Pain in the left hypochondrium. Pain under the ribs

A person, faced with pain localized in the left hypochondrium, begins to panic. The left hypochondrium is the area located under the two lower ribs on the left side of the conditional middle of the abdomen. With the designation exact reason the occurrence of pain, it is necessary to take into account its nature, duration and concomitant symptoms. Pain in the left side under the ribs can appear in any organ that is located in the left upper abdomen or chest.

You can determine the cause of pain under the ribs on the left based on the symptoms. Let's take a look possible reasons, which may cause pain in the left side under the ribs.

1. Not a rare cause of pain in the left hypochondrium are some diseases of the spleen, as it is located on the left, in the upper part of the abdominal cavity. Enlargement of the spleen can easily be the cause of pain, especially dangerous when its enlarged size leads to rupture, causing blue skin around the navel. In this case, the aching pain becomes acute, in which it is necessary to urgently seek emergency medical care. But not only the enlargement of the spleen leads to its rupture, but also the reason for this can be Infectious mononucleosis, spleen infarction and inflammation. The nature of the pain is important. A sharp pain in the left side under the ribs will most likely have other causes.

2. The next reason aching pains in the left hypochondrium are stomach problems, although the symptoms of stomach diseases appear much earlier, but people often dismiss them and start sounding the alarm only when the pain becomes constant, frightening with their location. Gastritis is the main cause constant pain, especially if it develops into a peptic ulcer, then the pain can also be given to the back - which greatly frightens a person. At hypersensitivity to stretching, the walls of the stomach with dyspepsia also give similar pain. Gastric cancer, which at the beginning of its development may not manifest itself in any way, but progressing, can also be the cause of pain in the left hypochondrium. If aching pain passes simultaneously with vomiting, then this is a symptom peptic ulcer.

3. Perhaps the main reason, which is in second place after diseases of the stomach, for the appearance discomfort, and then pain - these are violations correct operation pancreas. Inflammation of the pancreas is accompanied by acute or aching pain in the left side under the ribs. Along with this, it is observed constant belching and bitterness in the mouth. For chronic diseases, which is characterized by the appearance of dull girdle pains, but if the pain does not radiate to the back, then this means that the inflammatory process has begun. If you do not resort to treatment, then acute pancreatitis may develop, then symptoms such as vomiting and fever will be added to the aching pain.

4. Not so often, but still in some cases, aching pain in the left hypochondrium can be caused by a diaphragmatic hernia. This condition occurs when part of the esophagus and stomach enters the chest through the diaphragmatic ring. The cause of its occurrence is often severe physical work, but often it can be during pregnancy or obesity.

5. Malfunctions nervous system can also cause pain in the left side chest, after all, abdominal migraine, being enough rare disease, causes precisely aching pain in the left hypochondrium. Necessary full examination if this cause is identified, since abdominal migraine is a symptom of a form of epilepsy.

6. Disturbances in the endocrine system can also be the cause of pain, because during a vegetative crisis, pain manifests itself precisely on the left under the ribs - in this case, it is necessary to undergo a complete examination by an endocrinologist.

7. Of course, problems in cardiovascular systems They also give the same symptoms, but it is necessary to be able to distinguish pain associated with heart problems from the causes that were described above. Heart pain is accompanied by a burning sensation behind the sternum and irradiation to the left shoulder blade, arm and back, accompanied by shortness of breath. In this case, you must urgently call ambulance, since such symptoms may indicate an impending myocardial infarction.

Faced with aching pain in the left hypochondrium - do not delay a visit to a therapist who will prescribe you necessary examination to prevent the development of serious diseases.

Most diseases of the internal organs are accompanied by pain, and it is not at all easy to figure out why pain appeared in the left side under the ribs, from below, above, in front or behind. But if you know the main causes of the appearance of such pain, as well as features diseases of various organs, you can try to figure out the situation yourself and help your body cope with the problem before seeking professional help.

