Lower Left and Right Abdominal Pain

What causes lower left and right abdominal pain? Did you know that many physicians refer to the abdomen as the ‘magic box’?  That is because abdominal pain is difficult to diagnose. It could be pain in your lower abdomen. Or it could be more specific. Often the only way to correctly diagnose abdominal pain is with clinical test results, and sometimes during an operation, known as an intra-operative diagnosis.

To help clarify where abdominal pain is happening, health care practitioners divide the abdomen into either 9 parts or 4 quadrants with imaginary lines. That helps them to communicate with each other about the pain and to minimize the difficulty in diagnosis.  Is the pain in the lower right abdomen or the lower left abdomen? Those are good questions to help with the diagnosis of the pain. Identify where it is.

There are many  causes of lower left and right abdominal pain. Each can have various factors linked and influence the selection of the best treatment plan.

Lower Left and Right Abdominal Pain

Any discomfort or pain that occurs in the abdomen below the naval or the umbilicus is referred to as lower abdominal pain or suprapubic pain. Many different medical conditions can cause this pain in your lower abdomen. Pay attention to it.

Women often have lower abdominal pain because these organs are located there:

  • urine bladder,
  • womb or uterus,
  • upper part of vagina,
  • upper cervix and
  • fallopian tubes.

Lower Left and Right Abdominal Pain during Pregnancy

Sometimes a lower abdominal pain during pregnancy is specifically linked to the pregnancy.  Others are not.  Some  conditions leading to lower left and right abdominal pain in pregnant women are:

  • Acute appendicitis
  • Gallbladder disease like cholecystitis or biliary colic
  • Infection in the urinary tract
  • Duodenal ulcer
  • Miscarriage
  • Constipation
  • Braxton hicks contraction- painful contractions that resemble labor[4]
  • Polyhydramnios – excessive amniotic fluid in the womb.[5]

Any pain in the abdomen during pregnancy can be temporarily relieved using certain antibiotics that are proven safe for pregnant women.

Abdominal Quadrants Pictures – The ‘Magic Box’

Picture 1 : Lower left and right abdominal quadrants (highlighted)

Picture 2 : Lower left and right abdominal quadrants with abdominal organs (highlighted)

Source : wikimedia.org

Picture 3 : Lower right and left abdominal pain area (highlighted)

source : drshailja.com

Causes of Lower Left and Right Abdominal Pain

The various causes of lower left and right abdominal pain include the following:

  • Appendicitis
  • Constipation
  • IBS
  • Infection in the urinary tract
  • Diverticulitis
  • Ectopic pregnancy
  • Menstrual pain
  • Cystitis
  • Lower ureteric stones
  • Polycystic ovarian syndrome
  • Fibroids
  • Endometrosis
  • Intestinal gas
  • Celiac disease
  • Crohn’s disease an inflammatory condition of the intestines or bowels. [6]
  • Bowel cancer
  • Cancer of the womb or fallopian tubes
  • Pelvic pain syndrome
  • Bowel polyps

Because there are so many possible causes of lower abdominal pain, it helps to name where the pain is the found in the ‘magic box’.  The patient can then describe lower left abdominal pain or lower right abdominal pain.

The symptoms of lower left and right abdominal pain including the location and other signs are carefully noticed to identify the specific medical disorder causing the pain.

Lower Left Abdominal Pain

Abdominal pain in the lower left side is more commonly noticed than in the right side. The various organs and structures present in the lower left abdomen include:

  • Left ureter
  • Left kidney’s lower end
  • Sigmoid colon
  • Left ovary and fallopian tube
  • Some part of urinary bladder and the descending bowel (large).
  • Blood vessels, nerves, muscles and skin covering the left abdominal wall.

Any disease or disorder in these structures or organs can generate lower left abdominal pain.

