Causes of Left Side Abdominal Pain: Patients with gastrointestinal have many presentations.
Diagnosis of an individual on the basis of gastrointestinal symptoms is difficult as sometimes symptoms may overlap in a variety of diseases.
Hence it is very important to know the positions of the organs in the abdomen so that the diagnosing can be made easier.
Nine parts of our abdomen:
- Right hypochondriac
- Epigastric region
- Left hypochondriac
- Right lumbar
- Umbilical region
- Left lumbar
- Right iliac
- Hypogastric region
- Left iliac
Left side abdomen consists of the following:
- Part of spleen
- Descending colon
- Left kidney
- Part of pancreas
- Sigmoid colon
Lower part of left side of abdomen in males:
- Left testis
Lower part of left side of abdomen in females:
- Part of uterus
- Left ovary
- Left fallopian tube
Causes of Left Side Abdominal Pain
The daily stool frequency in a healthy population differs from thrice a week to twice a day in different geographical and ethnic groups.
Constipation is defined as less than three stools per week with straining, excessively hard stool, unproductive urges, and feeling of incomplete evacuation.
However, many individuals would report themselves as constipated with a stool frequency of three or more per week.
Constipation is a common symptom in all ages. In a study on 4500 adults from the Indian community, 43 (1%) reported passing less than three stools per week.
Although the exact frequency of constipation using various definitions in the Indian population is not known.
It is likely to be common, but many individuals manage it on their own and do not consult doctors for the same.
The perceptions of individuals and doctors about constipation is differ and making it difficult for an exact definition.
Causes for constipation
- Lack of fibre and fluid intake
- Slow-transit constipation
- Chronic intestinal
- Irritable bowel syndrome pseudo-obstruction
- Colonic carcinoma
- Hirschsprung’s disease
- Diverticular disease
- Obstructed defecation
- Anorectal disease (Crohn’s, fissures, hemorrhoids)
- Neurological disorders
- Endocrinal disorders
- Immobility due to severe illness
Clinical features of constipation
A careful history and physical examination usually give adequate pointers to the likely mechanism and type of constipation.
The presence of symptoms such as rectal bleeding, pain, and weight loss is important, as are excessive straining, symptoms suggestive of irritable bowel syndrome, a history of childhood constipation, and emotional distress.
A feeling that the rectum is loaded with stool with the urge to pass and repeated attempt for evacuation and straining at stool suggest of a functional disorder.
The first-line treatment of constipation is symptom relief and improving quality of life.
Adequate diet replete with nutrition, liquids, and fiber and physical activity is essential to ensure proper bowel function.
Fibre intake must be at least 20 gm/day. It may be necessary to supplement with fibre-rich food or fibre medication.
Physical activity is important to ensure general interest and zest for life, but attention to the abdominal wall and pelvic floor muscles may actively help in initiating defaecation.
Existing therapy may need to be modified; for instance, if the patient is on opioids for pain, the drug may have to be discontinued.
It is one of the common causes of left abdominal pain worldwide.
This is the third commonest disorder of the urinary tract after urinary tract infection and prostatic hyperplasia.
75% of stones are composed of calcium oxalate alone or mixed with calcium phosphate, 5% pure calcium phosphate, 5% to 10 % uric acid, 10% infection (struvite), and 1% cystine.
The risk for developing kidney stones
A calcium-deficient diet leads to the upregulation of oxalate absorption.
High animal protein intake lowers urine pH favouring crystallization. High salt intake increases urinary calcium excretion.
Oxalate rich foods (vide infra) and vitamin C intake may increase stone formation since vitamin C gets metabolized to oxalate.
A low potassium diet reduces citrate excretion.
Urine output less than one liter per day, due to less fluid intake increases stone risk.
Trace elements like fluorides in water, increase stone tendency by 5-fold.
Renal stones occur in 20% cases of primary hyperparathyroidism, and in 60% of gout, patients of Crohn’s disease, diabetes mellitus, hypertension are at increased risk.
Urinary infection caused by urease producing organisms (Proteus, Klebsiella, Pseudomonas, Ureaplasma) makes urine alkaline (urease acts on urine to produce ammonia) and increases the risk of struvite stones.
Matrix stones seen in proteus infections are composed of coagulated mucoids.
The pH of urine–uric acid and cystine stones are pH-dependent, Anatomical abnormalities like pelvic ureteric junction (PUJ) obstruction, horseshoe kidney, calyceal diverticulum, ureterocoele, vesicoureteral reflux, medullary sponge kidney, make one stone prone.
Medications like triamterene, indinavir act as a stone nidus.
