Quick overview
Pain in the upper left side of the abdomen (also called left upper quadrant pain) can come from the stomach, spleen, pancreas, left kidney, bowel, or even the chest wall/lungs. Most cases are digestive or muscle-related, but some causes are urgent.
Here’s the simplest way to think about it:
- After eating → often stomach irritation, reflux, trapped gas, or ulcer-type pain
- Constant and severe, with nausea/vomiting → consider pancreatitis or serious stomach inflammation
- With fever → infection becomes more likely (stomach, kidney, or lung)
- With shortness of breath or chest pressure → consider lung/heart causes
- After trauma (fall, sports hit, car accident) → the spleen must be taken seriously
A quick Houston reality check (seasonal context)
If you’re reading this in the middle of winter in Houston—especially around busy corridors like the Galleria/Uptown, Memorial, the Energy Corridor, Westchase, or Spring Branch—please know this: respiratory virus season increases coughing, chest wall strain, dehydration, and “viral stomach” symptoms that can mimic or worsen upper abdominal discomfort.
- In Texas, influenza activity has been elevated this season, with hospital lab positivity reported at 42.2% in a recent surveillance week.
- Nationally, CDC respiratory virus tracking has shown high overall acute respiratory illness activity with flu elevated and RSV elevated (and COVID-19 trends monitored alongside).
- Norovirus season typically peaks December to March, which matters because vomiting/diarrhea can cause significant upper abdominal cramping and irritation.
That doesn’t mean your pain is “just a virus.” It means your body may be under more strain than usual—so pattern and red flags matter.
Where is the upper left abdomen?
The upper left abdomen is the area under your left ribs and slightly toward the center.
Structures that can cause pain in upper left abdomen include:
- Stomach (reflux, gastritis, ulcer)
- Spleen (enlargement, injury)
- Pancreas (pancreatitis)
- Left kidney/urinary tract (stone, infection)
- Colon (trapped gas/constipation, inflammation)
- Lower left lung (pneumonia/pleurisy)
- Ribs and abdominal wall muscles (strain, costochondritis)
- Heart-related pain (sometimes felt in unusual places)
Because everything is close together, pain in the upper left side of the stomach doesn’t always mean the stomach is the cause.
When should you worry about upper left abdominal pain?
You asked for guidance without telling people to call 911—so here is the clean, practical version:
Seek urgent evaluation now if you have upper left abdominal pain with any of the following:
- Chest pressure, squeezing, or discomfort (especially with sweating, nausea, shortness of breath, or lightheadedness)
- Trouble breathing, rapid breathing, or chest pain that worsens with a deep breath
- Severe, constant pain that is escalating (not “waves,” not improving)
- Fainting, severe weakness, confusion, or gray/clammy skin
- Vomiting blood, black/tarry stools, or signs of internal bleeding
- Fever + flank/back pain + urinary symptoms (possible kidney infection/obstruction)
- Pain after trauma (even if the hit felt “not that bad”)—especially if you feel dizzy or weak
If you’re unsure, it is appropriate to be checked in an emergency setting. A quick exam plus basic testing often clarifies whether something dangerous is happening.
How to interpret your pain pattern (the “ER doctor” way)
Most people don’t feel pain in medical categories. You feel it as real life:
1) Is it burning, gnawing, or sour—especially after meals?
This leans stomach-related: reflux, gastritis, ulcer-type irritation.
2) Is it crampy with bloating, and better after passing gas or a bowel movement?
This leans bowel-related: constipation, trapped gas, colonic spasm.
3) Is it sharp under the ribs and worse with twisting, coughing, or pressing on the area?
This leans musculoskeletal: abdominal wall strain, rib cartilage irritation.
4) Is it severe, deep, and radiating to the back—especially with nausea/vomiting?
This raises concern for pancreatitis.
5) Is it higher and toward the flank with urinary changes?
This raises concern for kidney stones or infection.
Major causes of upper left abdominal pain
Digestive system causes
These are frequent reasons for upper left side abdominal pain and stomach discomfort upper left side.
Indigestion, reflux, and GERD
Often felt as burning or pressure in the upper abdomen or lower chest, sometimes with burping or sour taste.
