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13 Causes Of Left-Side Abdominal Pain In Women + When To Seek Urgent Help
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Pain is always disconcerting regardless of where it occurs, but it can be especially worrisome if it emanates from the left side of the body, where vital organs like the heart are located. The good news is that there are plenty of innocuous reasons you may be feeling discomfort, from indigestion to muscle strains. But just to be on the safe side, we asked a doctor to share more serious potential causes of pain under the ribs or in the lower left side of your abdomen so that you'll know when it may be time to seek medical attention.
4 causes of left-side pain under the ribsTo help understand when left-side pain might need attention, we spoke with internal medicine physician Erin N. Marcus, MD, MPH, professor of clinical medicine at the Miller School of Medicine at the University of Miami. While her insights can guide you, she emphasizes that they're not a substitute for professional medical care. "If someone has any concerning symptoms, they need to get medical attention right away" for an accurate diagnosis and treatment.
Here, she outlines a few potentially serious causes of left-side pain above the diaphragm or under the ribs.
Heart disease"For pain in the chest of a woman who has passed menopause or who has risk factors such as smoking, diabetes, a family history [of heart problems], high blood pressure or substance use, we would be most concerned about heart disease," Dr. Marcus says.
Heart disease often presents atypically in women, she continues. "They may have vague symptoms or symptoms brought on by stress rather than the classic presentation of chest pressure."
Pulmonary embolusIf you have left-side pain under your ribs and have been on a recent long trip, had recent surgery, been immobilized or have cancer, doctors would be worried about a blood clot that has traveled to the lung—also called a pulmonary embolus—says Dr. Marcus. "These [heart disease and embolisms] are diagnoses we would be on highest alert for because they can be catastrophic" and life-threatening.
Pneumonia and other lung issues"If the patient has a fever or chills or is coughing, we might consider pneumonia," Dr. Macus says. Other concerning diagnoses could be a tumor in the lungs or elsewhere in the chest, particularly in a smoker or someone who has been exposed to toxic fumes.
"A sharp, sudden pain could indicate a pneumothorax, a rupture in the lung tissue," she adds. "And for someone with asthma or who is a smoker, we might think about bronchoconstriction, in which the airways in the lungs constrict."
"If they have cancer or a chronic infection or an autoimmune condition, we might think about an accumulation of fluid in the chest cavity called a pleural effusion," Dr. Marcus notes.
Muscle strainOne reason to breathe easier if you feel pain in the left-side of your chest or under your ribs: "People can strain muscles through heavy lifting or even vigorous coughing," says Dr. Marcus. "And sometimes, people develop a condition called costochondritis, which is an inflammation of the cartilage in the chest wall." This pain can be confused with a heart attack, but it often resolves on its own through rest.
9 causes of pain in the lower left side of the abdomenFor left-side pain in or below the abdomen, there is also a wide array of possible causes, says Dr. Marcus. "We would want to know what other symptoms the person is having, as well as their age and medical history." A few potential culprits:
Gastrointestinal issues: ulcer, tumor, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), intestinal ischemia "when the bowel doesn't get enough blood circulation," intestinal inflammation or pain from constipation or an infection
Gynecological problems: an ovarian cyst, fibroids or a tumor
Pain from something in the chest, radiating into the abdomen
Neurological conditions such as shingles: "It can occur along a nerve anywhere in the body, and it's not uncommon for us to see it in the chest wall or along the abdomen," notes Dr. Marcus. "The pain is intense and can last a while; fortunately, there is an effective vaccine."
Inflamed or "pinched" nerve
In order to help pinpoint what's causing left-side abdominal pain, Dr. Marcus said your doctor might ask you the following questions:
Are you constipated or have you had other changes in your bowel movements, such as diarrhea or blood?
Do you still get your period, and is it regular or heavy?
Do you have a fever or chills?
Have you had bloating or swelling of your abdomen?
Do you drink significant amounts of alcohol or have you been diagnosed with hepatitis?
Dr. Marcus emphasizes that the range of causes of left-side abdominal pain is vast and depends on your individual symptoms and characteristics. "This is why it's important to get a thorough history and physical exam by a well-trained professional."
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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
Knowing The Signs Of Heart Disease
Symptoms of heart disease in the blood vesselsCoronary artery disease is a common heart condition that affects the major blood vessels that supply the heart muscle. Cholesterol deposits (plaques) in the heart arteries are usually the cause of coronary artery disease. The buildup of these plaques is called atherosclerosis (ath-ur-o-skluh-ROE-sis). Atherosclerosis reduces blood flow to the heart and other parts of the body. It can lead to a heart attack, chest pain (angina) or stroke.
Coronary artery disease symptoms may be different for men and women. For instance, men are more likely to have chest pain. Women are more likely to have other symptoms along with chest discomfort, such as shortness of breath, nausea and extreme fatigue.