Causes of pain in the left side

Pain in the left side is most often associated in people with diseases of the cardiovascular system, but, in fact, pain in this area can be associated with diseases gastrointestinal tract, spleen, pancreas, endocrine and nervous disorders and other pathologies.

Localization and nature of pain

The localization and nature of pain sensations can help determine the causes of pain.

By localization:
- pain in the upper abdomen on the left and in front can occur with diseases of the heart, stomach, inflammatory diseases respiratory organs or neuralgia;
- pain in the upper half of the back appears with diseases of the cardiovascular system, spine, spleen, pancreas or pregnancy;
- pain in lower sections chest on the left may indicate diseases of the intestinal tract, pathologies of the urinary or reproductive system, as well as developed appendicitis (despite the fact that appendix most often located on the right, pain in appendicitis may radiate to the left).

According to the nature of pain:
- acute pain - sharp, stabbing or cutting pain that occurs in the left side in a certain place, occurs with serious disorders and requires immediate medical attention. It can be caused by rupture of the spleen, perforation of a stomach or intestinal ulcer, damage to internal organs by bone fragments during injuries or accidents, or a sharp violation of blood circulation in the internal organs: myocardial infarction, torsion of intestinal loops or ovarian legs;
- dull, diffuse pains - such sensations occur with a sluggish flow inflammatory process and most often caused by gastritis, pancreatitis, cholecystitis. If such pains occur in the lower part of the left hypochondrium, they can be triggered by inflammation of the internal genital organs or kidneys;
- aching pains - constant aching pains in the upper half of the chest on the left can appear with angina pectoris, coronary disease heart and other diseases of the cardiovascular system, and if such pain occurs in the lower half, then the causes of their appearance are most likely duodenitis, colitis or diseases of the spine.

The most common causes of pain in the left side

1. Diseases of the gastrointestinal tract- gastritis, gastric ulcer, cholecystitis and pancreatitis, all of these diseases are characterized by dull or aching pain in the upper abdomen. With an exacerbation of an ulcer, an attack of pancreatitis or cholecystitis, the pain becomes intense, sharp, cutting or stabbing, there is a sharp deterioration in the condition and one cannot do without urgent medical attention. In all other cases, the pain is not too pronounced, occurs after eating, especially when overeating or breaking the diet, accompanied by dyspeptic disorders: heartburn, belching, nausea, sometimes vomiting, a feeling of heaviness and fullness of the stomach, as well as stool disorder. With a long course of the disease appear general symptoms digestive disorders: fatigue, headaches, decreased immunity, pallor, anemia and other deficient conditions.

Dull, aching pains that occur in the lower abdomen on the left are characteristic of intestinal diseases; with such pathologies, signs of indigestion and problems with stool are observed.

2. Diseases of the cardiovascular system- ischemic heart disease, angina pectoris and cardiomyopathy are manifested by sudden onset of acute pain in the upper half of the chest on the left or aching pain, a feeling of heaviness and shortness of breath. For diseases of the heart and blood vessels, the occurrence of pain after physical exertion or nervous strain, in the evening or at night, as well as shortness of breath, a feeling of lack of air, fear and increased heart rate, is characteristic. Pain may radiate to left hand, under the shoulder blade or in the back, pass or decrease with a decrease in the load or taking nitroglycerin, corvalol, validol and other similar drugs.

3. Respiratory diseases- left-sided bronchitis, pneumonia and pleurisy are also accompanied by the appearance of dull pains, aggravated by coughing, breathing or changing body position. It is quite easy to diagnose respiratory diseases by other characteristic signs: fever, cough, sore throat, nasal congestion, and so on.

4. Diaphragm pathologies- heavy physical labor, heavy lifting, age-related changes, obesity and pregnancy can provoke the occurrence of a diaphragmatic hernia. This is due to the weakening of the muscles of the diaphragm, which separates the upper thoracic region from the abdominal cavity, while expanding the hole in which the esophagus passes and aching pains may occur, which are aggravated immediately when the food is swallowed. Sometimes there may be severe pronounced pain, which is caused by excessive contraction of the muscles of the diaphragm, as a result of which part of the stomach enters the esophagus and is clamped.