Clues that fit:
- Worse after eating or lying down
- Acid taste, belching, chest/upper belly burning
Gastritis (stomach lining irritation)
Gastritis can cause pain in the upper part of the belly, nausea, and sometimes vomiting.
Clues that fit:
- Upper abdominal tenderness
- Nausea, reduced appetite
- Symptoms after irritating foods or heavy meals
Peptic ulcer disease
Ulcers can cause a gnawing or burning pain—sometimes worse at night or when your stomach is empty, sometimes triggered by meals.
Clues that fit:
- Recurrent upper belly pain
- Nausea, early fullness
- Any sign of GI bleeding warrants urgent evaluation
Trapped gas and constipation
Gas and stool can “hang up” near the splenic flexure (left upper colon), creating abdominal pain top left side that feels sharp, full, or crampy.
Clues that fit:
- Bloating
- Pain improves after passing gas or bowel movement
- Irregular bowel habits
Viral gastroenteritis (“stomach bug”)
This is especially relevant during winter months when norovirus peaks.
Clues that fit:
- Nausea, vomiting, diarrhea
- Cramping abdominal pain
- Sick contacts, daycare/school exposure, recent travel
Pancreatic causes
Pancreatitis
Pancreatitis typically causes pain in the upper left side or middle of the abdomen, often worse after eating and sometimes radiating to the back.
Clues that fit:
- Severe, constant pain (not mild cramps)
- Nausea/vomiting
- Worse lying flat; may feel better leaning forward
- Feels “deep,” not surface-level
Pancreatitis is not something to “wait out.” It deserves evaluation.
Spleen-related causes
Enlarged spleen (splenomegaly)
An enlarged spleen can cause pain or fullness in the left upper belly and may make you feel full quickly.
Clues that fit:
- Fullness under left ribs
- Feeling full after small meals
- Sometimes follows infections
Splenic injury or rupture
After trauma, left-sided pain can signal spleen injury. This can be dangerous even if symptoms start “later.”
Clues that fit:
- Pain after a hit to the abdomen/ribs
- Dizziness, weakness, shoulder-tip pain, worsening pain
Kidney and urinary causes
Kidney stones
Kidney stones can cause intense pain (often in the back/side) and may come with blood in urine, nausea/vomiting, or urinary urgency.
Kidney infection (pyelonephritis)
Often includes fever, chills, and flank pain, sometimes with nausea and urinary symptoms. This is urgent.
Lung and chest wall causes
Pneumonia or pleurisy
A lower lung infection can sometimes feel like upper abdominal pain, especially when breathing deeply or coughing.
Clues that fit:
- Fever, cough, shortness of breath
- Pain worse with deep breath
Pulmonary embolism (blood clot in the lung)
This is less common but serious: sudden shortness of breath, rapid breathing, and chest pain often worse with breathing are classic warning signs.
Musculoskeletal causes
Abdominal wall strain / intercostal muscle strain
This is one of the most common causes of upper left sided abdominal pain after coughing, lifting, twisting, or workouts.
Clues that fit:
- Sharp pain upper left abdomen when moving
- Reproducible pain when you press on a specific spot
- Worse with coughing or twisting
Rib cartilage irritation (costochondral-type pain)
Pain near the ribs that worsens with breathing/movement can be musculoskeletal and can mimic deeper problems.
Nerve/skin causes
Shingles
Shingles can start as burning pain on one side before a rash appears.
If you notice tingling/burning in a stripe-like pattern and then a rash, don’t ignore it.
Special situations people ask about
Upper left abdomen pain female / in women
Most causes are the same for everyone: stomach, bowel, muscles, kidney. What changes is the context—pregnancy, anemia risk, and how heart symptoms can sometimes be subtler.
If you searched this phrase specifically: woman pain in upper left side of stomach, the key is not the label—it’s the pattern. If pain is paired with chest discomfort, shortness of breath, faintness, or unusual sweating, take it seriously.
Upper left abdominal pain in pregnancy
Many cases are reflux, gas, constipation, or muscle strain from posture changes—but pregnancy is a reason to have a lower threshold for evaluation if pain is severe, persistent, or paired with vomiting, fever, or bleeding.