Symptoms of coronary artery disease can include:
You might not be diagnosed with coronary artery disease until you have a heart attack, angina, stroke or heart failure. It's important to watch for heart symptoms and discuss concerns with your health care provider. Heart (cardiovascular) disease can sometimes be found early with regular health checkups.
Heart disease symptoms caused by irregular heartbeats (heart arrhythmias)The heart may beat too quickly, too slowly or irregularly. Heart arrhythmia symptoms can include:
Serious congenital heart defects usually are noticed soon after birth. Congenital heart defect symptoms in children could include:
Less-serious congenital heart defects are often not diagnosed until later in childhood or during adulthood. Symptoms of congenital heart defects that usually aren't immediately life-threatening include:
Early stages of cardiomyopathy may not cause noticeable symptoms. As the condition worsens, symptoms may include:
The heart has four valves — the aortic, mitral, pulmonary and tricuspid valves. They open and close to move blood through the heart. Many things can damage the heart valves. A heart valve may become narrowed (stenosis), leaky (regurgitation or insufficiency) or close improperly (prolapse).
Valvular heart disease is also called heart valve disease. Depending on which valve isn't working properly, heart valve disease symptoms generally include:
Endocarditis is an infection that affects the heart valves and inner lining of the heart chambers and heart valves (endocardium). Endocarditis symptoms can include:
Seek emergency medical care if you have these heart disease symptoms:
Always call 911 or emergency medical help if you think you might be having a heart attack.
Heart disease is easier to treat when detected early. Talk to your health care provider if you have any concerns about your heart health. Together, you and your provider can discuss ways to reduce your heart disease risk. This is especially important if you have a family history of heart disease.
If you think you may symptoms of heart disease, make an appointment to see your provider.
Heart disease causes depend on the specific type of heart disease. There are many different types of heart disease.
How the heart workTo understand the causes of heart disease, it may help to understand how the heart works.
Four heart valves — the aortic, mitral, pulmonary and tricuspid — keep the blood moving the right way. The valves open only one way and only when they need to. Valves must open all the way and close tightly so there's no leakage.
HeartbeatsA beating heart squeezes (contracts) and relaxes in a continuous cycle.
The heart's electrical system keeps it beating. The heartbeat controls the continuous exchange of oxygen-rich blood with oxygen-poor blood. This exchange keeps you alive.
A buildup of fatty plaques in the arteries (atherosclerosis) is the most common cause of coronary artery disease. Risk factors include a poor diet, lack of exercise, obesity and smoking. Healthy lifestyle choices can help lower the risk of atherosclerosis.
Causes of irregular heartbeats (arrhythmias)Common causes of arrhythmias or conditions that can lead to them include:
A congenital heart defect develops while a baby is growing in the womb. A congenital heart defect forms as the baby's heart develops, about a month after conception. Congenital heart defects change the flow of blood in the heart. Some medical conditions, medications and genes increase the risk of congenital heart defects.
Causes of a thickened or enlarged heart muscle (cardiomyopathy)The cause of cardiomyopathy depends on the type:
A heart infection, such as endocarditis, occurs when germs reach the heart or heart valves. The most common causes of heart infections are:
Many things can cause diseases of the heart valves. Some people are born with heart valve disease (congenital heart valve disease). Heart valve disease may also be caused by conditions such as:
Risk factors for heart disease include:
Complications of heart disease include:
The same lifestyle changes used to manage heart disease may also help prevent it. Try these heart-healthy tips:
Understanding Post-COVID Interstitial Lung Disease: Causes, Treatment Options
After being hospitalized for three months with COVID-19 and double pneumonia in 2020, Houston police officer Hito Bazan awoke one morning to discover that he couldn't talk, eat, walk, or most importantly, breathe. Bazan was diagnosed with interstitial lung disease (ILD) known as pulmonary fibrosis (PF).
Three years into the COVID-19 pandemic, we are beginning to see the potential long-term effects of COVID-19, including, in some select cases, PF and ILD. As a relatively unknown disease, it is important to understand how post-COVID ILD occurs, and share the resources and treatment options available for those, like Bazan, who are affected by this lung condition.
"There weren't a lot of answers in the beginning," Bazan said. "I've come a long way since then, and we know a lot more about post-COVID ILD than we did nearly three years ago."
What is Post-COVID ILD?In its simplest sense, PF and ILD refers to scarring in the lung tissue. Over time, scar tissue may build up and block the movement of oxygen from the lungs into the bloodstream. Low oxygen levels – and the stiff scar tissue itself – can cause people who have PF or ILD to feel short of breath, particularly when walking and exercising.
Respiratory symptoms of ILD after COVID-19 may be similar to those of other types of ILD. Common symptoms of ILD include a chronic, dry cough, fatigue, and shortness of breath. While some people may have worsening symptoms over time, some patients can have gradual improvement in symptoms, and others can have stable but persistent symptoms. People with ILD after COVID-19 may experience additional symptoms of Post-Acute Sequelae of COVID-19 (PASC) or "long COVID," including heart palpitations, chest pain, or difficulty thinking and concentrating.