Nephrolithiasis occurs due to primary metabolic abnormality in 95% cases; systemic diseases account for only 5% cases.
Calcium stones are the commonest with multifactorial etiology.
Clinical presentation depends upon the size, position, and type of stone. Large staghorn stones are usually asymptomatic.
The common presentation is renal or ureteric colic; acute loin pain radiating to the groin with nausea, vomiting is classical; haematuria, microscopic or macroscopic, is invariably present.
Stone moving down the ureter causes intermittent ureteric obstruction; presents with acute colicky pain.
Urgency, frequency, strangury occur with stone at the ureterovesical junction; the presence of fever indicates infection.
Treatment is done under three major aspects:
- Management of acute stone episode. Renal stone, when complicated needs urgent intervention, uncomplicated stone can be treated conservatively with fluids and analgesics.
- Prevention of recurrent stone formation by medical treatment.
- Surgical treatment.
The spleen has the following function in our body:
- Maintain quality control over erythrocytes in the red pulp by removal of senescent and defective red blood cells.
- The spleen performs this function through its parenchyma and vasculature present in it.
- Synthesis of antibodies in the white pulp.
- The removal of antibody-coated bacteria and antibody-coated blood cells from the circulation.
An increase in the normal function of spleen causes splenomegaly (spleen enlargement). Besides these other causes which are responsible for splenomegaly are:
- Infections like mononucleosis
- Cirrhosis of liver
- Cystic fibrosis of the liver
- Juvenile rheumatoid arthritis
- Hodgkin’s disease
- Heart failure
- Tumors in the spleen which has spread to other organs
- Bacterial, viral, and parasitic infection
- Sickle cell leukemia
Clinical features of spleenomegaly
Few patients with spleen enlargement show no symptoms in few patients are discovered during a routine examination.
Symptoms for spleen enlargement include pain and discomfort in the spleen region where it is located that is the upper left side of the abdomen.
Feeling of fullness in the abdomen after eating a small amount of food, this is due to the pressing of the stomach due to spleen enlargement.
The main treatment is to prevent the spleen from rupture and damage if the spleen is enlarged.
If rupture of spleen happens, that will lead o heavy internal bleeding, which can be life-threatening.
Treatment is done after knowing the cause of the enlargement of the spleen.
If the reason for spleen enlargement is due to infection (bacterial, virus, or parasite), then antibiotics are given.
This can be described as pain or discomfort in the abdomen. Gastric pain is mostly felt in the upper abdomen.
This is another one of the main causes of left abdominal pain and includes symptoms like nausea, heartburn (burning in the chest), bloating, and belching.
If a patient comes with gastric pain, then the doctor will rule out for ulcer and inflammation and cancer by performing some tests if the test comes normal, then gastric pain is due to disturbed function.
Stress and anxiety are the main cause of gastric pain. So antidepressant and anxiety-free drugs are given to the patients. Other medicines are given to reduce gastric pain.
If pain in the left lower abdomen occurs then it is due diverticulitis.
Diverticula are the small pouches that are formed from pressure on the weak part of the colon.
When this pouch gets infected, torn, or gets inflamed, diverticulitis is caused.
- Pain in the lower left abdomen with tenderness
- Vomiting, and nausea.
Change in the diet plan from unhealthy to healthy can revert back the condition.
Antibiotics are given to stop the infection. If the condition is progressed, then surgery is done.
The hernia is an abnormal protrusion of abdominal content like bowel from the wall cavity of the abdomen.
In a few cases, it resides back but in few swelling persists, which can be shown by the naked eye.
The hernia is caused due to weakness of muscles or strain.
- Presence of bulge or lump in affected area.
- Discomfort or pain
- Bulging of mass in the groin region after coughing which resides back after lying
Early detection of symptoms and lifestyle management can decrease the prognosis of the hernia.
Medicine is given to reduce pain or discomfort. Surgery is advised in advance cases.
The condition such as Painful menstruation in females is called as a dysmenorrhea.
This occurs due to the contraction of muscles of the uterus to expel the blood from the vagina.
It can be treated easily by giving anti-spasmodic medicine, which provides relief in the contraction of the uterus.
If the pain is very severe, then this condition is called membranous dysmenorrhea.
This condition needs proper medical attention as this condition is very painful, which a patient cannot tolerate.
Every organ in our body is very important for the normal functioning of the body.
If the function of any of the organs, whether it is small or big, is disturbed, it disturbs the function of other organs too as all organs in our body are connected with each other.
So it is our duty to take care of our body for its normal functioning.