Upper Left Abdominal Pain: Causes and Warning Signs

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Upper Left Abdominal Pain: Causes and Warning Signs

By Your Health Magazine Health Information Team

Upper left abdominal pain can come from the stomach, pancreas, spleen, left kidney, colon, abdominal muscles, ribs, or even the heart or lungs. Common explanations include gas, indigestion, constipation, acid reflux, and muscle strain. However, sudden or severe pain—especially with chest discomfort, trouble breathing, fainting, fever, persistent vomiting, bleeding, or a recent injury—needs prompt medical evaluation.

What Is Located in the Upper Left Abdomen?

The upper left abdomen is the area beneath the left side of the rib cage and above the belly button. It contains parts of several organs, including:

• The stomach
• The spleen
• The pancreas
• The left kidney
• Parts of the small intestine and colon

Pain in this area does not always originate in an abdominal organ. Problems involving the abdominal wall, ribs, lower left lung, or heart can also be felt there. Because many structures are close together, the location alone cannot identify the cause.

Common Causes of Upper Left Abdominal Pain

Gas, Constipation, and Digestive Movement

Trapped gas near the bend of the colon under the left rib cage can cause sharp, cramping, or pressure-like left upper abdominal pain. Constipation may produce similar discomfort along with bloating or fewer bowel movements. Digestive movement can also cause noticeable noises; learn more about what may cause a rumbling sensation on the left side of the stomach.

Indigestion, GERD, Gastritis, and Ulcers

Indigestion can cause upper abdominal burning, discomfort, bloating, belching, or early fullness. Gastroesophageal reflux disease, or GERD, more often causes heartburn behind the breastbone, but some people describe discomfort in the upper stomach area.

Inflammation of the stomach lining and peptic ulcers can also produce pain at the top of the stomach. Warning signs of gastrointestinal bleeding include vomit containing blood or material resembling coffee grounds and black, tarry stools.

Pancreas, Spleen, and Kidney Causes

Pancreatitis is an important cause of severe upper abdominal pain. The pain may begin suddenly or gradually, spread to the back, and become constant. Nausea, vomiting, fever, a fast heartbeat, or a swollen and tender abdomen may occur. The National Institute of Diabetes and Digestive and Kidney Diseases advises immediate medical evaluation for symptoms of acute pancreatitis.

The spleen sits beneath the left ribs. An enlarged spleen may cause pain or a sense of fullness, while an injured spleen can bleed internally. Severe pain after a fall, collision, sports injury, or blow to the abdomen is an emergency, particularly if it occurs with dizziness, fainting, weakness, or pain near the left shoulder.

A left kidney stone can cause intense pain in the side or back that may travel toward the lower abdomen or groin. Kidney infection is more likely when pain occurs with fever, chills, nausea, urinary burning, or frequent urination.

Could Pain in the Upper Left Abdomen Be Heart-Related?

Yes. Heart-related discomfort is not always limited to the chest. A heart attack may cause pain or pressure in the chest or upper abdomen, as well as discomfort in the arms, back, shoulders, neck, or jaw. Other possible symptoms include shortness of breath, sweating, nausea, unusual fatigue, dizziness, or a rapid or irregular heartbeat.

Call 911 if upper abdominal discomfort occurs with possible heart attack symptoms, even if the discomfort is mild or resembles indigestion. Do not drive yourself to the hospital.

When to Seek Care

Call 911 or obtain emergency help immediately if the pain:

• Is sudden, sharp, severe, or rapidly worsening
• Occurs with chest pressure, shortness of breath, sweating, fainting, confusion, or pain in the arm, jaw, back, neck, or shoulder
• Develops after an abdominal or rib injury
• Occurs with vomiting blood, bloody stool, or black, tarry stool
• Is accompanied by a rigid, swollen, or extremely tender abdomen
• Occurs with repeated vomiting and an inability to pass stool or gas

Contact a healthcare professional promptly if:

• The pain persists for more than 24 to 48 hours, returns repeatedly, or continues to worsen
• You have fever, chills, persistent vomiting, jaundice, or unexplained weight loss
• You notice blood in the urine, painful urination, or difficulty urinating
• The pain regularly occurs after meals or wakes you at night
• You are pregnant, could be pregnant, or have a weakened immune system

General warning signs for abdominal pain are also outlined in the MedlinePlus abdominal pain guidance.

What to Do for Mild, Short-Lived Pain

If the discomfort is mild and there are no warning signs, note when it started, whether it is related to food or activity, and whether bowel movements change it. Rest, drink fluids, and avoid alcohol or foods that clearly worsen symptoms. If the area became sore after lifting or exercise, temporarily avoiding the triggering activity may help.

Do not assume recurring pain is “just gas,” and avoid repeatedly masking unexplained symptoms with medication. A primary care clinician can evaluate persistent pain and may recommend blood or urine testing, imaging, or referral to a gastroenterologist or another specialist based on the accompanying symptoms.