5. Neurological disorders - intercostal neuralgia, as well as pinched nerve endings, can cause pain in the left side of very different intensity: from dull, unexpressed pain to severe dagger pains, which are often confused with a developed myocardial infarction. Neuralgia is characterized by increased pain in any movement, coughing, sneezing or even breathing, the patient tries to maintain one body position, not to move, especially not to bend over, he has increased sweating, blanching or redness skin and chest numbness. When a nerve is pinched, the pain has a clear localization and increases with pressure on the certain part body.

6. Spleen pathologies- Enlargement of the spleen capsule, causing permanent dull pain behind the left under the ribs, occurs with infectious diseases or pathologies of the blood system. They are characterized by: fever, general weakness, pallor, frequent headaches, dizziness, fainting, joint and muscle pain, swollen lymph nodes and liver, as well as decreased immunity and increased sweating.

7. Injuries – strong blows, bruises and other injuries resulting from a fall, a car accident, and so on, can cause fractures and cracks in the ribs, damage to internal organs by fragments bone tissue or rupture of the spleen. Fractures and cracks of the ribs are accompanied by visible damage to the skin, severe pain in the ribs, aggravated by breathing and movement. Internal bleeding and rupture of the spleen requires immediate medical intervention, the patient develops great weakness, dizziness, fainting, a drop in blood pressure and a decrease in heart rate, as well as a sharp blanching of the skin and mucous membranes.

8. Pathologies of the spine– rheumatic diseases, osteochondrosis and hernias intervertebral discs can cause severe pain in the chest on the left rear. With such diseases, the pain is constant, aggravated by movement, especially when bending over and passing at rest.

9. Diseases of the urinary organs and female genital organs- pain in the lower part of the chest, more often in the back can occur with pyelonephritis, urolithiasis, adnexitis, ovarian cyst torsion, or ectopic pregnancy. All these diseases are accompanied characteristic symptoms: pain during urination, general malaise, fever in diseases of the urinary organs and impaired menstrual cycle, pain in the external genital organs and bleeding in diseases of the female genital organs.

Acute pain, accompanied by nausea, vomiting, weakness, loss of consciousness and a drop in blood pressure, can occur with torsion or rupture of an ovarian cyst, as well as with a blockage of the urinary canal with a stone - this condition occurs sharp violation urination, the patient cannot urinate. These pathologies require immediate medical intervention and cannot be treated at home.

The occurrence of pain in the left half of the chest is always a sign of a developed disease or pathology of internal organs, therefore, in such a situation, one cannot do without consultation and treatment of a specialist. If you or your loved ones have similar symptoms, it is necessary to start examination and treatment as soon as possible, because many diseases are successfully treated only with early diagnosis.

Pain in the upper abdomen under the ribs is a common symptom, especially characteristic of the following pathologies:

• Ulcer of the stomach and duodenum;
• pancreatitis;
• Cholecystitis.

Cutting under the ribs with right side characteristic of liver diseases. The pathology of the lungs is indicated by subcostal pneumonia, which occurs on the right, left, in the middle, and is aggravated by coughing. Vegetative-vascular dystonia is also distinguished by the same floating pain under the ribs. This article will discuss pain upper division abdomen, related to violations of the functions of the digestive system.

Dull, or vice versa, a sharp pain syndrome in the anterior hypochondrium of the abdominal cavity causes with increased or normal acidity. This pathology is characterized by pain in a state of hunger, from the fact that gastric juice irritates the inflamed gastric mucosa.

But eating does not alleviate the condition, but on the contrary, it can increase the pain, because after eating the inflamed mucosa is irritated by the accepted one, especially if it is hard, and with high content acids. Therefore, patients with gastritis are advised to eat starchy soups, jelly and other dishes that envelop the walls of the stomach.

