Causes of Abdominal Pain in the Lower Left Side

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is left lower quadrant pain?

Pain in the lower left side of the abdomen is called left lower quadrant pain. It is often related to the digestive tract, but can also be related to conditions of the body wall, skin, blood vessels, urinary tract, or reproductive organs. The area may be tender to the touch or the pain may be severe and the whole abdomen might be rigid.

Severe pain can be a symptom of inflammation of the bowel or bowel obstruction, particularly if constipation is present. Severe pain in women may result from twisting of an ovary (ovarian torsion), rupture of an ovarian cyst, ectopic pregnancy, or pelvic inflammatory disease. Men may experience severe left lower quadrant pain from testicular torsion or injury. Crampy pain may be due to gas, indigestion, inflammation or infection, or it may result from menstrual cramps, endometriosis, or pelvic inflammatory disease in women.

Severe pain that comes in waves may be caused by kidney stones. Trauma to the body wall, hernias, and shingles can also cause left lower quadrant pain. A hernia is a weakening of muscle or tissue that allows organs or other tissues to protrude through it. Shingles is a reactivation of the chickenpox (varicella-zoster) virus involving a painful, blistering rash that usually occurs on only one side of the body.

Pain that is sudden in onset, severe, persistent, recurring, or worsening, or that is accompanied by other serious symptoms is typically the most worrisome.

Left lower quadrant pain can be associated with serious medical conditions. Seek immediate medical care (call 911) if you stop having bowel movements, have bloody stools, are vomiting blood, have severe pain or a rigid abdomen, have been injured, had a sudden onset of sharp pain, have cancer, or might be pregnant and have abdominal pain or vaginal bleeding.

If your left lower quadrant pain is persistent or causes you concern, seek prompt medical care, particularly if it is worsening instead of improving. If you have bladder symptoms, fever, decreased appetite, or unintended weight loss, you should also seek prompt medical care.

What other symptoms might occur with left lower quadrant pain?

Left lower quadrant pain may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Typically, the symptoms are related to the digestive tract, but they may also involve other body systems.

Digestive symptoms that may occur along with left lower quadrant pain

Left lower quadrant pain may accompany other symptoms affecting the digestive tract including:

Other symptoms that may occur along with left lower quadrant pain

Left lower quadrant pain may accompany symptoms related to other body systems including:

Serious symptoms that might indicate a life-threatening condition

In some cases, left lower quadrant pain may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bleeding while pregnant
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • High fever (higher than 101 degrees Fahrenheit)
  • Inability to have bowel movements, especially if accompanied by vomiting
  • Rapid heart rate (tachycardia)
  • Rigidity of the abdomen
  • Severe abdominal or pelvic pain or sharp abdominal pain that comes on suddenly
  • Trauma to the abdomen
  • Vomiting blood, rectal bleeding, or bloody stool

What causes left lower quadrant pain?

Often, left lower quadrant pain is related to conditions of the digestive tract; however, it can also be related to conditions of the body wall, skin, blood vessels, urinary tract, or reproductive organs.

Digestive tract causes of left lower quadrant pain

Left lower quadrant pain may be caused by conditions of the digestive tract including:

Other causes of left lower quadrant pain

Left lower quadrant pain can also be caused by conditions involving other body systems including:

  • Abdominal hernia (weakened area of the abdominal wall through which internal organs can pass)
  • Cancer of an abdominal or pelvic organ
  • Endometriosis (condition where tissues resembling the uterine lining grow in other areas of the body)
  • Kidney stones
  • Menstrual cramps
  • Ovarian cysts (benign sacs in an ovary that contain fluid, air, or other materials)
  • Pelvic inflammatory disease (PID; infection of a woman’s reproductive organs)
  • Shingles (painful, blistering rash, often forming a stripe, resulting from a reactivation of the varicella-zoster, or chickenpox, virus)
  • Urinary tract infection
  • Uterine fibroids (abnormal growths of uterine muscle tissue that can cause uterine enlargement or discomfort)

Serious or life-threatening causes of left lower quadrant pain

In some cases, left lower quadrant pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Abdominal abscess
  • Bowel obstruction or perforation
  • Colonic volvulus (twisting of the colon)
  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
  • Intestinal ischemia (loss of blood supply to the intestines leading to death of intestinal tissue)
  • Intussusception (telescoping of the intestines into themselves, which can cause intestinal ischemia)
  • Ovarian torsion (twisting of the ovary)
  • Peritonitis (infection of the lining that surrounds the abdomen)
  • Significant abdominal trauma
  • Testicular injury
  • Testicular torsion (twisting of the spermatic cord)

Questions for diagnosing the cause of left lower quadrant pain

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your left lower quadrant pain including:

  • When did you first notice pain in your left lower quadrant?
  • Have you had pain like this before?
  • Do you have any other symptoms?
  • Does anything make your symptoms go away or make them worse?
  • What medications are you taking?
  • Have you been injured?
  • Is there any possibility you might be pregnant?

What are the potential complications of left lower quadrant pain?

Because left lower quadrant pain can be due to a serious disease, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Abdominal abscess
  • Bowel obstruction, perforation or infarction (severe injury to an area of the bowel due to decreased blood supply)
  • Fistula (abnormal hole or tube between organs or tissues)
  • Infertility
  • Internal hemorrhage
  • Intestinal obstruction and rupture of the intestinal wall
  • Organ failure or dysfunction
  • Spread of cancer
  • Spread of infection
  • Surgery to remove parts of the digestive tract due to inflammation, rupture, an obstruction, a serious infection, or a malignant condition
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 2
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Abdominal pain. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm.
  2. Abdominal Pain Syndrome. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/aps.asp.