Upper abdominal pain on the left


The left upper abdomen connects directly to the left costal arch and runs roughly up to the navel. Any kind of pain that occurs in this area can be described as left upper abdominal pain.
The Type of pain can vary greatly depending on the underlying cause and is therefore an important indicator of which disease could be the cause of the symptoms. The pain can be from under the abdominal wall Organs such as the stomach, intestines, or spleen, as well as emanating from other regions of the body radiate into the left abdomen.

General information about upper abdominal pain can be found here: Upper abdominal pain


In medicine, the abdomen is divided into four quadrants, with a vertical and a horizontal line drawn through the umbilical region. The upper abdomen is thus divided into the right and left upper abdomen. Often the epigastric region (Epigastrium), in the middle upper abdomen, considered separately. It should be noted that the localization of the pain cannot always be used to determine the cause, as in some diseases the pain radiates and each patient perceives pain differently.

An overview of pain on the left can be found at: Pain on the left side of the body


Upper left abdominal pain can be various causes to have. You will usually go through organs adjacent to this area caused. Accordingly, the cause of these complaints often lies in the stomach, for example caused by a Irritable stomach syndrome, one Inflammation of the stomach lining (gastritis), a Ulcer of the stomach lining (Ulcer) or a malignant degeneration of the gastric mucosa Gastric cancer.

It closes directly on the stomach Duodenum (Duodenum) on. You can also use a bacterial infection with the bacterium Helicobacter pylori or secondary to gastric mucosal inflammation with increased gastric acid production Ulcers arise. These can also cause left upper abdominal pain.
With inflammation of small sacs in the intestinal wall, usually in the Large intestine, one speaks of a Diverticulitis. This typically causes left abdominal pain.
Also the esophagus, which also connects directly to the stomach, can with inflammation or malicious change cause left upper abdominal pain.

Another organ that can be the source of the symptoms is the pancreas (pancreas). If you have inflammation of the pancreas (Pancreatitis), belt-shaped pain typically occurs, which can radiate from the upper abdomen to the back. Pancreatic cancer can also cause left upper abdominal pain.

The spleen is also on the left half of the body, but more towards the back. If you are e.g. Increased greatly due to infection, it can cause left pain due to pressure on the surrounding tissue.
Please also read our topic: Swollen spleen

In the case of very severe left upper abdominal pain, which may also radiate into the left shoulder, a splenic infarction must also be considered. The occlusion of blood vessels leads to an undersupply of the spleen tissue and consequently to its death, which is noticeable in severe pain. A spleen abscess is also an option for the symptoms. The spleen can also rupture when subjected to force or when the capsule is too tight and bleed in. This may also occur left upper abdominal pain.

If, in addition to the symptoms, the abdomen is very tense and very tender on pressure, it could also be peritonitis (Peritonitis) act.

Last but not least, a heart attack must always be considered in the case of upper abdominal complaints. A heart attack in women in particular often manifests itself through atypical symptoms, often also through pain radiating into the upper abdomen. The same applies to inflammation of the pericardium (Pericarditis). Since the heart is in the left rib cage, the pain can also preferentially spread to the left half of the body.

In principle, the upper abdominal pain can also come from the main body artery (aorta) if an aneurysm, i.e. a bulging of the vessel wall, develops in it. Typical are pain that begins in the back and then, among other things, radiate into the upper abdomen. If it is a so-called dissecting aortic aneurysm, the symptoms can also migrate, as the vessel wall continues to split open. The pain moves along with it according to the level of splitting.

The shingles (Herpes zoster), a viral disease triggered by the chickenpox virus, also often causes discomfort in the upper abdomen, with a characteristic skin rash with red, itchy blisters. This rash runs the length of a nerve and is usually only on one side of the body. This clinical picture can be accompanied by severe pain and burning. Typically, the nerve pain occurs 2-3 days before the rash.

Many diseases can present themselves in different ways in the patient. In some cases, diseases that are actually attributable to the chest area can also cause upper abdominal pain.
Examples of this are pleurisy, pneumonia, the aforementioned heart attack and pneumothorax.
With a pneumothorax, air enters the space between the lungs and pleura, causing the lungs to collapse. The air often comes from burst vesicles of emphysema on the surface of the lungs, but it can also get into the space through direct force on the chest with damage to the pleura (trauma, knife stab, etc.).
In principle, urological and gynecological diseases that primarily manifest themselves in the lower abdomen can also radiate into the upper abdomen and should be considered in differential diagnosis.