Gastritis with hyperacidity symptoms such as unstable, constipated, stools are also characteristic. Aching pain and feeling of heaviness under solar plexus indicate the presence of gastritis low acidity. This condition is especially aggravated after eating.

One of the signs confirming this diagnosis may be belching bitter, sour, or eaten. with this form of gastritis brings relief. Malabsorption leads to weight loss, excessive sweating hands and feet, chronic anemia, vitamin B12 deficiency.

Gastric and duodenal ulcer

In stomach ulcers sharp pain, localized in the left half of the hypochondrium.

As a result of indigestion, the body does not receive the necessary nutrients, which causes the patient to lose weight, develops general exhaustion of the body and beriberi.

Pancreas cancer

When cancerous tumor in the pancreas, the pain resembles acute attacks pancreatitis. The pain comes from the location of the tumor. If the head of the pancreas is affected by the tumor, then the pain is concentrated in the right side. Malignant neoplasms the body or tail of the pancreas make themselves felt with intense pain under the left rib at night, the pain radiates to the back.

Hepatic colic and cholecystitis

Chronic cholecystitis declares itself with moderate pain under the right rib, radiating under the right shoulder blade or in the epigastrium. As a rule, pain occurs when the diet is violated, when eating spicy and fatty foods. Accompanied by bitter belching, vomiting, heartburn. Chronic cholecystitis is complicated by cholelithiasis, which requires surgical intervention.

On the acute cholecystitis may indicate sharp pain in front of the abdomen under the right rib.

Acute cholecystitis or inflammation of the gallbladder may be indicated by sharp pain in the front of the abdomen under the right rib. Unbearably sharp pain makes the patient toss about in search of a position that would help to make the pain less acute.

The patient suffers from fever and persistent vomiting. The disease is accompanied by yellowing of the skin and eyeballs. If inflammation is suspected

Most people associate pain under the ribs in the left side with disorders of the heart. However, such a syndrome can also be a sign of other diseases - from intercostal neuralgia to kidney failure. There is no single reason that will initially determine the diagnosis based on the localization of pain sensations. That is why pain under the left rib requires specialist advice.

A visit to the clinic under such circumstances should not be postponed in order to avoid unforeseen health consequences. Timely diagnosis will help to establish the cause, and the treatment prescribed by the doctor will relieve you of ailments in the shortest possible time.

Causes of pain on the left under the ribs

Localization discomfort in the area of ​​the left rib may indicate the development of an acute process or the presence of chronic diseases from the nervous, endocrine, respiratory, cardiovascular systems, gastrointestinal tract, injuries of the diaphragm, ribs, liver, kidneys, spleen, etc.

Periodicity, irradiation, accompanying syndromes (nausea, vomiting, headaches), factors that increase the pain syndrome (physical activity, respiratory activity, repositioning, eating or drinking) - this information provides the basis for a detailed analysis of pain and understanding why it hurts on the left under the ribs.

For the diagnosis of pain, a list of studies (laboratory, instrumental) is used: KLA, blood biochemistry, urinalysis, radiography, ultrasound, MRI, CT. Depending on the anamnesis, external examination and research results, a consultation with specialized specialist(gastroenterologist, traumatologist, cardiologist, endocrinologist, surgeon, etc.).

Diseases associated with pain on the left under the ribs

• cardiomyopathy, myocardial infarction;
• enlargement of the spleen, rupture of the spleen;
• gastrointestinal dysfunction (ulcer, gastritis, gastroduodenitis, stomach cancer, pancreatitis);
• kidney dysfunction;
• pulmonary diseases (pneumonia, pneumonia, oncopathology, pleurisy);
• endocrine disorders;
• vegetative-vascular dystonia;
• injuries of the ribs, diaphragm, internal organs;
• musculoskeletal system (osteochondrosis, protrusion, etc.).

