Left lower quadrant (LLQ) pain is tummy pain that is mainly in the lower half on the left-hand side. It is sometimes also called left iliac fossa (LIF) pain, although this really means pain in a smaller area in the lower left corner of your tummy. Show
Where is my left lower quadrant?The left lower quadrant (LLQ) is a section of your tummy (abdomen). Look down at your tummy (abdomen) and mentally divide the area from the bottom of your ribs down to your pubic hair into four quarters. The quarter on your left side below your belly button (umbilicus) is your LLQ. Abdominopelvic QuadrantsBlausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. What is in my left lower quadrant?Quadrant organsMariana Ruiz Villarreal, modified by Madhero88 [Public domain], via Wikimedia CommonsBy Mariana Ruiz Villarreal, modified by Madhero88 [Public domain], via Wikimedia Commons
And don't forget the skin and nerves of that area. What are the most common causes of left lower quadrant pain?The list of causes of left lower quadrant (LLQ) pain is almost endless but the following are some of the more common possibilities. They are not in order of how common they are. What are the gut problems that can cause left lower quadrant pain?All sorts of common and uncommon problems to do with your guts can give you pain in this area. For example: Constipation
See the separate leaflet called Constipation for more information. Gastroenteritis and food poisoning
See the the separate leaflets called Gastroenteritis and Food Poisoning for more information. Irritable bowel syndrome (IBS)
See the separate leaflet called Irritable Bowel Syndrome (IBS) for more information. Diverticulitis
See the separate leaflet called Diverticula (including Diverticulosis, Diverticular Disease and Diverticulitis) for more information. Colon cancer and rectal cancerSevere LLQ pain, bloating and not being able to open your bowels at all, not even to pass wind (flatus), are symptoms that suggest you may have a colon cancer that is blocking your bowel. You should seek urgent medical advice.
See the separate leaflet called Colon, Rectal and Bowel Cancer (Colorectal Cancer) for more information. Trapped inguinal or femoral hernia
See the separate leaflet called Hernia for more information. What is a common kidney problem that can cause left lower quadrant pain?Kidney infection
See the separate leaflet called Kidney Infection (Pyelonephritis) for more information. What are the problems that only women get that can cause left lower quadrant pain?Mittelschmerz
Pelvic inflammatory disease
See the separate leaflet called Pelvic Inflammatory Disease for more information. Twisted ovary
See the separate leaflet called Ovarian Cyst for more information. Endometriosis
See the separate leaflet on Endometriosis for more information. Ectopic pregnancyYou should always see a doctor urgently if you think you might be pregnant and are experiencing LLQ pain. You could have an ectopic pregnancy.
See the separate leaflet called Ectopic Pregnancy. There is also a separate leaflet called Left Lower Quadrant Pain in Pregnancy. What are the problems that only men get that can cause left lower quadrant pain?Any pain coming from the left side of the scrotum can cause pain in the LLQ but usually the pain in the scrotum will be worse. Torsion of the testicle
See the separate leaflet called Torsion of the Testis for more information. Epididymo-orchitis
See the separate leaflet called Epididymo-orchitis for more information. What are the other possible causes of left lower quadrant pain?Inflammatory bowel diseaseCrohn's disease and ulcerative colitis are forms of inflammatory bowel disease (IBD). IBD is not to be confused with irritable bowel syndrome (IBS) which is very different. These conditions cause the lining of the gut to become inflamed. Diarrhoea (sometimes with blood mixed in) is usually the main symptom.
See the separate leaflet called Crohn's Disease for more information.
See the separate leaflet called Ulcerative Colitis for more information. Sigmoid volvulus
Kidney stones
See the separate leaflet called Kidney Stones for more information. Shingles
See the separate leaflet called Shingles (Herpes Zoster) for more information. Abdominal aortic aneurysm
See the separate leaflet called Abdominal Aortic Aneurysm for more information. What else could it be?These lists of possible causes for LLQ are by no means exhaustive and there are many other conditions that can cause pain in the LLQ. Problems in your spine or back could be 'referred'. Referred pain in this situation means that it is coming from your back but you are feeling it around the front. Muscular pulls and sprains can also affect you in the tummy area. If this is the case, moving the particular muscle would make the pain worse, whereas if you were to lie completely still, it wouldn't hurt. Should I see a doctor?Yes, if you have a pain which doesn't settle, you will probably need to consult a health professional to help you figure out the cause. Consult a doctor urgently if you:
What are the usual tests for left lower quadrant pain?Your doctor will narrow the (enormous) field of possible LLQ pain diagnoses or treatments by talking to you and examining you. They may be able to find the cause simply by doing so. For example, if they find the typical rash of shingles, you will need no further tests to find the cause. The doctor will certainly need to feel your tummy (abdomen) in the area you have the pain, but may also need to examine other parts too, such as the rest of your tummy. Your doctor may also need to examine your bottom (rectal examination). You will probably be asked to provide a sample of urine, to rule out kidney problems. You may well have to go for blood tests. These might include tests to:
What other tests might be needed for left lower quadrant pain?Next it will depend on what the examination and the tests above have suggested. In some cases no further tests will be needed - if, for example, your doctor is confident you have constipation or shingles. If a problem with your large bowel is suspected, you may need an examination with a tube with a camera put into your large bowel (a colonoscopy). A computerised tomography (CT) scan or an ultrasound scan may be helpful to look for diverticula and to look at your kidneys. These tests are also used in women to look at the ovary and tubes. In some cases an X-ray of the tummy may be useful. Further tests include other 'scopes' (such as a sigmoidoscopy), a barium enema and other scans (such as a magnetic resonance imaging (MRI) scan). If it is thought you might have an ectopic pregnancy - women - or a torsion of your testicle (testis) - men, you may only have one or two of these tests before having emergency surgery to treat your problem. Nobody will need all these tests, and some people may not need any. What treatment will I need for left lower quadrant pain?There is no single answer to this until you know what the cause of your pain is. See the relevant leaflet for the condition with which you have been diagnosed. Treatments for a few of the causes of LLQ pain are briefly discussed below.
What is the outlook?Again this depends entirely on the cause of the pain. Some conditions settle very quickly on their own (for example, gastroenteritis), or with the help of antibiotics (for example, a kidney infection). Others can be cured with surgery, such as torsion of the testis. Some are long-term conditions, for which there is no cure, although there are treatments, such as those used for people who have Crohn's disease. Your doctor should be able to give you an idea of the outlook (prognosis) once a diagnosis has become clear. When should I worry about lower left side pain?Causes of pain in the lower left abdomen can be benign, such as gas pain, or they may be a sign of a chronic condition. People experiencing persistent or chronic pain in the lower abdomen should seek medical attention. Sudden onset of severe pain in the lower left abdomen may require immediate medical care.
What would cause pain in lower left abdomen?Left lower quadrant
Pain that is specifically in your lower left abdomen is most often related to diverticulosis and diverticulitis of the colon. Diverticula (small outpouchings in the bowel wall) can occur throughout your colon, but they usually develop in the lower left part.
What causes lower abdominal pain on the left in females?Crampy pain may be due to gas, indigestion, inflammation or infection, or it may result from menstrual cramps, endometriosis, or pelvic inflammatory disease in women. Severe pain that comes in waves may be caused by kidney stones. Trauma to the body wall, hernias, and shingles can also cause left lower quadrant pain.
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