Pain under your left rib cage isn’t uncommon, but figuring out the culprit can take some trial and error. The left side under the ribs is home to several major organs, including your heart, left lung, pancreas, spleen, stomach, and left kidney.
Determining which part might be affected — and whether the problem is serious — involves paying close attention to your symptoms, and in many cases, seeking medical attention, according to Julia Blank, MD, a family medicine physician in Santa Monica, California.
Here’s a list of some of the potential causes of left side pain under the ribs (or pain in the LUQ — left upper quadrant — in medical lingo) and when to seek care from a doctor.
1. Injuries
Trauma or injury to your left rib, like a pulled muscle or a broken rib, can cause intense pain that’s concentrated in that area. If you have pain when pushing on your left rib or stretching, it may be due to an injury. Most often, the cause is a fall, car accident, or contact sports, according to Mayo Clinic.
“You might experience sharp pain or pain with deep breathing or moving,” Dr. Blank says. “Typically, there is an inciting trauma or event that’s associated with the start of the pain.”
How to treat it: Broken ribs can heal on their own in about six weeks, but you’ll need to rest and ice the area regularly to help healing. Your doctor might also recommend breathing exercises to help you breathe more deeply, because avoiding deep breaths can increase the risk of pneumonia. Oral medications like over-the-counter or prescription pain relievers can ease your discomfort as your rib heals.
2. Cardiovascular Problems
Because your heart sits under your left rib, upper left abdominal pain under the ribs could be a sign of a cardiovascular issue. According to Blank, the pain could be a sign of:
Heart Attack
Heart attacks happen when blood flow to the heart is blocked. They’re usually marked by chest pressure or tightness; pain that spreads to the shoulder, jaw, or upper abdominal area; fatigue; a cold sweat; dizziness; nausea or shortness of breath, according to the American Heart Association.
How to treat it: A heart attack is an emergency that requires immediate medical attention. If you or someone you know is experiencing possible symptoms, call 911 immediately.
Angina
Angina is a type of chest pain caused by temporary reduced blood flow to the heart (due to one or more partially blocked blood vessels), and symptoms often feel similar to a heart attack.
Like a heart attack, angina can develop from heart disease and should be treated seriously, as it can often progress to a heart attack.
Unlike a heart attack, symptoms of angina can come and go.
How to treat it: If you have already been diagnosed with chronic angina, your doctor may recommend rest or medications like nitroglycerin to ease angina pain in the short term. Lifestyle changes or medication to lower blood pressure or cholesterol are also often used. But for anyone else, call 911 for sudden angina or anything that feels similar to angina symptoms — it could be a sign of a heart attack.
Heart Infection
Cardiovascular infections, such as pericarditis or endocarditis, happen when parts of the heart become inflamed. They’re often caused by viral infections like a chest cold or pneumonia, or sometimes by bacterial or fungal infections. The most common symptom is sharp or stabbing pain in the upper left abdomen or chest that gets worse when you lie down, breathe deeply, or cough.
How to treat it: Seek medical attention if you have signs of a heart infection. Depending on the infection and its cause, you may need to take high doses of anti-inflammatory medications to reduce inflammation around your heart or take antibiotics or antifungals to clear the infection.
3. GI Problems
Because your stomach, pancreas, and spleen all sit under your left rib, left rib cage pain could stem from a GI issue, says Blank. Here are the most common causes:
Indigestion
Indigestion is another word for upper abdominal discomfort, which can happen on your left or right side (or both) and is caused by overeating, anxiety, stomach infections, and other possible conditions.
According to Mayo Clinic, you might feel uncomfortably full after eating just a little bit or have pain between your breastbone and belly button, nausea, and a burning or bloating feeling.
How to treat it: Eating smaller, more frequent meals, managing your stress, and taking over-the-counter medicines like antacids can help manage mild indigestion, which will typically clear up in a week or two. But let your doctor know if symptoms persist.
GERD
Gastroesophageal reflux disease, or GERD, happens when acids in your stomach flow up into your esophagus (and potentially your throat), which can cause a burning feeling in the chest or back, especially when lying down. This can lead to trouble swallowing, a sore throat, or coughing over time.
GERD can be triggered by certain foods or medications, or when there’s increased pressure on your abdomen — like during pregnancy.
How to treat it: Johns Hopkins Medicine suggests avoiding possible triggers, like spicy or fatty foods, and avoiding large or heavy meals close to bedtime. If lifestyle changes aren’t making a difference, talk with your doctor about taking an over-the-counter antacid.
IBS or IBD
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two distinct conditions. But both can cause sharp or dull abdominal pain and bloating that could extend up toward your left rib cage, along with gas, diarrhea, or constipation.
Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis can also cause rectal bleeding and lead to weight loss, according to the Centers for Disease Control and Prevention (CDC). Untreated, both can lead to serious complications such as intestinal perforation, internal bleeding, and colon cancer.
How to treat it: See your doctor if you suspect you could have IBS or IBD. IBS can usually be managed with lifestyle changes, including a special diet, but IBD is a more serious disease that typically requires medication and sometimes surgery, according to the CDC.