The nature of the pain (sharp, dull, aching, pulling, shooting) also provides information about the possible source of the problem. Pain in the left side under the ribs often accompanies injuries and ruptures of internal organs. Dull spilled prolonged pain distinguishes diseases of the gastrointestinal tract, they are also indicated by pain in the morning in the epigastric region. morning pain after long sleep shooting character at sudden movements- characteristics of osteochondrosis. Permanent aching pain is a sign of disturbances in the work of the heart, and aggravated by nausea and vomiting - stomach ulcers.

Elimination of pain on the left under the rib

Localization of pain makes it possible to focus on the dysfunction of specific organs. Pain in the left side under the ribs in front, retrosternal pain associated with functional disorders cardiac activity - clinical forms ischemic heart disease (myocardial infarction). The same localization of pain is observed in gastrointestinal ulcers, gastric cancer and gastritis with high / low acidity. Damage to the diaphragm is characterized by pain on the left under the rib in front, radiating to the supraclavicular region or under the shoulder blade, aggravated by respiratory activity, coughing, sneezing.

Pain, accompanied by headaches, migraines, manifestations of convulsions - a sign of disorders of the nervous system. The pain is localized on the left under the ribs on the side and is paroxysmal in nature. The same symptomatology is characteristic of a disease of a viral nature - herpes zoster. The pain is aching at first, becoming sharp over time. Pain syndrome precedes the appearance of herpetic eruptions.

Kidney disease and vertebral osteochondrosis are distinguished by pain in the back on the left under the ribs. Acute strong pain indicates renal colic. Tolerable pain of a permanent nature - about an increase in the organ and the development of inflammation. With osteochondrosis, pain sensations change the level of intensity as motor activity. The answer to the question of what hurts in the left side below the ribs is the same in most cases - the spleen. Violations in her work entail the appearance of aching pains.

An understandable desire of the patient is the relief of acute pain syndrome with the help of antispasmodics and analgesics. However, this is a situational temporary solution that does not eliminate the cause and is very dangerous to health. If you have pain in the left side under the ribs, especially in combination with pallor / cyanosis of the skin, nausea, vomiting, increased pain when taking lying position, fever - immediately contact a medical institution.

Treatment of pain in the left side

Based on the causes and nature of pain in the left side in the region of the rib, it is possible to use various methods treatment. To eliminate the pain syndrome, specialists of our clinic use it.

• stomach diseases and duodenum(gastritis, ulcer, stomach cancer);
• diseases of the pancreas (acute and chronic pancreatitis, pancreatic cancer);
• gallbladder disease (acute and chronic cholecystitis, hepatic colic, biliary dyskinesia);
• liver diseases (hepatitis, cirrhosis, neoplasms).

• hemoblastic pathologies (leukemias and lymphomas);
• hemolytic anemia;
• sharp infectious diseases(Infectious mononucleosis);
• septic conditions (bacterial endocarditis, septicemia);
• chronic infections (tuberculosis, malaria);
• immune disorders (systemic lupus erythematosus).

A thorough analysis of the pain syndrome in conjunction with the accompanying symptoms, taking into account previously diagnosed diseases and the history of the onset of pain, will help determine which doctor to contact, and will allow a preliminary diagnosis to be made with sufficient accuracy.

Sharp pain under the ribs requiring emergency medical attention

Acute pain under the ribs in front in the middle with a perforated stomach ulcer and
duodenum

Initially, the pain is localized in the epigastrium (under the pit of the stomach), and then shifted under the right lower rib. Such migration is associated with the spread of gastric contents in the abdominal cavity. After the strongest pain attack there comes a period of imaginary well-being, often leading to erroneous tactics of waiting. If the patient does not receive adequate treatment, diffuse peritonitis develops, which can cause the death of the patient.

The history of the disease can help in the diagnosis. As a rule, patients have a long history of ulcers, and the perforation of the ulcer is preceded by a period of exacerbation of the disease. The exception is the so-called acute ulcers, which sometimes occur in postoperative period after serious surgical interventions, with polytrauma, septic conditions, etc.

