What’s Causing Pain Under My Ribs in the Upper Left Abdomen?

Pain in your upper left abdomen under your ribs can have a variety of causes. This is because there are several important organs in this area, including the:

• spleen
• kidney
• pancreas
• stomach
• colon
• lung

Although the heart isn’t in the upper left abdomen, it can refer pain to the area.

Some of the causes of pain in the upper left abdomen may be treated at home, but others can be life threatening. So it’s important to contact your doctor if your pain is unexplained, persistent, or severe — even if you don’t think it’s serious.

Read on to find out the possible causes and symptoms of this type of pain, and what you should do.

Life threatening causes

Heart attack

If you suspect you may be having a heart attack or another medical emergency, call 911 or your local emergency number immediately.

One of the most common symptoms of a heart attack is tightness, pain, aching, pressure, or squeezing in your chest or arms. This may spread to your jaw, back, or neck.

Other common heart attack symptoms include:

• fatigue
• sudden dizziness
• nausea, indigestion, heartburn, or pain in your abdomen
• shortness of breath
• cold sweat

You may have all or just one or two of these symptoms, but if you experience any of them and think you may be having a heart attack, call 911 or your local emergency number immediately.

Treating a heart attack

Heart attacks must be treated in a hospital. The treatment options include medications and surgery, such as:

• blood thinners
• aspirin
• pain medications
• nitroglycerin
• angiotensin converting enzyme (ACE) inhibitors
• beta-blockers
• surgically implanted stent
• heart bypass surgery

Angina

Angina is another heart-related condition that may cause pain in this area. Angina occurs when the blood traveling to your heart doesn’t contain enough oxygen. This may cause tightening or pain in your chest, jaw, back, shoulders, and arms.

Additional symptoms include:

• shortness of breath
• dizziness
• nausea
• fatigue
• sweating

Angina isn’t a disease of the heart. Rather, it’s a symptom of a possible undiagnosed heart issue such as coronary heart disease or coronary microvascular disease.

Treating angina

The treatment options for angina depend on the underlying cause. Treatment options include:

• medications like blood thinners and beta-blockers
• lifestyle changes to reduce risk of further heart disease
• surgical procedures such as stents or bypass surgery

Pericarditis

Pericarditis is caused by the swelling of the membrane around your heart. This membrane, which also becomes irritated, is called the pericardium.

There are four types of pericarditis. The type is determined by how long the symptoms last. These four types are:

• Acute: Symptoms last less than 3 weeks.
• Incessant: Symptoms are continuous and last 4 to 6 weeks.
• Recurrent: Symptoms reoccur 4 to 6 weeks later with no symptoms between the prior episode.
• Chronic: Symptoms last longer than 3 months.

The symptoms vary slightly for each type, and may include:

• sharp pain in the middle or left side of your chest that may worsen when you inhale
• a general feeling of being sick, exhausted, or weak
• cough
• unusual swelling in your abdomen or leg
• shortness of breath while lying down or reclining
• heart palpitations
• slight fever

Treating pericarditis

Treatment depends on the type, cause, and severity. Options include:

• medications, such as aspirin, corticosteroids, and colchicine
• antibiotics, if it’s caused by an infection
• pericardiocentesis, a surgical procedure that drains excess fluid from the pericardium (usually only in a complication called cardiac tamponade)
• pericardiectomy, a surgical procedure for constrictive pericarditis in which a rigid pericardium is removed

Digestive causes

Trapped gas

Trapped gas occurs when gas is slow or not able to move through your digestive tract. It can be caused by foods or digestive conditions. The symptoms of trapped gas include:

• painful cramps
• a feeling of knots in your abdomen
• passing gas
• abdominal bloating

Treating trapped gas

Gas is a normal part of the digestion process, but it can cause discomfort. Trapped gas can be treated by:

• making changes to your diet
• reducing or eliminating foods that can cause gas, such as:
  • foods high in fiber
  • dairy
  • fried foods
  • carbonated drinks
• changing your eating habits by eating slower and taking smaller portions
• stopping gum chewing or using a straw
• taking over-the-counter (OTC) medications like Beano, GasX, or Mylanta

If you experience chronic trapped gas, it’s a good idea to check in with your doctor to see if it’s being cause by a digestive condition.

Constipation

Constipation occurs when you have fewer than three bowel movements per week or have stools that are hard and difficult to pass.

Constipation is the most common cause of abdominal pain in children. Symptoms of constipation include:

• hard stools
• straining to pass stool
• feeling unable to empty bowels
• feeling a blockage preventing a bowel movement
• needing to press on the abdomen to pass stools

Treating constipation

Treatment options for constipation may include:

• making lifestyle changes such as ensuring you regularly exercise
• not delaying when you have the urge to have a bowel movement
• consuming more fiber in foods and supplements
• taking OTC and prescription medications such as laxatives
• getting therapy to tighten and loosen your pelvic floor muscles

For some people with chronic constipation, surgery may also be needed.

