Why does my lower left abdomen hurt?

Lower abdominal pain on the left side can be caused by an injury, inflammation, or infection of one of the following organs:

• Colon
• Small intestine
• Ovaries
• Uterus
• Ureters
• Bladder
• Peritoneum

The kidneys are located closer to the back of the torso, but their proximity to the abdomen means kidney issues can also cause lower abdominal pain. Specifically, an issue with the left kidney may cause lower left belly pain. 

Many nerves run through the lower abdominal region, so testicular problems can also cause abdominal pain on the lower left side.

Note: This guide will focus on pain in the lower left abdomen. You can find more information about what causes left-side abdominal pain here.

What causes lower abdominal pain on the left side?

Diverticulitis is the most common cause of pain specific to the lower left abdomen, says Amy Lee, MD, RDN, chief medical officer at Lindora Clinic. However, there are many causes of pain in the lower left side of the abdomen, from relatively harmless gas or ovulation pain to serious conditions such as testicular torsion or ectopic pregnancy.

Diverticulitis 

Diverticulitis is inflammation or infection of the diverticula, small pouches that form and bulge outward from the colon walls (large intestine). We don’t know why some people with diverticulosis get a bout of diverticulitis. However, Dr. Lee says inflammation and infection may occur when food particles or bacteria accumulate in these pockets.

Seventy percent of patients with diverticulitis experience abdominal pain on the lower left side. 

Akash Attreya, DO, an Albuquerque, New Mexico-based osteopathic physician specializing in family medicine, says other symptoms of diverticulitis include nausea, vomiting, change in bowel habits with either constipation or diarrhea and fever or chills. 

“In this situation, prompt evaluation by a medical provider is needed,” says Dr. Attreya. While diverticulitis is not always serious, severe cases may require hospitalization or surgical intervention.

RELATED: How to relieve diverticulitis pain fast

Kidney stones

A kidney stone in the left kidney is another common cause of lower left belly pain. This type of pain originates in the affected kidney and radiates to the back, side, and abdomen. As the stone moves down the ureter, a tube between the kidney and bladder, the pain will also migrate. Kidney stones often cause back and side pain and pain during urination.

“Kidney stone formation takes time, and you may not know it until you get a flare-up, which results in a visit to the ER,” says Dr. Lee. 

Testicular torsion

Testicular torsion is “spontaneous or traumatic twisting of the testicle,” Dr. Attreya says. Though testicular torsion occurs inside the scrotum, the dense network of nerves in the pelvis and abdomen can send pain signals into the lower belly.

Testicular torsion is a medical emergency because it cuts off the blood supply to the testicles. If the testicle “dies” due to lack of blood, it must be surgically removed.

Gynecological causes

Pain in the lower left side of the abdomen in females can be linked to a variety of gynecological conditions, including:

• Ovulation: The process of an egg being released from the ovary can cause pain similar to menstrual cramps, called mittelschmerz, which lasts from a few minutes to 48 hours.
• Ovarian cyst:  A non-cancerous sac on the ovary that could also cause bloating and pelvic pressure. When an ovarian cyst ruptures, it causes sudden, severe pain on the side of the abdomen where the cyst is located and vaginal spotting or bleeding.
• Ectopic pregnancy: A potentially life-threatening condition in which a fertilized egg implants and grows outside the uterus.
• Ovarian torsion, which Dr. Attreya describes as painful “twisting of the ovary.”
• Endometriosis: A painful disorder in which uterine lining-like tissue grows outside the uterus.
• Pelvic inflammatory disease (PID): An infection in the uterus, fallopian tubes, and or ovaries that can cause lower abdominal pain, fever, and unusual vaginal discharge.

Gastrointestinal causes

There are several possible causes of pain in the lower left abdomen related to the lower digestive tract. These include:

• Excessive gas from swallowed air, gastrointestinal bacteria, or an underlying gastrointestinal disorder.
• Irritable bowel syndrome (IBS) is a chronic disorder that can cause abdominal cramping, diarrhea, constipation, and gas.
• Inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis, can cause severe abdominal pain, rectal bleeding, fatigue, and weight loss.
• Bowel obstruction is a complete or partial blockage of the intestine, which is a medical emergency.
• Celiac disease is an immune system-related response to gluten that can cause sharp pain in the belly, diarrhea, weight loss, gas, and very bad-smelling stools.

Other causes

Lower left abdominal pain can caused by other chronic and acute medical conditions, including:

• Inguinal hernia: When soft tissue, such as a part of the lower intestines, bulges through a weak spot in the abdominal wall.
• Psoas abscess: A rare condition in which pus collects in a muscle in the lower back and pelvis.
• Abdominal aortic aneurysm: A potentially life-threatening bulge in a weak spot of the body’s main artery.