Pancreatitis
Pancreatitis happens when cells in the pancreas become irritated and inflamed. This can stem from problems like gallstones, drinking too much, infections, abdominal surgery, taking certain medications, or, in some cases, pancreatic cancer.
This inflammation often leads to upper abdominal pain that gets worse after eating, and in some cases, fever, nausea, vomiting, or weight loss, according to Mayo Clinic.
How to treat it: Pain medications and IV fluids can help get pancreatitis symptoms under control and are given in the hospital. Depending on the underlying cause of the inflammation, you may need additional treatment such as surgery or endoscopic procedures.
Enlarged Spleen
The spleen is normally a fist-sized organ that helps filter blood, remove waste, and produce white blood cells to fight infection. But if it becomes enlarged, it can cause pain in your upper left abdomen that radiates to your left shoulder or back.
An enlarged spleen might make you feel full sooner after meals, and it is always caused by an underlying condition, like an infection or liver disease. But in some cases, it can be from cancer or blood disorders.
How to treat it: See your doctor if you’re noticing symptoms of a possible enlarged spleen. Doctors may rule out spleen pain by examining your abdomen, doing a blood test, or running a CT or MRI. To decide on the right treatment, your doctor will need to determine what’s causing the spleen to become enlarged.
4. Lung Problems
Your left lung sits inside your left rib cage, Blank says. So if your rib pain is accompanied by changes in breathing or other related symptoms, it could be from a lung problem like:
Pneumonia
This is an infection that causes the air sacs in one or both lungs to become inflamed. It’s often a result of viral upper-respiratory infections like a cold or the flu, as well as certain types of bacterial infections, according to the American Lung Association (ALA).
Pneumonia symptoms can range from mild to severe and may include a cough with greenish or blood-tinged mucus, fever or chills, shortness of breath, fatigue, and sharp or stabbing chest pain that gets worse when you breathe deeply, the ALA notes.
How to treat it: The ALA says treatment will depend on whether the infection is caused by bacteria or a virus. Bacterial pneumonia typically requires antibiotics to get better, while viral pneumonia may clear up on its own with rest and fluids. But in some cases, your doctor might also opt to prescribe an antiviral medication.
Pleurisy
Pleurisy is an inflammation of the lung lining that can be caused by an infection or autoimmune disease. It’s typically marked by sharp, stabbing chest pain that comes from one specific place and worsens when you breathe or cough.
The pain can be so strong that you have to take shallow breaths to minimize discomfort.
How to treat it: Pleurisy treatment depends on the underlying cause. Some infections will require antibiotics; in other cases, your doctor may recommend pain relievers or corticosteroids to ease your discomfort. If fluid is building up in your lungs, you may need to have it drained, according to Cleveland Clinic.
5. Other Problems
Other issues can trigger left upper quadrant pain near the rib cage, including:
Ectopic Pregnancy
Ectopic pregnancies — when a fertilized egg implants outside the uterus — are first marked by light vaginal bleeding and pelvic pain. This pain can move into the shoulder, also known as “referred pain,” because a nerve causes pain sensations in an area of the body not directly involved in the pregnancy.
You may also experience an urge to poop, severe abdominal pain, lightheadedness, or fainting, according to Mayo Clinic.
How to treat it: Ectopic pregnancies can cause life-threatening complications and require immediate medical attention. Depending on how far along the pregnancy is, the ectopic tissue may be removed with medication or surgery, according to Mayo Clinic.
Kidney Stones
Kidney stones are hard mineral or salt deposits that form inside the kidney. Because this organ is located high in the abdomen, a stone there can feel like upper abdominal pain under the ribs or back pain.
The pain is usually sharp and comes with cloudy or bloody urine, fever or chills, and burning while urinating, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
How to treat it: You may be able to pass a small kidney stone on your own without treatment; drinking plenty of fluids can encourage it to move along. If the stone is difficult to pass, you may need to have it removed or have it broken into smaller pieces so it can pass more easily.
Can You Treat Pain Below Your Left Rib Cage?
There’s no one-size-fits-all way to manage left upper quadrant pain. “Treatment depends on the cause of the pain,” Blank says. If you’re not sure what the underlying issue might be, make an appointment to discuss your symptoms with your doctor.
If you suspect your discomfort stems from an injury, you can start by resting, applying ice to the affected area, and taking an over-the-counter pain reliever like acetaminophen or ibuprofen, according to the National Library of Medicine.
When Should You Worry About Pain Under Your Left Rib?
Pain around the left rib cage isn’t always cause for concern, and sometimes the problem will clear up on its own. But in other cases, the discomfort could be a sign of a serious problem.
According to Blank, you should contact your doctor for upper left abdominal pain if:
- The pain occurred after trauma or an injury
- The pain is severe and hasn’t gotten better after 24 to 48 hours
- The pain is accompanied by other concerning symptoms like a fever, vomiting, shortness of breath, a rash, or a mass that you can feel with your fingers
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