Pain in the intestines on the right and left side of the lower abdomen can be caused by various reasons. This symptom is typical for people who have gastroenterological, gynecological and urological diseases. Pain in the intestines on the right and left side of the lower abdomen indicates pathologies in the pelvis. At the first complaint, the patient should contact a medical expert. At the private clinic “KDS Clinic”, specialists will conduct an initial examination, give advice and refer you for a diagnostic examination. We will help you determine the cause of the disease and select an individual treatment program.
Severe pain inside the abdomen is a clear sign of diseases that affect the large or small intestine. The process of spasms leads to the accumulation of lactic acid in the body, which irritates the nerve endings and causes pain.
Severe pain in the intestines is the result of poor nutrition, a side effect after taking medications, or an inflammatory process. Inflammatory processes in the intestines are accompanied by pain, nausea, bloating, colic and bad bowel movements.
1.General information
As you know, ribs are not only part of the musculoskeletal system, but also serve as mechanical protection for vital internal organs: heart, lungs, liver, gall bladder, etc. Therefore, any pain behind or under the ribs should alert you. If pain discomfort in the hypochondrium has become recurrent or chronic, you should definitely consult a doctor: there are simply no problems in this area that can be neglected. But it is, on the contrary, very easy to waste precious time and miss the development of a dangerous pathology, and this happens, unfortunately, all the time in clinical practice.
On the left under the ribs there are many potential sources of pain: individual parts of the intestines, stomach, spleen, pancreas. Heart pain often radiates to the left hypochondrium, but it would be wrong to assume that “any pain on the left is from the heart.” Possible causes are far from limited to cardiac problems.
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Causes of heaviness in the hypochondrium
Biliary dyskinesia
Heaviness under the ribs on the right is a typical manifestation of the hypokinetic-hypotonic variant of JP. An unpleasant sensation bothers a person constantly and intensifies 40-60 minutes after eating food. Patients experience a feeling of fullness in the stomach, mild aching pain in the right hypochondrium. If there are errors in the diet, belching and bitterness in the mouth appear. Heaviness in the hypochondrium decreases when following a low-fat diet, after taking choleretic drugs.
Hepatitis
Regardless of the etiological factor, with acute inflammation of the liver, overstretching of its capsule occurs, which is manifested by severity and moderate pain in the right hypochondrium. Symptoms are observed constantly, without any visible connection with a violation of the diet. The uncomfortable feeling intensifies when the body is tilted to the right, when palpating the projection area of the organ. Aching pain worsens with physical activity.
In addition to heaviness in the side, signs of dyspepsia are troubling: nausea and vomiting, poor appetite or lack thereof, unstable stool. Yellowness of the skin, mucous membranes, and sclera is often noticeable. The disease is accompanied by fever and asthenovegetative symptoms. This clinical picture is determined by different types of hepatitis: viral, autoimmune, alcoholic.
Cholecystitis
Violation of the outflow of bile provokes discomfort and heaviness in the area of the right hypochondrium, which intensifies half an hour to an hour after finishing a meal. Such symptoms are characteristic of the chronic course of inflammation of the gallbladder, mainly for its acalculous form. With calculous cholecystitis, in addition to heaviness in the hypochondrium, patients experience intense pain similar to biliary colic, which develops after eating fatty and heavy foods.
Heaviness in the hypochondrium
Parasitic infections
Heaviness in the projection of the right hypochondrium is noted with the invasion of helminths that affect the liver parenchyma. These include echinococcosis and alveococcosis. At the first stage, when the parasite invades the liver, patients feel slight discomfort and heaviness in the hypochondrium after a heavy meal. Dyspeptic disorders are not detected at this stage.
An enlarged hydatid cyst leads to increased symptoms. Patients complain of constant heaviness, bursting sensations, loss of appetite, nausea and vomiting. After finishing eating or exercising, there is a dull pain in the liver area. Diarrhea associated with disorders of bile formation and bile excretion occurs periodically. With a complicated course and rupture of the cyst, acute pain appears.
Liver neoplasms
Benign liver tumors are mild in severity with discomfort in the right abdomen. They grow slowly and do not interfere with digestion. Large cysts cause a feeling of fullness in the hypochondrium, which intensifies after eating. Liver cancer is characterized by early onset of dyspeptic disorders, lack of appetite, and sudden weight loss in patients. As the tumor grows, heaviness in the hypochondrium is replaced by constant dull pain.
Cardiac diseases
Right ventricular heart failure is accompanied by stagnation in the systemic circulation, which causes a feeling of fullness and heaviness in both hypochondriums. Patients notice an enlarged abdomen, difficulty bending the body, and rapid fatigue when walking. Symptoms may occur with more rare cardiac pathologies - mitral-tricuspid disease, tricuspid stenosis, post-pericardiotomy syndrome.
Spleen diseases
Heaviness in the left hypochondrium most often develops against the background of diseases of the spleen. In this case, the unpleasant symptoms are not associated with errors in nutrition, but intensify during bending and physical activity. Heaviness, moderate aching pain are manifestations of splenomegaly caused by infections (malaria, leishmaniasis, mononucleosis), hemoblastoses (leukemia, lymphogranulomatosis), autoimmune processes (SLE, periarteritis, vasculitis).
Rare causes
- Diseases of the respiratory system
: lower lobe pneumonia, exudative pleurisy. - Rare hepatobiliary pathologies
: liver peliosis, perihepatitis, amoebic liver abscess. - Vascular damage
: portal vein thrombosis, splenic vein thrombosis, Budd-Chiari syndrome. - Congenital diseases
: Crigler-Najjar syndrome, Gilbert's disease, hereditary anemias (microspherocytosis, thalassemia).