Should I be worried about lower left abdominal pain?

Some causes of lower left-side abdominal pain are serious. Some are not. But since lower left belly pain can indicate a medical emergency like testicular torsion or ectopic pregnancy, it shouldn’t be ignored.

If your abdominal pain is severe enough to limit activity, Dr. Attreya and Dr. Lee recommend calling your primary care provider to schedule an appointment as soon as possible. 

“If you are unable to get a timely evaluation by your primary care provider, or you do not have one, then you must get seen in the emergency department,” Dr. Attreya adds. 

Dr. Lee also suggests urgent medical attention if your pain is intolerable or accompanied by fever, chills, bloody stools, bloody urine, or unusual fatigue.

It is important to talk to your healthcare provider about lower left abdominal pain if you have a history of gastrointestinal, urinary, or reproductive system problems. Complications from diverticulitis, a ruptured cyst, or ovarian or testicular torsion can be serious. For instance, testicular torsion requires emergency surgery to save the testicle.

How is the cause of pain in the lower left abdomen diagnosed?

A healthcare provider diagnosing the cause of lower abdominal pain on the left side will start with discussing your medical history and performing a physical examination. Before your physical exam, be prepared to answer a variety of questions about:

• Recent impact or injury to the lower abdomen
• Your eating and bowel habits
• Known underlying conditions such as lactose intolerance, Celiac disease, gallstones, or endometriosis
• Other symptoms, such as nausea, vomiting, fever, or pain or blood with urination
• The frequency and severity of the pain
• Your history of digestive or reproductive conditions
• Any medications or supplements you’re taking

“For any concerning abdominal pain, medical evaluation will include a physical examination, blood work, and imaging, such as an ultrasound, X-ray, CAT scan, or  MRI,” Dr. Attreya says.

Sometimes, your healthcare provider may also need to examine the digestive system through a colonoscopy or endoscopy.

RELATED: Does Medicare cover a colonoscopy?

How long does lower left-side abdominal pain last?

If lower left abdominal discomfort is caused by something harmless, such as gas, or mild and chronic, such as IBS, then acute pain will go away within hours or days. Of course, lower abdominal pain caused by IBS and IBD also tends to recur frequently.

Other causes of lower left belly pain, such as diverticulitis or kidney stones, require medical treatment or lifestyle changes to get rid of the pain. 

The timeline for pain relief will depend on the underlying cause.

You don’t need to worry about the pain in your lower left abdomen spreading to another person. The causes are not contagious.

How to stop abdominal pain on the lower left side

Relieving lower left abdominal pain depends on the underlying cause. However, people wondering how to get rid of pain in the lower left abdomen while waiting for a diagnosis can usually use over-the-counter NSAIDs (ibuprofen or naproxen) or acetaminophen to manage pain.

Pain caused by gas or an IBS flare-up will go away on its own. OTC simethicone can help relieve gas pains, while IBS flares are often helped by medications such as dicyclomine.

Lower belly pain caused by gastrointestinal conditions, kidney or ureter stones, or testicular or ovarian torsion requires a treatment plan. 

People with kidney stones may need medications to control uric acid production, such as allopurinol. 

Treatment for diverticulitis often includes antibiotics. Complications of untreated diverticulitis can include an abscess, intestinal perforation, or obstructions. Emergency surgery may be needed in these cases.

Hernias and torsion typically require surgical treatment.

Living with lower left abdominal pain

People with gastrointestinal conditions such as diverticulitis, IBS, or IBD are more likely to experience frequent lower left-side abdominal pain. Sticking to your treatment plan and managing the condition with lifestyle changes is essential.

People with recurrent lower left abdomen pain can reduce discomfort by:

• Eating small meals throughout the day to ease digestion
• Eating easy-to-digest foods like rice, bananas, and crackers
• Avoiding hard-to-digest foods such as alcohol, caffeine, spicy foods, and fatty or greasy foods
• Staying hydrated with water and sports drinks
• Consulting a healthcare provider about which OTC painkillers to take

RELATED: IBS diet | Diverticulitis diet

See a doctor if lower left abdominal pain is sudden or severe

Causes of pain in the lower left abdomen may include diverticulitis, kidney stones, ovarian or testicular torsion, and more. The cause of pain in the lower left abdomen may resolve on its own without treatment. However, if pain in the lower left abdomen continues, worsens, or is accompanied by nausea, vomiting, or fever, it could be a sign of an infection, a ruptured ovarian cyst, or testicular torsion, and require medication or surgery. Only your healthcare provider can rule out serious health conditions. Visit your healthcare provider to determine the best treatment for pain in the lower left abdomen.