Abdominal pain upper left side male
Again, causes are usually the same. The key difference is risk profile (work strain, heavy lifting, dehydration patterns, and kidney stones in some populations). If pain is severe, persistent, or paired with urinary symptoms, get checked.
Pain in upper left side and back
This pattern can point to the pancreas, kidney/urinary tract, or sometimes musculoskeletal causes. The deciding factors are severity, persistence, vomiting, fever, and urinary symptoms.
What to do next
If your symptoms are mild and improving
Focus on what an ER doctor listens for first:
- Hydration
- Rest
- Small, bland meals
- Avoid heavy/fatty meals if pain is meal-triggered
- Watch for any escalation or red flags
If symptoms are persistent (over 24–48 hours), recurrent, or disruptive
You should be evaluated—because imaging and labs answer what guessing cannot.
How doctors evaluate upper left abdominal pain
In the ER, we’re trying to answer: Is this dangerous today? Then: What’s the most likely cause?
You can expect:
- A focused history: timing, triggers, foods, vomiting/diarrhea, urinary symptoms, trauma, fever, pregnancy status
- Exam: tenderness location, guarding, rib/chest wall reproducibility
- Testing depending on symptoms:
- Bloodwork (infection, anemia, pancreatic markers)
- Urine testing (infection, blood)
- EKG when chest/heart symptoms are possible
- Imaging (ultrasound, CT, sometimes chest X-ray)
Frequently Asked Questions
Why does the left side of my stomach hurt?
Most commonly: reflux/gastritis, trapped gas/constipation, or muscle strain. The next step is checking the pattern: after meals, with movement, with fever, or with vomiting.
Upper left abdominal pain that comes and goes—what causes that?
Intermittent pain is often bowel spasm, gas/constipation, reflux, or muscle strain. If the episodes are getting stronger, lasting longer, or paired with fever/vomiting, you should be checked.
Upper left abdominal pain under ribs—what does it usually mean?
Under the ribs can still be stomach/bowel pain, but it’s also where spleen issues and rib/cartilage strain show up. If it started after trauma, don’t ignore it.
Upper left abdominal pain after eating—what are the top causes?
Reflux, gastritis, ulcer-type irritation, and sometimes pancreas-related pain. Persistent severe pain after eating, especially with vomiting, warrants evaluation.
When should I worry about upper left abdominal pain?
Worry (and seek urgent evaluation) when it’s severe, sudden, persistent, or paired with chest symptoms, breathing trouble, fainting, or bleeding.
Sharp pain upper left abdomen—could it be serious?
It can be musculoskeletal (very common), gas/colon spasm, or less commonly something urgent. If it’s reproducible with touch/movement, that leans muscular. If it’s deep, constant, worsening, or paired with vomiting/fever, get checked.
Stomach ache on upper left side—what should I watch for?
If it’s mild and improving, hydration and rest may be reasonable. Watch for persistent vomiting, fever, black stools, blood, or worsening pain.
Pain in upper left quadrant of abdomen with breathing—what does that suggest?
Pain that worsens with deep breathing can come from chest wall inflammation, pneumonia, or (less commonly) a blood clot in the lung. The presence of shortness of breath, rapid breathing, or chest pain shifts this toward urgent evaluation.
Upper left part of stomach hurts—how do you tell stomach vs pancreas?
Stomach irritation often feels burning/gnawing, sometimes tied to meals and nausea. Pancreatitis pain tends to be more severe, persistent, and can radiate to the back, often with vomiting.
Pain left side upper abdomen—what if it’s stress?
Stress can worsen reflux, bowel spasm, and muscle tension, but stress should never be used to “explain away” severe or escalating pain. Use the red flags section as your safety net.
Most upper left abdominal pain is not life-threatening—but the job is to separate “common and manageable” from “rare but dangerous.” The fastest way to do that is pattern recognition plus timely evaluation when red flags are present.
If you’re in Houston and you need an in-person evaluation for persistent or concerning upper abdominal pain, Post Oak ER can assess abdominal pain with appropriate testing and imaging, while keeping the focus on clear answers and patient-first care.
Reference List
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