Heartburn

Heartburn is a common condition that involves mild to severe pain in the chest. It’s estimated that more than 60 million Americans experience heartburn at least once a month. Heartburn usually occurs after eating.

It typically happens when acid comes back up from the stomach into the esophagus. This causes a burning sensation and discomfort in your chest. The pain can feel sharp or burning, or cause a tightening sensation.

Some people may also describe heartburn as burning that moves up around their neck and throat, or as discomfort located behind the breastbone.

Treating heartburn

Depending on the cause and your method of treatment, heartburn can last 2 or more hours. You may be able to manage your heartburn by:

• losing weight
• quitting smoking
• eating fewer fatty foods
• avoiding spicy or acidic foods

Mild, infrequent heartburn can also be treated with medications like antacids. Buy antacids now.

However, if you’re taking antacids several times or more per week, your doctor should evaluate you. The heartburn may be a symptom of a bigger problem like acid reflux or GERD.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD), commonly called acid reflux, is a condition that occurs when you experience heartburn more than two times each week. The symptoms of GERD may also include:

• regurgitating acid
• hoarseness
• chest pain
• throat tightness
• cough
• bad breath
• trouble swallowing

Treating GERD

The treatment options for GERD vary depending on the severity of your symptoms. They also generally include a combination of lifestyle changes and medications.

Lifestyle changes that can help relieve GERD include:

• losing weight
• quitting smoking
• limiting alcohol consumption
• elevating your head while you sleep
• eating smaller meals
• not lying down within 3 hours of eating

Medications for GERD include:

• antacids
• H2 receptor blockers
• proton pump inhibitors (PPIs)
• prokinetics

In severe cases, when medications and lifestyle changes aren’t effective, or when complications occur, your doctor may also recommend surgery.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic condition involving a group of intestinal symptoms that typically occur together. The symptoms vary in severity and duration from person to person. Symptoms include:

• abdominal pain or cramping, usually with diarrhea or constipation
• stools with a white mucus
• bloating or gas
• an inability to finish a bowel movement or feeling like you can’t finish

Treating IBS

There’s no cure for IBS. Treatment is aimed at symptom relief and condition management. This may include:

• increasing fiber intake
• following a gluten-free diet
• trying a low-FODMAP diet
• getting enough sleep
• exercising regularly
• reducing stress
• taking medications or probiotics
• practicing relaxation techniques, such as mindfulness or meditation

Inflammatory bowel disease (IBD)

Inflammatory bowel disease (IBD) includes any disorder that causes inflammation in your digestive tract. The most common of these conditions is ulcerative colitis and Crohn’s disease.

Symptoms of IBD may include:

• exhaustion or fatigue
• fever
• cramping and pain in your abdomen
• diarrhea
• bloody stools
• unintended weight loss
• loss of appetite

Treating IBD

There are a number of treatment options for IBD, many of which can be combined for the best condition management. Treatments include:

• making lifestyle changes, such as changes to your diet, exercise regimen, and stress reduction techniques
• taking medications, such as:
  • antibiotics
  • anti-inflammatories
  • immunosuppressants
  • supplements
  • antidiarrheal medication
  • pain relievers
• getting nutritional support in the form of a feeding tube, if necessary
• having surgery that may include removing the damaged part of your digestive tract or removing all or part of your colon
• using alternative treatments like acupuncture

Kidney stones

Kidney stones happen when waste builds up in your kidneys and sticks together. This is due to not enough water passing through. Common symptoms of kidney stones include:

• a sharp pain in your abdomen and back
• pain when you urinate
• vomiting
• nausea
• blood in your urine

Treating kidney stones

The treatment for a kidney stone varies based on the severity and size of the kidney stone. Treatments may include:

• taking pain medications
• increasing your water intake
• having a surgical procedure such as:
  • shock wave lithotripsy, which uses sound waves to break up the stone
  • ureteroscopy, which involves using a small scope inserted into your ureter to remove the stone
  • percutaneous nephrolithotomy, in which a small scope is inserted through an incision in your back to take out the stone

Pancreatitis

Pancreatitis occurs when your pancreas is inflamed. There are two types of pancreatitis: acute and chronic. The symptoms vary for each one.

Acute pancreatitis symptoms may include:

• abdominal pain that spreads to your back
• abdominal pain that’s worse after eating
• stomach tenderness
• fever
• vomiting and nausea
• increased pulse rate

Chronic pancreatitis symptoms may include:

• pain in your upper abdomen
• unintentional weight loss
• stools that smell and look oily

Treating pancreatitis

Treatment options for acute pancreatitis include:

• pain medications
• temporary fasting
• fluids through a tube into your vein (intravenous line, or IV)
• surgical procedures that may involve gallbladder removal, draining fluid from the pancreas, or removing obstructions in the bile duct

Treatment options for chronic pancreatitis may include all of the treatments for acute pancreatitis, as well as:

• dietary changes
• pancreatic enzyme supplements
• pain management

Enlarged spleen

An enlarged spleen, or splenomegaly, can be caused by a number of diseases and conditions.