Aortic aneurysm as a possible cause

  • Extension or Bulging the abdominal artery

  • Noticeable pulsation in the abdomen, more acute in the case of a tear Stomach ache from blood in the abdomen

  • Diagnosis by ultrasound examination of the abdomen

  • therapy: If the diameter is small, you can first wait and check closely; If the bulge is very large, it should be operated on immediately

  • Complications: Tear of the artery with strong Blood loss

Read more about this: Aortic aneurysm

Spleen diseases (e.g. ruptured spleen) as a possible cause

  • Tear of the spleen capsule e.g. from an accident or blow in the left abdomen

  • Strongest, sudden pain, mainly at the To breathe are very strong (sometimes the pain only occurs a few days after the injury)

  • Diagnosis through Ultrasound examination and CT of the abdomen

  • therapy: immediate surgery (usually the spleen has to be removed)

  • Complications: excessive blood loss, complications from the operation

Read more about this: Tear of the spleen capsule

Types of left side epigastric pain

Upper abdominal pain on the left with flatulence

Generally all diseases of the gastrointestinal tract can Flatulence cause.
Her left upper abdominal pain Often originates in the stomach are typical clinical pictures of Irritable stomach, Food intolerance, such as infectious gastrointestinal diseases. In all of these clinical pictures, left upper abdominal pain with flatulence can occur.

Of the Irritable stomach Has no previously known organic cause and is mostly due to psychological stress and stressful situations conditionally. Affected suffer from recurring stomach problems, the often with heartburn, Bloating and also Flatulence accompanied. Symptoms usually last longer than four weeks on.

At Intolerance to certain foods or food components left upper abdominal pain can also occur.
E.g. at a Fructose- or lactose intolerance (Fructose / lactose intolerance). The types of sugar can be due to one Deficiency of enzymes in the intestine cannot be further reduced and require a increased bowel movement with increased fluid influx in the intestines. This allows it to Diarrhea come. The Sugar residues are increasingly broken down by bacteria, in which Gases arisewhich are then in the form of Flatulence can go off.
Another intolerance reaction is that Gluten intolerance, also Celiac Disease or Sprue called. In this clinical picture, gluten, which occurs in many types of grain, is the trigger for the symptoms. The clinical picture is similar to that of lactose and fructose intolerance.

Infectious gastrointestinal diseases can also manifest in left upper abdominal pain with flatulence. The increased germ count in the gastrointestinal tract favors the Formation of gasesthat come off the intestines in the form of gas.

Also a general one unbalanced diet with a high-fat diet can cause gastrointestinal problems, which are accompanied by the corresponding symptoms.

You might also be interested in this topic: Upper abdominal pain and gas

Upper abdominal pain on the left with nausea

Upper left abdominal pain associated with nausea go along, let in first Problem of the stomach think.
A harmless cause can e.g. a Meal that is too lush, too high in fat or too much sugar be.
Nausea occurs as well often in infectious gastrointestinal diseases on.
Differential diagnostic should always clarified a heart attack become. In women in particular, this often manifests itself in atypical symptoms, e.g. Upper abdominal pain, back pain, nausea and vomiting.
Typical diseases of the stomach, such as one chronic inflammation of the gastric mucosa or a Gastric ulcer (Ulcus), can also cause such symptoms.

In general, a stomachache is a must urological disease be thought.
Ureteral stones can severe stomach and back pain, such as violent onset of nausea with vomiting cause. Typically these are One-sided pain, depending on which ureter is affected, and start at the level of the navel downwards and on the flanks. However, they can also radiate into the upper abdomen.

In addition, a Irritable stomach syndrome Nausea associated with left upper abdominal pain trigger. Those affected suffer from recurring stomach problems, which can also be accompanied by severe nausea.

Also one Inflammation of the pancreas (Pancreatitis) cause a corresponding symptom with left upper abdominal pain and nausea, with the upper abdominal pain usually associated with this disease belt-shaped up to the back radiate.

There is also a early pregnancy with many women Nausea and abdominal pain manifested, this possible cause should not be forgotten either.

Also read our topic: Abdominal pain and nausea

Upper abdominal pain on the left under the costal arch

If the pain is just below the costal arch, there can be several causes. The is located directly under the left costal arch spleen. Diseases of this organ can therefore be associated with the symptoms described.
However, it can also be the Stitch known phenomenon, which has its origin in diaphragm has, which is also located approximately at the level of the costal arch.

Flatulence or Diseases of the intestine can be responsible for the pain under the left costal arch, depending on the location of the intestinal loops and the large intestine. Infectious diseases like that Shingles also often show up under the costal arch.
Also Diseases of the ribs themselves can be felt as pain under the costal arch. The same applies to complaints made on move arise and show through the nerves running there on the left upper abdomen under the costal arch.