Causes of Lower Left Abdominal Pain

Some of the common medical disorders that lead to lower left abdominal pain are:

  • Bowel cancer diagnosed in the left side of bowel.
  • A swollen aorta resulting in ruptured or leaking abdominal aneurysm.
  • Trapped wind.
  • Any type of blockage in the bowel leads to abdominal pain.
  • Constipation, both acute and chronic, leads to lower abdominal pain. A pain felt on the lower left side of abdomen indicates that the bowel is affected more on the left side
  • Transverse colon volvulus (twisting) or Sigmoid volvulus.
  • Crohn’s Disease.
  • Diverticulitis is another common cause of pain in the lower left abdomen.[7]
  • Food poisoning could lead to burning lower abdominal pain in 1-48 hrs following a meal involving contaminated food.
  • Hernia — A  part of the bowel pouching out though an irregular abdominal wall opening can cause a hernia.
  • An irritable bowel (IBS) is a common cause of  irritable bowel syndrome, one of the most common causes of lower left abdominal pain.
  • Endometriosis results from presence of a womb tissue on the external side of womb. It causes left abdominal pain if the left tube or ovary is affected.[8]
  • Lower abdominal pain during pregnancy is usually caused due to ectopic pregnancy.
  • Kidney stones and kidney infections.
  • Other conditions that lead to lower back and abdominal pains include ovarian cyst, psoas abscess, rectus sheath hematoma and in rare cases, Henoch-Schonlein purpura.

Lower Right Abdominal Pain

An acute or chronic pain in the lower right quadrant of the abdomen is defined as lower right abdominal pain. This pain often spreads to the left or backwards not necessarily being confined to the lower right abdomen. The various organs or structures found in the lower right abdomen are:

  • Appendix
  • Caecum
  • Ascending colon (large bowel’s first part)
  • Right kidney’s lower part
  • Right ovary and fallopian tube
  • Right part of womb
  • Lower part of liver
  • Small intestines
  • Blood vessels, nerves, muscles, skin.

Any disorders or illnesses linked to these organs or structures usually result in pain the lower right abdomen

Lower Right Abdominal Pain Causes

The most common cause of lower right abdominal pain is appendicitis. Starting as a dull pain, it later develops into severe abdominal pain on the lower right side. Other conditions include:

  • Constipation
  • Bowel Cancer
  • Kidneys stones or stones in ureters on the right side.
  • Ectopic pregnancy.
  • Bowel telescoping on itself leads to condition similar to bowel obstruction. This is usually found in children.
  • Endometriosis causes pain on the right side if the right tube or ovary is affected.
  • A ruptured ovarian cyst on the right side creates  sudden severe pain on the lower right side of abdomen.
  • Ulcerative colitis

Numerous other medical conditions lead to lower right abdominal pain including:

  • lymphoma,
  • diverticulitis (very rare),
  • right sided hernia,
  • merkels diverticulum,
  • mesenteric lymphadenitis,
  • psoas abscess,
  • pelvic inflammatory disease
  • salpingitis,
  • trapped wind,
  • ureteric stone,
  • caecum volvolus,
  • sickle cell disease,
  • twisted ovarian cyst (similar to ruptured ovarian cyst) and
  • torsion of testis.

Treatment for Lower Abdominal Pain

As you can easily see, there are many reasons for lower abdominal pain. This is why it is difficult to diagnose the exact cause of the pain. A complete medical history and examination of the patient  is necessary before treating that condition.

Sometimes, painkillers may be prescribed until the correct diagnosis is determined. However this can lead to complications in some cases. Any other medicines available for abdominal pain relief are meant for the symptoms noticed. Any abdominal pain needs the root-cause to be eliminated.

Some of the common medications that provide temporary relief and are used in combination with other drugs include paracetamol, diclofenac, tramadol, cocodamol, codydramol, codeine phosphate, and pethidine or morphine injections.

References:

  1. http://www.medicinenet.com/abdominal_pain/article.htm
  2. http://www.healthline.com/symptomsearch?addterm=Lower%20Abdominal%20Pain
  3. http://en.wikipedia.org/wiki/Abdominal_pain
  4. http://www.mayoclinic.com/health/signs-of-labor/PR00083/NSECTIONGROUP=2
  5. http://www.mayoclinic.com/health/polyhydramnios/DS01156
  6. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/
  7. http://digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/
  8. http://www.emedicinehealth.com/endometriosis/article_em.htm



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