Infections are one of the most common causes of an enlarged spleen. Problems with your liver, such as cirrhosis and cystic fibrosis, can also cause an enlarged spleen.

Symptoms you may experience with an enlarged spleen include:

• feeling full even after eating very little
• back pain on your left side
• back pain that spreads up to your shoulder
• an increased number of infections
• shortness of breath
• tiredness

You can also experience no symptoms with an enlarged spleen.

Treating an enlarged spleen

Treatment for an enlarged spleen depends on the underlying cause. Treatments may include:

• antibiotics
• medications
• surgery
• rest

Other causes

Pneumonia

Pneumonia is an infection that occurs in one or both of your lungs. It can have various causes including fungi, bacteria, and viruses. The following are the most common symptoms of pneumonia:

• chills
• fever
• cough containing mucus
• headache
• shortness of breath
• sharp chest pain when coughing or breathing deeply
• extreme tiredness

Treating pneumonia

Pneumonia can often be treated at home under the direction of your doctor. These at-home treatments include:

• resting
• increasing fluid intake
• taking antibiotics
• taking fever-reducing medications

Severe or persistent pneumonia requires treatment in the hospital, including:

• IV fluids
• antibiotics
• treatments to help breathing
• oxygen

Pleurisy

Pleurisy is an inflammation of the membrane around your lungs, as well as on the inside of your chest wall. Symptoms of pleurisy may include:

• chest pain when you cough, sneeze, or breathe
• cough
• fever
• shortness of breath

Treating pleurisy

The treatment options for pleurisy include:

• antibiotics
• prescription pain and cough medication
• anticoagulants, or medications to break up any blood clots or large collections of pus and mucus
• bronchodilators via metered dose inhaler devices, such as those used to treat asthma
• OTC anti-inflammatory medications and pain relievers

Collapsed lung

A collapsed lung, also called pneumothorax, can occur when air gets in the space between the lung and the chest wall.

As the air expands, it pushes against the lung, and eventually the lung may collapse. The pressure from this trapped air can also make it difficult to take in a full breath.

The most common symptoms include:

• sharp chest pains
• a bluish tint to your skin
• fast heartbeat
• shortness of breath
• fatigue
• increased rate of shallow breathing
• cough

Treating a collapsed lung

If the collapse is mild, then your doctor may just want to watch to see if it resolves. Otherwise, treatment for a collapsed lung may include:

• oxygen therapy
• draining the excess air
• surgery

Costochondritis

Costochondritis occurs when the cartilage that connects your rib cage to your breastbone becomes inflamed. It can have symptoms that are similar to a heart attack.

The symptoms of costochondritis include the following:

• pain on the left side of your chest
• pain that’s sharp, feels like pressure, or feels achy
• pain that increases when you breathe or cough
• pain in more than one of your ribs

Treating costochondritis

Costochondritis may be treated with:

• anti-inflammatories
• narcotics
• antiseizure medications to help with pain control
• antidepressants to help with pain control

Broken ribs

Broken ribs are normally caused by a severe or traumatic injury. However, if you have osteoporosis or another condition that affects your bones, you can get a broken rib from a minor injury. The symptoms include:

• severe chest pain
• pain that’s worse when you breathe
• pain that makes it difficult for you to take a full breath
• pain that lasts for an extended period of time, sometimes weeks

Treating broken ribs

Broken ribs are usually treated with:

• pain relievers
• deep breathing exercises
• coughing, to avoid pneumonia
• hospitalization

Endocarditis

Endocarditis is an infection of your heart’s inner lining. The symptoms of endocarditis may include:

• heart failure
• fever
• heart murmur
• fatigue
• unintended weight loss
• dull abdominal pain
• feeling full even after a small meal

Treating endocarditis

The treatment options for endocarditis include antibiotics and surgery.

Appendicitis

Appendicitis occurs when your appendix is inflamed. Although the appendix isn’t located in the upper left abdomen, in rare cases, it can cause pain in the area. The symptoms may include:

• abdominal pain that’s usually in the lower right quadrant
• abdomen being tender to the touch
• in very rare cases, abdominal pain in the upper left section of the abdomen

Treating appendicitis

In most cases, appendicitis is treated by an appendectomy surgery to remove the appendix.

When to see a doctor

As you can see, the cause of upper left abdominal pain varies significantly and may be from something as minor as heartburn. However, if the pain is new, persistent, and severe, you should visit your doctor.

If your symptoms include any of the life threatening symptoms mentioned in this article, you should call 911 or your local emergency services immediately.

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