First aid for perforation of a stomach or duodenal ulcer consists in emergency transportation to surgery department hospital.

Sharp girdle pain under the ribs in acute pancreatitis

The second will help in the diagnosis feature acute pancreatitis - nausea and repeated vomiting, which occurs both spontaneously and when trying to eat or drink a few sips of water. Pain after vomiting does not decrease, and sometimes even intensifies.

The pancreas contains many enzymes, which, when it is inflamed, enter the bloodstream and cause severe intoxication, manifested by characteristic symptoms: cyanosis (cyanosis) of the face, trunk and extremities, marbling of the skin of the abdomen, petechial hemorrhages on the lateral surfaces of the body and in the region of the navel. In extremely severe cases, collapse develops ( sharp drop blood pressure), often leading to the death of the patient.

When making a diagnosis, it should be taken into account that, as a rule, acute pancreatitis develops after abundant intake alcohol in combination with fatty sweet foods (doctors often call the pathology "holiday" or "New Year's" disease).

If acute pancreatitis is suspected, emergency hospitalization to the department intensive care because delay is fraught with the death of the patient.

Severe pain under the lower right rib in front with acute cholecystitis and hepatic
colic

The clinical picture is complemented by severe fever, nausea and repeated vomiting bringing no relief. Often there is jaundice of the skin and sclera (eyeball proteins).

Acute cholecystitis - inflammation of the gallbladder, should be distinguished from an attack of hepatic colic that occurs when a gallstone moves along the duct.

Hepatic colic is also characterized by acute pain under the right rib with the same irradiation, but repeated vomiting and fever are usually not observed. An attack of hepatic colic lasts several hours, and goes away on its own. The pain syndrome is relieved by antispasmodics, while in acute cholecystitis they are ineffective.

If acute cholecystitis is suspected, emergency hospitalization in the surgical department is indicated.

Sharp pain when inhaling under the ribs in front in the middle with a subdiaphragmatic abscess

In such cases, the pain is quite intense, aggravated by coughing, sneezing, deep breathing, sudden movements, and makes the patient take a forced position (half-sitting in bed or lying on the sore side). The pain radiates under the scapula and into the supraclavicular region of the corresponding side.

Pain in a subdiaphragmatic abscess, as a rule, is accompanied by severe fever and severe symptoms of general intoxication of the body.

Significant assistance in the diagnosis of pathology will be provided by the fact that the most common cause subphrenic abscess - surgical interventions. Another common cause of pathology is trauma to the abdominal organs. less often subphrenic abscess occurs as a complication of purulent processes in the liver and as a result of local peritonitis (acute cholecystitis, appendicitis, etc.).

Pain in the side under the ribs with severe injuries of the liver and spleen

Contribute to the rupture of the liver and spleen, some serious diseases that lead to disruption of the structure of the body (enlargement of the spleen in leukemia, cirrhosis of the liver, etc.). In such cases, a rupture can occur even with a slight force of the traumatic factor.

Characteristic difference of pain syndrome in severe injuries liver and spleen - a symptom of "roly-poly": the victim cannot be in horizontal position because the pain is exacerbated. This feature is due to the ingress of blood under the dome of the diaphragm, and irritation of the nerve endings located there.

In addition to pain under the ribs on the corresponding side (with rupture or crushing of the liver - on the right, with damage to the spleen - on the left) clinical picture complemented by symptoms acute blood loss(pallor of the skin and visible mucous membranes, rapid pulse with low blood pressure, dizziness and weakness).

Separately, it is necessary to highlight the so-called two-stage ruptures of the liver and spleen. They occur in those cases when, during an injury, the parenchyma of the organ is torn, and the capsule remains intact.

The blood poured out from the affected area accumulates under the capsule and gradually stretches it. Then, as a rule, with a minor injury (a slight push, a careless turn in bed) or a slight physical effort (sometimes even when coughing or sneezing), the capsule ruptures, and the collected blood is poured into abdominal cavity causing symptoms of peritonitis. Bleeding from the damaged organ after the rupture of the capsule increases, so that a sharp drop in blood pressure and death of the victim is possible.

