The ribs are a veritable collection of bone, muscle, and organs, most of which are fairly important for living and other useful functions.
Consequently, pain from the rib cage tends to cause alarm, especially if it comes on suddenly. However, pain can mean different things depending on location and other associated symptoms.
Pain under the left rib cage, for instance, can mean anything from a ruptured spleen to needing to have a good fart.
The Primary Causes of Pain under the Left Rib Cage
The rib bones can break in response to injury, usually something like a car crash or other type of collision or blunt force trauma. The most apparent sign of a broken rib is intense pain in the area, especially when moving or bending. Pain under the left rib cage when breathing is also not uncommon, but again, it will depend on where specifically the broken rib is located.
There may also be signs of bruising around the injury site. In the worst case scenario, a section of the rib cage can fully break and detach from the chest wall.
This results in a medical emergency known as “flail chest” and presents with painful, labored breathing, as well as something called “paradoxical breathing,” where the chest can appear to move opposite to the normal patterns of inhalation/exhalation.
The spleen is used to filter red blood cells and hangs in the upper part of the abdomen. An enlarged or ruptured spleen can cause sudden or chronic pain under the left rib cage that ends up migrating towards the back and/or shoulders.
An enlarged spleen is usually due to specific types of infection or inherited conditions that affect the organ’s function. An enlarged spleen does not necessarily present with pain and in some cases will simply come with a feeling of “fullness” despite not eating or only eating a small amount (the spleen is pressing on the stomach). You may also experience anemia, fatigue, and begin to bleed more easily.
A ruptured spleen is much more dramatic and can present with sudden, intense pain under the upper left rib cage as well as potential pain in the left shoulder and confusion or lightheadedness. Since the spleen is filled with blood at any given time, a rupture will likely lead to signs of bruising as blood begins to pool under the skin.
The spleen can rupture in response to trauma or when an enlarged spleen is left untreated for a prolonged period. Due to the organ’s positioning, the spleen is in the perfect spot to get poked by a broken rib and can sometimes rupture as a result of an untreated rib injury.
On the less-scary side of the spectrum, pain under the left rib cage can also be from heartburn. Heartburn, also known as acid reflux, is when excess stomach acid is produced or some of the stomach acid splashes back up the esophagus. This can create a sharp pain under the left rib cage that seems to be coming from the heart, hence the name “heartburn”.
The pain under the left rib cage will come after eating in most cases, especially if the meal was highly acidic or spicy. A bloating sensation is not uncommon, either.
An ulcer is when a sore develops in the lining of the stomach or small intestine and are caused by long-term NSAID use, chronic excess of stomach acid, or infection by H. pylori bacteria.
The irritation of a stomach ulcer can cause a dull pain under the left rib cage, reduced appetite (due to pain), acid reflux or heartburn, nausea and vomiting, gastritis (stomach inflammation), and unintended weight loss. In rare cases, untreated stomach ulcers can lead to a persistent, sharp pain and begin to bleed into the digestive tract.
Indigestion or Irritable Bowel Syndrome
IBS can result in intestinal or bowel irritation in response to digestion that will produce sharp pains under the left rib cage along with intestinal cramps, diarrhea, or constipation, especially after large meals. Even without IBS, large meals can still produce pain under the ribs.
Basically, when you eat a lot of food, your digestive system slows in order to accommodate it all properly. This leads to the trapping and buildup of gasses and pressure, resulting in pain.
A kidney stone is a calcium deposit that can form under various conditions. If a stone migrates to the urinary passage it may get lodged in place due to its size. This results a sharp pain under the left or right rib (depends which kidney) that is located near the small of the back.
Kidney stones are spectacularly painful and if suspected they should be brought to a doctor’s attention as soon as possible.
If something is wrong with your lungs, such as inflammation, infection, fluid buildup, or a puncture, you will likely experience a pain under the rib cage that worsens when breathing or coughing. Generally speaking, if your pain seems connected to lung function or comes with difficulty breathing, you should get it checked out ASAP.
The heart is located under the left rib, so the pain from a heart attack will be felt there as well. A heart attack is when something has impaired blood flow to the heart and part of the organ begins to starve and die from lack of oxygen.
The symptoms of a heart attack can emerge more gradually than most people realize and take the form of tightness or squeezing pain in the chest that can radiate to the left arm, jaw, back, or abdomen, along with shortness of breath, excessive sweating, nausea/vomiting, dizziness, or weakness.
There may also be something called “Levine’s sign”, which is where the chest pain can be localized (focused) by clenching the first over the breastbone (sternum).
How to Treat Pain under the Left Rib Cage
The above conditions and ailments all have wildly different treatment approaches and are not an exhaustive lift of causes for pain under the left ribs. Possible approaches can be anything from antibiotics to diet changes to emergency surgery depending on the underlying cause.
The best treatment, therefore, is to be aware of the signs your body is sending you and to speak to your doctor.
To generalize, if the pain under your ribs is connected to eating, then you are more likely to have a digestive issue. Under other circumstances, especially if you have breathing difficulties or suffered blunt force to the chest in the past few days, then you should get checked out as soon as possible.