes the destruction of Helicobacter pylori, changing drugs that injure the mucous membrane or reducing the doses taken, the use of healing agents and drugs that reduce the production of hydrochloric acid.

Surgical treatment is used only in severe cases of peptic ulcer, and also if the patient develops complications that cannot be stopped by conservative methods.

The tactics of treating pathologies of the spleen depend on the cause. So, antibiotics are used to treat bacterial infections, and anti-inflammatory and painkillers help relieve pain and stop the spread of inflammation during an abscess.

Treatment of abdominal injuries

The slightest suspicion of rupture of the spleen with blunt abdominal trauma is an indication for urgent hospitalization and emergency surgical treatment.

Treatment of inflammation of the lungs and pleura

In general, pleuropneumonia is mild and is successfully treated with a course of antibacterial, antiviral, or antifungal drugs. In rare cases, severe complications develop, such as respiratory failure, which require hospitalization.

Treatment of myocardial infarction

The main thing is to restore blood flow to the heart. The main ways to do this are to inject drugs into the vein that destroy blood clots in the vessels (thrombolytics) or install a stent (a thin tube that keeps the vessel open). This is done on an emergency basis in a hospital setting.

In severe cases, heart surgery may be required – coronary bypass surgery: the surgeon takes a part of a healthy vessel from the leg, arm, chest or abdomen and attaches it to a blocked artery near the heart. So the blood will be able to bypass the clot along the new vessel.

Treatment of intercostal neuralgia

Treatment of intercostal neuralgia depends on the cause that led to nerve damage. So, for herpes zoster, a course of antiviral drugs is prescribed, and for cancer, surgical removal of the tumor, chemotherapy or radiation therapy.

For unbearable pain that interferes with normal life, the doctor may perform an intercostal nerve block. This helps to anesthetize the affected nerve and bring relief at the same time. Sometimes the blockade relieves pain for several months. Sometimes local anesthetics, such as patches or ointments, are also used.

Treatment of gynecological pathologies

Painkillers and anti-inflammatory drugs are used for treatment. In severe cases, minimally invasive treatment (laparoscopic surgery) or abdominal surgery may be required.

What to do with pain in the left hypochondrium

Any pain is a reason to see a doctor. You can start with a therapist or immediately make an appointment with a specialized specialist who deals with the treatment of gastrointestinal diseases – a gastroenterologist.

In the event of acute pain in the left hypochondrium, it is urgent to call a medical team. Before the ambulance arrives, you should lie down and not take any medications so as not to worsen the condition and not interfere with the correct diagnosis.

Sources

1. Gastroenterology: clinical treatment protocols. 2021.
2. Acute myocardial infarction with ST elevation electrocardiogram: clinical guidelines. 2022.
3. Inflammatory diseases of the female pelvic organs: clinical guidelines. 2021.

Why does the left side hurt under the ribs

Pain in the left side is typical for diseases of the abdominal organs. Sometimes there are cases when pathologies of the lungs, heart and neuralgia can become the cause of pain. To identify the exact cause, instrumental diagnostics is used using ultrasound, x-rays and radio wave studies. Depending on the cause of pain in the left side, appropriate treatment is prescribed. Below, we will talk in detail about the most common pathologies that cause pain. But it is worthwhile to understand that self-diagnosis and self-treatment are likely to only worsen the condition, so you should contact a qualified specialist for help as soon as possible.

• Diseases of the spleen. The spleen is a hematopoietic organ. With inflammation, a rapid increase in the size of the spleen (splenomegaly) is characteristic, and with injuries, there is a high risk of rupture of the organ capsule with heavy bleeding. In diseases of the organ, arching, pressing pain in the left hypochondrium is characteristic, which does not depend on physical activity and food intake.
• Intestinal diseases. Pathology of the small intestine leads to visceral or referred pain in the left side. The tumor of the left part of the colon in the later stages of the disease causes aching pain, which intensifies 2-3 hours after eating. The pain syndrome occurs against the background of weakness, weight loss, aversion to food.
• Diseases of the stomach. Gastritis and gastric ulcer cause pain in the epigastric region and in the left hypochondrium. In the case of gastritis, the pains are stabbing, boring, shooting, worse after eating spicy and fatty foods. Characterized by a feeling of heaviness in the stomach, belching rotten or sour, heartburn, nausea.
• Diseases of the pancreas. Inflammation of the pancreas is called pancreatitis. Chronic pancreatitis causes indigestion and periodic pain in the left side. Characterized by diarrhea, fatty stools with lumps of undigested food, flatulence. Pain of a stabbing, arching, shooting character, occurs 1-1.5 hours after eating. Often the pain syndrome becomes shingles – spasmodic pain squeezes the “ring” of the left and right hypochondrium.
• Muscle disease. Muscle inflammation – myositis may be accompanied by pain in the left side. The pain syndrome is shooting and cramping, aggravated by stretching the muscle fibers while bending in the opposite direction. Dull or burning pain develops when food passes through the esophagus and when the body bends after eating.
• Intercostal neuralgia. Inflammation of the intercostal nerves is commonly called intercostal neuralgia. In most clinical cases, the disease develops with herpes zoster. There is an acute burning pain, which is localized in the left hypochondrium, can spread to the back in the region of the shoulder blades and spine. Discomfort is aggravated by tilting towards the lesion.
• Disease of the left lung. Pain in the left side can appear with left-sided lower lobe pneumonia with involvement of the pleura in the pathological process. There is a cutting, stabbing, boring pain in the region of the left hypochondrium, which intensifies at the height of inspiration. Pneumonia is characterized by fever up to 40 degrees, shortness of breath, weakness, dry or productive cough, wheezing when listening to breathing.