The difficulty in diagnosing two-stage ruptures of the liver and spleen lies in the fact that immediately after the injury, the victims feel relatively satisfactory, they do not go to the doctors, and sometimes even engage in physical work which is extremely dangerous in their position.

Pain under the ribs with two-stage ruptures of the liver and spleen increases gradually, sometimes weakly present pronounced signs blood loss (shortness of breath with slight physical activity weakness, dizziness).

At the slightest suspicion of damage to the liver and spleen, you should contact surgical hospital for additional examination, since the earlier the operation to suture the torn organ is performed, the better the prognosis.

Pain in the abdomen under the ribs in front with gastralgic form of myocardial infarction

Patients complain of pain and a feeling of support under the heart. The pain syndrome is often quite intense, the pain causes increased sweating and is accompanied by a fear of death, so that patients behave very restlessly.

Diagnosis of heart disease is complicated by the presence of symptoms such as nausea, vomiting, painful hiccups, frequent stools. Because of this, patients are often misdiagnosed and prescribed inappropriate treatment.

Help in the diagnosis will be the presence of symptoms such as expiratory dyspnea (difficulty exhaling), which increases with the movements of the patient, and central cardiac cyanosis (a puffy, yellowish-pale face with a bluish tinge, purple-blue lips).

The pain may radiate downward and cause protective tension in the abdominal muscles. Therefore, with this pathology, patients are often diagnosed acute appendicitis and prescribe life-threatening surgery.

However, unlike " acute abdomen", pain in right-sided pneumonia does not have a clear localization, and the patient cannot name exact time occurrence of pain syndrome.

Other symptoms of pneumonia can be of great help in the diagnosis. Often the pain is preceded by one or more bouts of fever, which is not typical for abdominal catastrophes. Like all febrile diseases, pneumonia is accompanied by constipation, while diarrhea is more characteristic of pathologies that cause an "acute abdomen" picture. Often, with pneumonia, a very characteristic symptom is observed - flushing of the cheek or herpetic eruptions on the side of the lesion.

In addition, with abdominal catastrophes, the patient takes a forced position in bed, and with pneumonia, he can move, but often his movements increase shortness of breath. Shortness of breath and a pale bluish color of the nasolabial triangle is also a common sign of pneumonia and can be helpful in diagnosis.

And finally, for a preliminary diagnosis, a thorough history taking is necessary - pneumonia often complicates SARS.

If right-sided pneumonia is suspected, emergency hospitalization is necessary, additional research and treatment in a hospital (therapeutic department).

Pain under the ribs in chronic diseases

Dull aching or sharp pain under the ribs in front in the middle with chronic
diseases of the stomach and duodenum

• gastritis type A (gastritis with high or normal acidity);
• stomach or duodenal ulcer;
• gastritis type B (gastritis with reduced acidity);
• stomach cancer.

Pain under the ribs in the front in the middle with gastritis with high or normal acidity
For gastritis with increased or normal acidity, the onset of pain on an empty stomach is characteristic, caused by irritation of the mucous membrane with gastric juice. One and a half to three hours after eating, the pain may increase due to a mechanical effect on the inflamed mucosa, therefore, patients with gastritis are advised to take mucous soups and other dishes that have a softening and enveloping effect.

In addition to pain under the ribs in the front in the middle, gastritis with high acidity is characterized by such a symptom as excruciating heartburn. On the part of the intestines, there is instability of the stool with a tendency to constipation.

Sharp pain under the ribs in front in the middle and under the left rib with peptic ulcer of the stomach and duodenum
With a stomach ulcer and duodenal ulcer, a special cyclical pain is characteristic. Pain often occurs at night, while exacerbations of the disease are most often observed in spring and autumn. They can radiate left edge, in the back and lower back.

