Acute and Chronic Left Upper Quadrant (LUQ) Abdominal Pain – Causes, Diagnosis, Treatment

Acute pain is sudden onset of pain which lasts for few minutes or hours. The period of pain would be less and short-lived. Chronic pain is long-term and often it occurs as a result of underlying medical condition. The onset of pain progresses gradually and often it goes for months together and even years. Arthritis pain is a kind of chronic pain where the symptoms flares for some months and disappears after that period. Several types of chronic pain are long-lived and the symptoms can be managed through medications. Left upper quadrant of the abdomen includes stomach, part of liver, spleen, part of pancreas, left kidney, splenic flexure of colon and parts of descending colon.

Let us know about the possible causes of left upper quadrant pain.

• Thoracic Factors – Thoracic cavity that may cause LUQ includes the lungs and heart.
• Heart – Sudden heart attack can cause sharp excruciating pain in the LUQ. The heart is located between the lungs and is very close to the upper and middle abdomen. Hence heart attack can begin as sharp pain in the abdomen and further proceeds towards the chest and lower shoulder. Angina pectoris can cause sharp pain behind the sternum. Any infection in the heart like myocarditis or pericarditis can also cause pain in the LUQ. Any intense pain in the lower abdomen accompanied with other symptoms like shortness of breath, and palpitation should not be ignored. Lung infection like pneumonia can cause pain in the left abdomen.
• Abdominal Factors – Several organs are located in the abdomen and any infection or inflammation of the organs can cause sudden acute pain in the LUQ.
• Injury Of Muscles – Injured abdominal muscles can cause intense pain. Sometimes fluid or blood gets collected in the muscle leading to bruise and the area becomes tender to touch.
• Rib Fracture – Broken ribs, or tear in the rib can cause pain while coughing or breathing or while moving the body.
• Pancreas – Pancreatic infection can cause left upper abdominal pain along with other symptoms like nausea, and vomiting.
• Spleen – Ruptured spleen, acute sequestration of the spleen, and splenic infiltration can cause LUQ and back pain.
• Stomach – Gastric ulcer and gastric carcinoma can cause pain in the abdomen with other symptoms like bloated feeling and constipation.
• Kidneys – Any disorders in the kidneys like renal stones and pyelonephritis can cause pain in the left upper abdomen.
• Colon – Any disease or infection in the colon like inflammatory bowel disease, diverticulitis, ischemic colitis, IBS, and severe constipation can affect the normal functions of the colon causing acute pain in the abdomen.
• Diaphragm – Bleeding inside the abdomen (peritonitis) can irritate the diaphragm causing sharp pain in the LUQ. Formation of abscess in the diaphragm can cause LUQ along with shoulder pain and fever.
• Chronic Pain – Pain that develops gradually and exists for long term (for weeks together and months) is described as chronic pain.

Some Of The Causes Of Chronic LUQ Are Discussed Below :

• Trapped Air – If the descending colon contains trapped air due to bloating or celiac disease or lactose intolerance it can cause considerable pain in the LUQ. Gas gets trapped in some part of the colon causing splenic flexure and it gets relieved only after passing the gas. Such kinds of pain can resemble a heart attack.
• IBD – Ulcerative colitis or Crohn’s disease can cause LUQ pain or in any part of the abdomen. It would cause other symptoms like skin rash, diarrhea, nausea, vomiting, fever and mouth ulcers.
• Colitis – Chronic form of colitis like inflammation of large intestine can occur in elderly people. It can cause pain in the left abdomen along with blood leakage in the stool and diarrhea.
• Kidney Disorders – Any infection or disease in the kidneys can cause chronic pain in the LUQ.

Similarly chronic pain can occur due to spleen inflammation, chronic gastritis and pancreatitis.

Diagnosis :

The doctor would complete the physical examination looking for any abscess or swelling or tumor in the abdomen. He may request for lab testing like blood tests and renal and liver function test to verify if something is wrong in the liver or kidneys. If breathlessness or palpitation is present he may order for ECG to check cardiac problems. Imaging tests like CXR and kidney ureter bladder X-rays for ruling out any anomalies. Further ultrasound test, CT or MRI scan of the abdomen can be done.

Treatment :

Treatment for LUQ depends on the direct cause. For some patients immediate admission and vital treatments is to be given. For others further investigation would be done to find out the cause.

• For cardiac problems immediate resuscitation and CPR is to be done on emergency room.
• For people who can tolerate the pain, OTC painkillers can be helpful in managing the pain.
• For severe pain, IV injection of opiate analgesia would be started and the condition of the patient will be monitored.
• Medications including pain-killers are given for managing reflux disease, inflammation and ulcers.
• Antibiotics are prescribed for bacterial infections.
• Most of the abdominal pain can be managed by making changes in eating habits and personal behavior.
• Spinal injections like corticosteroid or numbing agents are given for managing severe pain.
• In severe cases like appendicitis surgery is the only remedy.

Home Remedies For Abdominal Pain :

• Often pain in the abdomen occurs due to gas or indigestion. Before visiting the doctor you can try some of the easy home treatment.
• Take antacids if you have pain due to gas or indigestion. Drink plenty of water. This will give relief in few hours.
• Drink ginger tea, lemon tea or cardamom tea or green tea for getting instant relief from gas. Include coriander, clove, garlic and fenugreek in your daily food to prevent gas and indigestion.
• Avoid taking coffee, tea, soda or carbonated drinks.
• Eat little meals frequently instead of taking heavy meals. Avoid spicy and fried items since it can worsen the pain.
• If your stomach is upset, you can try eating bananas, rice or crackers.

Prevention :

• Do not postpone passing the stool since it may lead to constipation.
• Eat foods in regular time. Do not overeat if you are going for a party or restaurant since it can upset your stomach.
• Eat slowly after chewing the food.