2. Reasons
The most common causes of pain in the left hypochondrium include:
- diseases of the stomach in their entire spectrum (from mild dyspepsia to peptic ulcer of the stomach and/or duodenum);
- enlargement (splenomegaly) or damage to the spleen (especially bruises with rupture);
- inflammatory processes in the pancreas (pancreatitis);
- malignant neoplasms that have reached a certain size;
- pyelonephritis, calculi (stones) in the left kidney;
- myocardial infarction and (less commonly) other heart diseases;
- osteochondrosis;
- pathology of the diaphragm (usually an abscessing inflammatory process);
- lung damage (pneumonia, metastatic stages of cancer, etc.).
However, this list is not complete. Some neurological and endocrine disorders can also manifest as pain in the left hypochondrium; finally, the reason may lie in damage to the ribs themselves - their bruise or fracture.
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Pancreatitis
It hurts most often under the left rib due to inflammation of the tail of the pancreas. Due to the disruption of the release of enzymes as a result of blockage, the process of self-digestion begins in the gland, which leads to severe pain. The amount of enzymes increases after eating, and accordingly, pain increases during this period. In acute pancreatitis, the pain gradually intensifies.
Pancreatitis develops as a result of:
- chronic alcoholism;
- autoimmune diseases (immune cells recognize body cells as foreign and attack them);
- parasite penetration;
- metabolic disorders (the walls of blood vessels narrow due to the deposition of lipids on them);
- long-term hormonal therapy;
- exposure to viral infection (mycoplasma, hepatitis, mumps).
Signs of pancreatitis are:
- abdominal pain when palpated and after eating;
- nausea, vomiting;
- foamy stools, there is pain during bowel movements;
- cardiopalmus;
- dyspnea;
- weight loss.
The diagnosis is confirmed by ultrasound examination. In acute pancreatitis, fasting is indicated for 3–5 days to ensure functional rest for the organ. In some cases, intravenous nutrition is prescribed. Then the patient is recommended to adhere to a strict diet (table No. 5 P) for 2–4 months.
Antispasmodics and a cold compress will help relieve pain. For pancreatitis, conservative therapy is prescribed, and in case of blockage of the bile duct with a stone, surgical treatment is prescribed. The patient is prescribed antispasmodics (No-spa, Drotaverine) to relieve pain, diuretics (Furosemide, Diacarb) to remove toxins and relieve swelling of the gland, enzyme inhibitors (Kontrikal, Gordox), antibiotics for purulent infections, vitamins (groups B, C, E , A).
3. Symptoms, diagnosis
Pain in the left hypochondrium, given the huge number of possible causes, is so diverse that its common property can only be considered localization at the edge of the costal arch. However, options are also possible here: pain in the left hypochondrium in the front carries slightly different information than pain on the side or behind. The nagging, tolerable, but almost constant debilitating pain in chronic inflammation of the internal organs is incomparable with the sharp, dagger-like pain in renal colic, perforated gastric ulcer or myocardial infarction.
Therefore, quick and accurate diagnosis of the causes is very important. For this purpose, the most detailed anamnesis is collected, an external examination, palpation (palpation), auscultation (listening), percussion (tapping) is necessarily performed, and for an experienced doctor these “ancient” methods are sometimes as important and informative as the most modern high-tech ones devices. As the situation becomes clearer, additional tests are prescribed and/or the patient is referred to a specialized specialist.
Obviously, in the diagnosis of subcostal pain, imaging methods are of great importance: various types of radiography, ultrasound, and tomography. In some cases, the primary role is given to laboratory analyzes of biological fluids, in others, only a biopsy, endoscopy or diagnostic laparoscopy can provide decisive answers.
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4.Treatment
Of course, it would be wrong to talk about the treatment of pain in the left hypochondrium itself, or, even more so, to give some “general approaches” to their treatment. Modern medicine strictly follows the etiopathogenetic principle: at all costs, find the cause and, as far as possible, eliminate it (ideally, eliminate it completely). Considering the special importance of the left hypochondrium zone, the examination should be as thorough as possible, even if it takes a lot of time and requires significant costs, and its results should give, as far as possible, complete, evidence-based, comprehensive answers about the nature and localization of the pathology, probable prognosis options and the most effective methods of treatment ad hoc (Latin for “for a given case”). A common, fully justified and advisable practice is the above-mentioned redirection of the patient to a specialized specialist: it is wiser to entrust the treatment of the stomach to a gastroenterologist, and the lungs to a pulmonologist; and if the initial contact was made to the wrong address, or the reason could not be determined “on the fly,” this does not mean that “doctors are playing tricks on each other” or “grabbing money for examinations.”
In conclusion, we emphasize once again: the causes of pain in the left hypochondrium, as well as the pain itself, are very diverse, but this is always a reason to visit a doctor. And if you are not sure which one, i.e. If you don’t know what exactly hurts—for example, you’ve never had pain before—it’s best to start by consulting a therapist as the most universal of all doctors.
Accurate diagnosis of the causes of pain
Effective therapy is possible only after an informative diagnosis. Allows you to prescribe the correct treatment MRI examination. Method:
- harmless, since only safe magnetic waves affect the patient’s body;
- takes a little time (15-30 minutes);
- gives 95% accurate results.
Based on the tomography findings, the doctor offers the most effective treatment options. You can undergo the examination in our clinic at a time convenient for the patient.