Often, to alleviate the pain syndrome, patients take a forced position: they squat, clasping their stomachs with their hands, press their stomachs against the edge of the table, or lie on their stomachs.

Just like with gastritis with high acidity, pain occurs on an empty stomach (especially for duodenal ulcers, “hunger pains” are characteristic) and 1.5-3 hours after eating. By the time interval between eating and the onset of pain, one can judge the location of the ulcer (the closer to the entrance to the stomach, the shorter this interval).

Provoke pain physical and nervous strain. Relieves - taking antacids (often patients use baking soda) and a heating pad.

In addition to sharp pain under the ribs in front and under the left rib, stomach and duodenal ulcers are characterized by heartburn and constipation, flatulence. With a long course of the disease, patients lose weight, they develop asthenic syndrome: weakness, irritability, headache increase.

Aching pain under the ribs in front in the middle and on the left with gastritis with reduced acidity
For gastritis with reduced acidity, pain and a feeling of heaviness under the ribs in front in the middle or on the left, after eating, are characteristic. Vomiting in this case brings relief, therefore, in the old days, gastritis with reduced acidity was called "indigestion."

The disease proceeds with a decrease in appetite and a tendency to diarrhea. Also very characteristic is the eructation of sour, bitter or eaten food.

With a significant violation of absorption, common symptoms appear: weight loss, hyperhidrosis of the extremities, seizures around the mouth. May develop chronic anemia associated with vitamin B 12 deficiency.

Sharp or aching pain under the ribs in front in the middle and on the left with stomach cancer
Pain under the ribs in front, in the middle and on the left with stomach cancer, as a rule, already appears on late stages diseases, with the germination of the stomach wall by the tumor and compression of the surrounding organs and tissues. The initial period often goes unnoticed.

suspect oncological cause pain is possible in the presence of so-called "small signs" that appear already on early stages diseases:

• weight loss;
• change taste habits, picky attitude to food, aversion to meat;
• signs of anemia and early intoxication (yellowish-pale complexion, yellowness of the sclera);
• progressive weakness, overall decline working capacity;
• psychological changes (depression, loss of interest in the surrounding reality, alienation, apathy).

Most often, gastric cancer occurs against the background of gastritis with reduced secretion. gastric juice. Polyps and ulcers of the cardia of the stomach are very prone to malignancy, therefore, with these diseases, special vigilance is necessary.

Girdle pain under the ribs in chronic pancreatitis and pancreatic cancer

A characteristic feature of the pain syndrome in chronic pancreatitis is the intensification of pain in a horizontal position lying on the back, so that patients during an attack try to sit, leaning forward.

In addition to a specific pain syndrome, chronic pancreatitis is characterized by pronounced signs of malabsorption of substances in the intestine - diarrhea, "fatty feces", sometimes meat fibers can be detected in feces with the naked eye. As a result of insufficient income nutrients in severe cases, patients lose a lot of weight (sometimes up to 20 kg), vitamin deficiency and general exhaustion of the body develop.

Pain under the ribs at the back with kidney damage has two mechanisms. For acute or chronic inflammation an increase in the size of the organ occurs, which leads to stretching of the capsule. The pain in this case is constant, but they are not very intense, and most often have the character of a feeling of heaviness in the lumbar region.

The basis of another mechanism for the occurrence of pain is a spasm of smooth muscle muscles. primary departments urinary tract. This pain is like renal colic, it is acute, paroxysmal, gives down to the groin and genitals, is removed by heat and antispasmodics.

Back pain under the ribs with osteochondrosis lumbar of the spine is caused by inflammation of the roots spinal nerves. In such cases, the pain extends along the fibers of the corresponding nerves down to the buttocks, and outer surface thighs and lower legs.

Pain syndrome in osteochondrosis can also have a different character. Patients are often worried about aching pain after morning sleep or prolonged stay in one position. Another type of pain is shooting. They occur with sudden movements, and cause the patient to freeze for a long time in one position.