Severe Left Upper Abdominal Pain: Possible Causes and Insights

Left upper abdominal pain

Hello, doctor! I have been experiencing severe pain in the left upper abdomen, around the rib area, possibly between the third and fourth ribs.
The pain is located at the midpoint between the ribs on both sides, approximately 4 to 5 centimeters to the left.
It is an intense pain that makes it difficult to breathe, to the point where I feel like I can't endure it.
This is the third occurrence of this situation.
The first time was many years ago when I experienced continuous pain for about two days.
I was afraid to breathe deeply because even a gentle breath caused significant pain.
I would wake up in pain after falling asleep, and no medication seemed to help; I just had to endure it for two days until it suddenly resolved on its own, which left a lasting impression on me.
After that, many years passed without any similar experiences until around November of last year when I had a severe chest pain.
Since the pain was in the area of my heart, I endured it for two days without relief and instinctively felt something was wrong, so I went to the emergency room.
However, the examination results indicated that there was no issue, and it was suggested that the pain might have been caused by nerves in the thoracic cavity being pulled due to previous vomiting.
After that incident, everything was fine until around March or April of this year when I suddenly experienced that same intense pain again, which lasted for almost a week.
Eventually, the pain began to subside, but then it shifted to the corresponding area on the right side, although it was less intense.
However, I still felt pain with deep breaths or even slight movements, and then it suddenly disappeared, returning to normal.
Three days ago, I unexpectedly started experiencing abnormal peristalsis in my abdomen, and I had diarrhea three times in one night, which is very unusual for me since I have a history of constipation.
Since then, I have noticed continuous peristalsis and excessive gas, especially after eating, which has become more frequent.
I also started experiencing burping, and the gas has an unusually foul odor.
This has persisted for three days, and today the pain in my left upper abdomen has returned, seemingly increasing in intensity.
I tried taking muscle relaxants and painkillers, but they did not provide relief; instead, the pain became more pronounced, causing me to cry out in agony.
Lying down to rest made me feel faint from the pain, so I had to sit up instead.
I then thought to try drinking hot tea, which provided slight relief, and using a heating pad also helped alleviate some discomfort.
Eventually, I was able to relax and fall asleep at the edge of my bed.
Upon waking, I still feel slight pain, and I am unsure how long this pain and diarrhea will last.
What I would like to ask you, doctor, based on your experience, what kind of condition do you think I might have? I have never seen a doctor about this before, so I have no idea what to expect.
I have avoided seeking medical attention mainly because I have had many experiences where I felt I had serious health issues, but each time I went to the doctor, the results indicated that there was no problem or only minor issues.
I really dislike the feeling of going to the hospital, which is why I have endured this.
However, I am now very curious about what might be happening, so I would appreciate your help in clarifying my concerns.
Thank you very much for your hard work and effort.
I sincerely appreciate it.

Ling Ling, 40~49 year old female. Ask Date: 2023/06/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

A chest X-ray can be performed to rule out any specific issues.
Other possibilities may include nerve or fascial inflammation, which can be treated with local heat application and analgesics.
For bowel movements, it is advisable to reduce oil and dairy intake, and if necessary, medications can be used for adjustment.
If there are concerns, a stool occult blood test can be conducted.

Reply Date: 2023/06/19

More Info

Severe left upper abdominal pain can be a concerning symptom, and there are several potential causes that could explain your situation. Given the complexity of abdominal pain and the variety of structures in that area, it is essential to consider a range of possibilities.

1. Gastrointestinal Issues: Conditions such as gastritis, peptic ulcers, or even pancreatitis can cause severe pain in the upper abdomen. The pancreas is located in the upper abdomen, and inflammation (acute or chronic pancreatitis) can lead to significant pain that may radiate to the back. Symptoms of pancreatitis often include nausea, vomiting, and sometimes diarrhea, which aligns with your recent experience of abnormal bowel movements.

2. Musculoskeletal Pain: Given that you have experienced this pain intermittently over the years, it could also be related to musculoskeletal issues. Strain or injury to the muscles or ribs in the area can cause sharp pain, especially with movement or deep breathing. This type of pain can often mimic more serious conditions but is typically less concerning.

3. Kidney Issues: The left kidney is located in the upper abdomen, and conditions such as kidney stones or infections can cause severe pain that may radiate to the abdomen. If you have a history of kidney stones, this could be a potential cause of your pain, especially if there are accompanying symptoms like changes in urination or flank pain.

4. Splenic Issues: The spleen is also located in the upper left abdomen, and conditions affecting the spleen, such as splenic infarction or enlargement, can lead to pain in that area. However, these conditions are less common and usually present with additional symptoms.

5. Referred Pain: Sometimes, pain in the abdomen can be referred from other areas, such as the heart or lungs. Given your history of chest pain, it’s essential to consider that some of your abdominal pain could be related to cardiac issues, especially if it is accompanied by other symptoms like shortness of breath or sweating.

6. Infection or Inflammation: Conditions such as diverticulitis, which involves inflammation of the diverticula in the colon, can also cause severe abdominal pain. This is often accompanied by changes in bowel habits, fever, and sometimes nausea.

Given the severity and persistence of your symptoms, it is crucial to seek medical attention. While it is understandable to feel hesitant about visiting the hospital due to previous experiences, the nature of your current symptoms—especially the severe pain and changes in bowel habits—warrants a thorough evaluation.
A healthcare provider may recommend imaging studies, such as an abdominal ultrasound or CT scan, to visualize the organs and structures in your abdomen. Blood tests may also be necessary to check for signs of infection, inflammation, or other abnormalities.

In the meantime, managing your pain with over-the-counter medications, staying hydrated, and avoiding foods that may exacerbate your symptoms can be helpful. However, these measures are not a substitute for professional medical evaluation and treatment.

In summary, while there are several potential causes for your severe left upper abdominal pain, it is essential to consult a healthcare professional for a proper diagnosis and treatment plan. Your health and well-being are paramount, and addressing these symptoms promptly is crucial.

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