Pain in the left side is observed with constipation, IBS, inflammatory (sigmoiditis, UC, diverticulitis) and neoplastic diseases of the intestine. Pain in the left flank and iliac region is characteristic of intestinal infections, chronic pancreatitis, hernias. Women are worried about pain in pathologies of the genital organs. To diagnose the causes of pain, laboratory, radiological, endoscopic and ultrasound methods are prescribed. Therapeutic measures include diet selection, probiotics and enzymes, laxatives, NSAIDs and antispasmodics. In complicated forms of gastroenterological diseases, surgical intervention is performed.
The left side often hurts after physical exertion. During intense exercise, blood rushes to the abdominal cavity, in particular to the spleen. This explains the characteristic stabbing sensations in the side, which disappear after 5-1 minutes of rest. The next day after training, abdominal pain on the left is possible due to tension in the abdominal muscles. Soreness is aggravated by getting out of bed, turning the body to the left, laughing and straining.
Soreness in the left iliac region occurs when there is no bowel movement for 2-3 days or longer. A person complains of a feeling of fullness and dull pain in the lower abdomen on the left. Periodically there are urges to defecate, in which soreness intensifies, excruciating spasms are observed. The intensity of pain depends on the duration of constipation. Patients report the need for strong straining at the time of defecation, burning in the rectum during the passage of dry feces.
IBS is the most typical pathological cause of pain in the left side. In this disease, pain sensations of various nature are noted: dull, aching, acute, constant or cramping. The most intense pain syndrome occurs in the morning after waking up, it is accompanied by excruciating tenesmus. After a bowel movement, the pain decreases or completely disappears.
In some cases, to improve the condition, a person needs to visit the toilet several times in the morning, because after a single bowel movement there is a feeling of incomplete emptying of the intestine. During the day, pain in the left abdomen can be disturbing, but they are of lesser intensity. IBS sufferers do not have night pains that interfere with sleep. Typically, the pain syndrome increases with psycho-emotional overstrain, in women - before and during menstruation.
With inflammation of the sigmoid colon, patients experience severe paroxysmal pain in the left side, which usually radiates to the lower back, perineum and thigh. The symptom is accompanied by painful false urge to defecate, loose, fetid stools with impurities of mucus and blood. In acute sigmoiditis, such signs are observed constantly, and in chronic pain they are provoked by errors in the diet, physical or mental overstrain.
Diverticula of the large intestine are manifested by moderate pain in the left side of the abdomen, which intensifies before the start of a bowel movement and disappears after a bowel movement. The intensity of pain increases if there is no stool for 3 or more days. Less commonly, there is paroxysmal pain that lasts for several hours. In addition to the pain syndrome, patients are concerned about the instability of the stool - the alternation of constipation and diarrhea.
NUC is characterized by severe spastic pain on the left above the ilium. With the spread of the pathological process to the descending colon, pain is felt throughout the left side. The pain syndrome is accompanied by constant diarrhea, the stool contains a large amount of blood, mucus. In the period of remission, there are aching pains and discomfort in the abdominal cavity on the left. With NUC, appetite disappears, weight decreases, painful tenesmus is possible.
The defeat of the pancreas is characterized by mild aching pain in the left side. Soreness worries a person constantly, increases when eating large portions of food, eating fatty or fried foods. Sometimes severe paroxysmal pain develops, which lasts from several minutes to several hours. Pain in the chronic form of pancreatitis is combined with stool instability, flatulence, and rumbling in the abdomen.
Cramping pains in the side on the left are found in infectious processes that occur with colitis syndrome - dysentery, amoebiasis, some forms of escherichiosis and salmonellosis. Severe cramps begin 12 to 48 hours after ingestion of contaminated food or water. They are accompanied by painful tenesmus, diarrhea up to 10-2 times per day. During defecation, feces with blood, mucus are excreted, there is a stool of the “rectal spit” type.
With benign intestinal polyps, dull pains are observed in the left side without a clear localization. The symptom is not associated with eating and defecation. Increased soreness occurs as the polyps increase in size, which creates obstacles for the movement of feces. A person feels a strong bursting in the flank or iliac region on the left. There are chronic constipation, to excrete feces, patients strain or help themselves with their hands.
