Types of left upper abdominal pain
In general, all diseases of the gastrointestinal tract can cause flatulence. Since left upper abdominal pain often originates in the stomach, typical clinical pictures are irritable stomach, food intolerance and infectious gastrointestinal diseases. In all these clinical pictures, left upper abdominal pain with flatulence can occur.
The irritable stomach has no known organic cause and is usually caused by psychological strain and stress situations. Those affected suffer from recurring stomach complaints, which are often accompanied by heartburn, a feeling of fullness and also flatulence. The symptoms usually last longer than four weeks.
Left upper abdominal pain may also occur if the patient is intolerant to certain foods or food components. This is the case, for example, with a fructose or lactose intolerance (fruit sugar/milk sugar intolerance). Due to an enzyme deficiency in the intestine, the sugars cannot be further broken down and cause increased intestinal movement with increased fluid flow into the intestine.
This can lead to diarrhoea. The sugar residues are increasingly broken down by bacteria, producing gases which can then be released in the form of flatulence. Another intolerance reaction is the gluten intolerance, also called celiac disease or celiac sprue.
In this clinical picture, gluten, which occurs in many types of grain, is the trigger for the symptoms. The clinical picture is similar to that of lactose and fructose intolerance.Infectious gastrointestinal diseases can also manifest themselves through left upper abdominal pain with flatulence. The increased bacterial count in the gastrointestinal tract favors the formation of gases that leave the intestine in the form of flatulence.
A generally unbalanced diet with a high-fat diet can also cause gastrointestinal problems associated with the corresponding symptoms. Left upper abdominal pain associated with nausea initially suggests a problem of the stomach. A harmless cause can be, for example, a meal that is too rich in fat/sugar.
Nausea also occurs frequently with infectious gastrointestinal diseases. The differential diagnosis should always include a heart attack. Particularly in women, this is often manifested by untypical symptoms, such as upper abdominal pain, back pain, nausea and vomiting.
Typical diseases of the stomach, such as chronic inflammation of the mucous membrane of the stomach or a stomach ulcer (ulcer), can also cause such symptoms. In general, a urological clinical picture must always be considered when dealing with abdominal pain. Ureteral stones can cause severe abdominal and back pain, as well as severe nausea with vomiting.
Typically, these pains are unilateral, depending on which ureter is affected, and start from the level of the navel downwards and on the flanks. However, they can also radiate into the upper abdomen. In addition, a irritable stomach syndrome can also cause nausea in combination with left upper abdominal pain.
Those affected suffer from recurring stomach complaints, which can also be accompanied by severe nausea. Inflammation of the pancreas (pancreatitis) can also cause a corresponding clinical picture with left upper abdominal pain and nausea, whereby upper abdominal pain in this disease usually radiates in a belt shape into the back. Since an early pregnancy also manifests itself in many women through nausea and abdominal pain, this possible cause should not be forgotten either.
If the pain occurs directly under the costal arch, it can have various causes. The spleen is located directly under the left costal arch. Diseases of this organ can therefore be associated with the described complaints.
However, it can also be the phenomenon known as lateral stinging, which originates in the diaphragm, which is also located approximately at the level of the costal arch. Depending on the position of the intestinal loops and colon, flatulence or intestinal disorders can be responsible for the pain under the left costal arch. Infectious diseases such as shingles are also frequently found under the costal arch.
Diseases of the ribs themselves can also manifest themselves as pain under the costal arch. The same applies to complaints that develop on the back and are manifested by the nerves running there on the left upper abdomen below the costal arch. Left upper abdominal pain, which occurs mainly after eating, can be caused by various factors.
A typical clinical picture associated with these symptoms is inflammation of the mucous membrane of the stomach (gastritis). This can be caused either autoimmune, bacterial or chemical, i.e. for example by drugs or other harmful substances. If the patient has eaten something, the symptoms usually get better at first, but then return very severely shortly afterwards.
In the case of an ulcer of the stomach lining (ulcer), on the other hand, there is usually increasing pain in the upper abdomen directly after eating. In the case of an ulcer of the duodenum, complaints can also occur depending on the meal, but they initially become better immediately after eating and only return after about 2-3 hours. They often occur at night (see: Upper abdominal pain at night).
Upper abdominal pain after eating can also be caused by food intolerances, apart from the above-mentioned mucous membrane lesions. Affected persons often suffer from cramp-like abdominal pain, nausea, bloating, flatulence and sometimes diarrhoea and vomiting after eating foods containing certain food components. The same applies to irritable stomach and irritable bowel syndrome.
Affected persons often suffer from diarrhea, nausea and vomiting, as well as flatulence and abdominal cramps. As they are often very sensitive to fatty foods and then suffer from these symptoms especially after eating, they should avoid them if possible and eat a balanced and healthy diet.It is also important that these patients allow themselves sufficient time for eating, otherwise the symptoms can deteriorate considerably after the meal. Some women experience left upper abdominal pain during pregnancy.
Usually these have a harmless cause and are caused, for example, by the growing child, which increasingly requires space and pushes the surrounding organs to the side. This leads to increasing tension in the abdominal cavity and the abdominal wall is stretched more and more. This can cause pain in the upper abdomen.
In addition, the increased pressure in the abdomen promotes heartburn, as the stomach acid can be pushed up the esophagus by the pressure. This can also manifest itself as pain in the upper abdomen and a burning sensation behind the breastbone. A serious complication of pregnancy that can be accompanied by pain in the upper abdomen is HELLP syndrome.
This usually occurs towards the end of pregnancy and is characterized by severe high blood pressure, protein in the urine, liver dysfunction and many other non-specific symptoms (e.g. headaches, nausea). Upper abdominal pain is usually caused by an enlargement of the liver and begins on the right side, but can also radiate into the left upper abdomen. The HELLP syndrome can be life-threatening for mother and child.
Another cause of left upper abdominal pain during pregnancy can be the so-called hyperemesis gravidarum, or morning sickness. This causes upper abdominal pain with nausea and vomiting. The morning sickness occurs mainly in the first third of the pregnancy. Left upper abdominal pain in pregnancy can of course also be due to causes that can cause these symptoms independently of pregnancy (gastritis, pancreatitis, splenic infarction, etc. ).