The symptoms of shortness of breath and cough are common to many different illnesses, so if one has these symptoms following a COVID-19 infection, it does not always mean that ILD is present. Persistent symptoms should always prompt a conversation with your medical provider."
Dr. Amy Hajari Case, Senior Medical Advisor for Education and Awareness for the Pulmonary Fibrosis Foundation (PFF)
Causes of ILD after COVID-19Because COVID-19 pneumonia causes inflammation in the lungs, Bazan was at the highest risk for developing PF and ILD. People with severe cases of COVID-19 infection – particularly those who develop acute respiratory distress syndrome (ARDS) and require mechanical ventilation – are also at risk to develop the disease. In many cases, the lung damage from ARDS will fully resolve over time, but in other cases, permanent lung damage can develop.
The ways in which less severe COVID-19 infection causes ILD and PF are still unclear. Studies are ongoing to better understand this connection and the risk factors for development of ILD after COVID-19. These studies aim to determine if ILD seen in patients who have had COVID-19 is inflammation that improves with time, if it is fibrosis that does not improve but is stable, or if it is a disease that continues to worsen over time.
"The impact of the COVID-19 pandemic has been unprecedented. We are still learning the ways in which post-COVID ILD affects patients and continue to gain a better understanding of the progression of the disease for patients with different risk factors and exposures," added Dr. Hajari Case. "In time, we are hopeful that more research will emerge to shed light on the causes of post-COVID ILD and the long-term effects on our overall health."
Diagnosing post-COVID ILDPeople who develop pneumonia from COVID-19 will often have chest imaging, such as a chest x-ray or CT scan, as part of their medical evaluation. Abnormalities found on chest imaging or persistent respiratory symptoms after recovery from a COVID-19 infection can be clues that ILD may be present.
A healthcare provider who suspects that a patient has ILD might also perform blood work and pulmonary function tests to measure how much air the lungs can hold. Doctors may also perform a high-resolution computed tomography (HRCT) scan, which shows detailed images of the lung. In some cases, a diagnosis of ILD can be made from these tests and in others, a lung biopsy may need to be performed. Patients may be monitored over time to evaluate if the scarring or inflammation progresses, stabilizes, or resolves. Following his own diagnosis with PF, Bazan has had to make several life changes, including retiring from his career as a police officer. However, through finding the right medical care, resources and the use of an oxygen machine, he has been able to exercise, complete DIY projects around his home, and spend time with his family.
"It was a long road getting back to where I am now," Bazan said. "I used to be very focused on work, but now I'm driven to beat this disease, and I'm not going to stop living. I've learned that life does not end – it just takes some adjustments."
Treating post-COVID ILDCurrently, there are no guidelines or clinical trials available to help clinicians make treatment decisions. Monitoring a person's disease without medication is appropriate in some cases. In other cases, when inflammation is present in the lung, steroid medications, such as prednisone, are commonly used. The antifibrotic medications pirfenidone and nintedanib, which can be prescribed to treat other forms of PF, are currently being studied in clinical trials of ILD after COVID-19.
"While there is significant uncertainty regarding the prognosis of ILD after COVID-19, studies show that most survivors of severe illness from COVID-19 experience gradual improvement or stability, although they may have ongoing lung function impairment if they developed PF," concluded Dr. Hajari Case. "Studies are essential to better understand the natural history and risk factors for development of ILD after COVID-19."
Despite not having a cure for the disease, post-COVID ILD patients like Bazan can find support and resources to improve their quality of life through the Pulmonary Fibrosis Foundation (PFF).
"What helps the most is talking to people who have gone through similar struggles and can show you what is possible on this journey," Bazan said. "At the PFF, you'll find a strong community of people with the disease and those who are engaged in the fight against PF."
The PFF provides education and resources for those affected by post-COVID ILD. Pulmonary rehabilitation, supplemental oxygen, smoking cessation, routine vaccinations (such as influenza, COVID-19, and pneumonia vaccination), and disease management by a specialist skilled in treating patients who have ILD can improve quality of life while living with ILD. Patients experiencing post-COVID ILD are also encouraged to search for research studies via the PFF Clinical Trial Finder and utilize the PFF Care Center Network to connect with a community of patients and support groups affected by the disease.
"Two years ago, the quote 'breathing is the greatest pleasure in life' wouldn't have meant much to me. Today, it means everything," Bazan said. "With each breath, I'm determined not to let this disease keep me down. I'm going to continue living my life the best I can."
To learn more about PF and ILD, explore treatment options or seek support for post-COVID ILD, review the PFF's Post COVID-19 Interstitial Lung Disease fact sheet and visit pulmonaryfibrosis.Org.
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