Discomfort in the left side is a sign of cancer of the sigmoid or descending colon. With the growth of the tumor, severe abdominal pains appear, which are constantly present, do not depend on external provoking factors. Against the background of the pain syndrome, alternation of constipation with diarrhea develops, traces of fresh blood are found in the feces. Intolerable pains in the left side indicate the decay or ulceration of the tumor, its germination in neighboring organs.
Soreness in the lower abdomen is possible with a left-sided inguinal hernia. During the formation of a hernial protrusion, a dull pain occurs, which is aggravated by straining, physical activity, and torso tilts. With large hernias, irreducible or strangulated hernias, patients complain of severe pain. More rare causes are a hernia of the Spigelian line on the left, postoperative hernia.
The appearance of pain in the left side in women is often caused by pathologies of the internal reproductive organs. Soreness is of a different nature, taking into account the degree of activity of the process and the depth of tissue damage. Gynecological pain in the abdomen is characterized by an increase in 2-3 days before menstruation, irradiation to the pubic region and perineum, dyspareunia (painful sexual intercourse). Most often, pain in the lower abdomen on the left occurs with left-sided adnexitis, endometriosis, ectopic pregnancy.
Боли в левом боку наблюдаются при обострении мочекаменной болезни — левосторонней почечной колике. Беспокоят мучительные постоянные или приступообразные болевые ощущения, которые иррадиируют по ходу мочеточника к низу живота и промежности. Больные мечутся по кровати или комнате, пытаясь найти положение, в котором боли будут не такими интенсивными. Симптом сопровождается повышением температуры, задержкой мочи.
Pain on the left in the iliac zone occurs with dysbacteriosis (dysbiosis) caused by the use of antibiotics. Patients complain of constant discomfort in the abdomen, cramps in the left side, aggravated after eating and before defecation. When emptying the intestines, a greenish feces with a fetid odor is released, the stool becomes more frequent up to 3-7 times a day. Characteristic signs of dysbiosis: flatulence and rumbling in the intestines, malabsorption syndrome, lack of appetite.
During the examination, the gastroenterologist draws attention to the exact localization of pain, identified by palpation of the abdomen, evaluates the symptoms of peritoneal irritation. Valuable information can be obtained from a digital examination of the rectum, a standard gynecological examination. To confirm the diagnosis, a complex of laboratory and instrumental examination methods is prescribed, which includes:
Palpation of the left iliac region
With colic in the side that occurs during training, no treatment is required. It is recommended to temporarily limit physical activity until the discomfort disappears. To get rid of left-sided pain caused by constipation, you need to add fresh or baked vegetables and fruits, sour-milk products, black bread to the diet. These products stimulate intestinal motility.
To reduce pain caused by emotional upheavals (for example, with IBS), it is important to minimize stressful situations, if necessary, visit a psychologist. Severe pain in the left side indicates severe gastroenterological or gynecological diseases, so self-medication in this case is unacceptable. The combination of a pain attack with a sharp deterioration in the condition is an indication for emergency medical care.
Treatment is selected after establishing the cause of pain in the side. With a strong pain syndrome, anesthesia comes to the fore - non-narcotic and narcotic analgesics, antispasmodics, local anesthetics in the form of blockades are used. To eliminate pain, it is necessary to act on the cause of their appearance, so therapy includes the following drugs:
For gynecological pain, preparations of female sex hormones are used. For pain that occurs due to neurological disorders, sedative herbal preparations, mild sleeping pills are indicated. Physiotherapeutic methods are prescribed: electrosleep, neurosedative massage, reflexology. Patients are advised to undergo a course of psychotherapy.
Surgical interventions are performed with complicated diverticulitis, ineffectiveness of conservative treatment of ulcerative colitis. An absolute indication for surgical treatment are malignant tumors of the intestine. The scope of the operation is determined by the nature and severity of the pathology. A segmental resection of the colon is performed, an extended resection with the formation of an ileorectal anastomosis or a colostomy.