Upper abdominal pain on the left after eating

There may also be nausea and vomiting

Left upper abdominal pain, the especially after eating occur can be triggered by various factors.
A typical clinical picture that is associated with these symptoms is Inflammation of the stomach lining (gastritis). This can be either autoimmune, bacterial or chemical, i.e. for example, medication or other pollutants. When the patient has eaten, the discomfort increases mostly better at first, however, then return very violently shortly afterwards.

At a Ulcer of the stomach lining (Ulcer), however, it usually occurs Increasing upper abdominal pain directly when eating.
At a Ulcer of the duodenum can also Meal-related complaints occur, but they will Immediately after eating better at first and only return after about 2-3 hours. They often also occur at night (see: Upper abdominal pain at night).

Upper abdominal pain after eating can also result from the aforementioned mucosal lesions Food intolerance be evoked. Affected people often suffer from after eating foods that contain certain food components cramping abdominal pain, nausea, Bloating, Flatulence and sometimes too diarrhea and Vomit.

Same goes for that Irritable stomach and irritable bowel syndrome. Affected people often suffer from diarrhea, nausea and Vomit, such as Flatulence and Abdominal cramps. Since they are often very sensitive to high-fat foods and then especially after eating suffer from the symptoms mentioned, you should avoid them and yourself Eating a balanced and healthy diet. It is also important that these patients allow themselves enough time to eat, otherwise the symptoms can worsen sharply after the meal.

Upper left abdominal pain in pregnancy

Kick in some women as part of her pregnancy left upper abdominal pain on. Most of them have one harmless cause and will e.g. conditioned by the growing child, which increasingly requires space and pushes the surrounding organs to the side. This is how it comes to increasing tension in the abdomen and the abdominal wall is stretched more. This can cause the upper abdominal pain.

also the increased pressure in the abdominal cavity is beneficial heartburn, because the pressure can push the stomach acid up the esophagus. This can also result Upper abdominal pain and a burning sensation behind the breastbone express.

Learn more about the topic: Heartburn during pregnancy

A serious complication of pregnancy that can be accompanied by upper abdominal pain is this HELLP syndrome. This usually occurs towards the end of pregnancy and is characterized by strengthen high blood pressure, Protein in the urine, liver dysfunction and many other unspecific symptoms (e.g. headache, nausea). The Upper abdominal pain usually arise from a Enlargement of the liver and begin on the right, but can also radiate into the left upper abdomen. The HELLP syndrome can life-threatening for mother and child be.

Another cause of left upper abdominal pain during pregnancy can be the so-called Hyperemesis gravidarum, or also Pregnancy sickness be. Here it comes to Upper abdominal pain with nausea and Vomit. The pregnancy sickness occurs especially In the first third pregnancy.

Left upper abdominal pain during pregnancy can of course also be attributed to causes that can cause these symptoms regardless of pregnancy (gastric mucosal inflammation, pancreatitis, splenic infarction, etc.).

Read more about this: Upper abdominal pain during pregnancy

Left-sided abdominal pain illustration

Illustration of the left abdominal cavity
  1. Heart - Cor
  2. Liver - Hepar
  3. Spleen - Sink
  4. Stomach - Guest
  5. Pancreas -
  6. Colon -
    Intestine tenue
  7. Small intestine -
    Intestinum crassum
  8. Fallopian tubes -
    Tuba uterina
  9. Ovary -
  10. Uterus -

You can find an overview of all Dr-Gumpert images at: medical illustrations


To find out the underlying cause, which is responsible for the symptoms, a doctor should be consulted. This is especially true when the pain have existed for a long time or very strong are. With the help of diagnostic methods, he can determine the causative disease and initiate suitable therapy.
Besides the detailed anamnesis as well as one physical exam, in which both the intestinal noises are listened to and the abdomen is felt, are frequent imaging methods for use. Both with one Ultrasound machine as well as one MRI scan of the abdomen the internal structures can be assessed well and any existing problems can be identified quickly.

Upper abdominal pain on the left in the child

There are many different causes of pain in the left costal arch in children. Pain in children is often much more unspecific than in adults. Depending on the age of the child different causes occur with different probability. It is especially important to look at the child's body other symptoms to investigate. Here, there are often indications that allow a conclusion about the cause of the pain.

Left-sided upper abdominal pain in children is in most cases caused by a infectious bowel disease or indigestion caused.
The so-called hypertrophic Pyloric stenosis is another one for that Infancy typical disease that can cause pain in the left upper abdomen.
Between the ages of 2 months and three years can the Intussusception of loops of intestine lead to severe upper abdominal pain.
Since certain metabolic and kidney diseases are first diagnosed in childhood, should also Urinary tract diseases should be considered as the cause of the pain that occurs.

Severe and long-lasting pain in the left upper abdomen should always be examined by a pediatrician in order to rule out serious clinical pictures or, if necessary, to initiate suitable therapy.

For more information, see: Abdominal pain in children