What lies under the left ribs?
The left side of the ribcage protects the heart (toward the middle), the left lung, the stomach, the spleen, the tail of the pancreas, part of the large bowel and the left kidney toward the back. The ribs themselves, the cartilage that joins them at the front, and the muscles between them can all be sources of pain. Where exactly the pain is, front, side or back, upper or lower, and what makes it worse, helps narrow down the cause.
Musculoskeletal causes
- Intercostal muscle strain: sharp pain with twisting, coughing or deep breaths; see intercostal muscle strain.
- Costochondritis: tender front of the chest beside the breastbone, often on the left.
- Bruised or broken rib: after a fall, blow or severe coughing.
- Slipping rib syndrome: sharp pain at the lower rib edge with a click.
- Rib joint irritation at the back: pain beside the spine on breathing.
- Shingles: burning band of pain followed by a rash.
Digestive causes
- Gastritis and stomach ulcers: burning upper abdominal pain, sometimes under the left ribs, related to meals.
- Trapped wind and constipation: bloating and cramping that can be felt under the left ribs (where the bowel bends near the spleen).
- Indigestion and reflux: burning in the upper abdomen and chest.
- Pancreatitis: severe upper abdominal pain spreading to the back, with vomiting; often linked to gallstones or alcohol.
- Irritable bowel syndrome: cramping and bloating that can be felt anywhere in the abdomen.
Spleen problems
The spleen sits under the left lower ribs. It can enlarge with infections such as glandular fever, blood disorders and liver disease, causing fullness or discomfort under the left ribs and sometimes pain in the left shoulder. A blow to the left upper abdomen, for example in a fall, sport or car accident, can injure the spleen, which may bleed internally. This is why contact sports are avoided during glandular fever, and why abdominal injury with pain, dizziness or pale skin needs emergency care.
Heart and lung causes
- Angina or heart attack: pressure, tightness or heaviness, often with exertion, breathlessness, sweating or nausea.
- Pericarditis: sharp chest pain that eases when leaning forward, sometimes after a viral illness.
- Pleurisy: sharp pain on breathing in, often with infection.
- Pneumonia: cough, fever and breathlessness with chest pain.
- Pulmonary embolism: sudden breathlessness and sharp pain.
- Collapsed lung: sudden one-sided pain and breathlessness.
Clues to the cause
- Tender to press, worse with movement or twisting: usually muscle, rib or cartilage.
- Related to meals, with burning or bloating: stomach or bowel.
- With exertion, breathlessness or sweating: possible heart cause, needs urgent assessment.
- With fever and cough: possible chest infection.
- Sudden and sharp after a fall or blow: rib fracture or spleen injury.
- Burning followed by a rash: shingles.
What to do
For mild pain that is clearly linked to a movement or strain, rest from aggravating activities, use heat, take simple pain relief if suitable and keep breathing deeply. For digestive symptoms, smaller meals, avoiding trigger foods and treating constipation can help. Any pain with warning signs needs prompt medical assessment, which may include an ECG, blood tests, a chest X-ray or an abdominal ultrasound. Pain on the left side of the back is covered in our guide to back rib pain.
When to see a doctor
- Pain that lasts more than a few days or keeps coming back.
- Pain that wakes you at night or is getting worse.
- Pain with fever, cough, vomiting, change in bowel habit or weight loss.
- Pain after an injury.
- Any chest pain if you have heart risk factors.
- A feeling of fullness under the left ribs with tiredness or easy bruising.
Three common situations
- Sharp pain under the left ribs after a week of coughing: intercostal strain is likely; see a doctor if you are breathless or feverish.
- Burning pain under the left ribs after meals: gastritis or reflux; avoid triggers and see a doctor if it persists.
- Footballer hit in the left side, now dizzy and pale: possible spleen injury; call emergency services.
Key points to remember
- Most left-sided rib pain is muscular, rib or cartilage related.
- Digestive problems and, less often, the spleen and pancreas can cause pain under the left ribs.
- Heart and lung causes must be ruled out when there are warning signs.
- Pain with breathlessness, sweating, fever or after injury needs prompt care.
Questions about left-sided rib pain
These answers are general information and do not replace an examination or individual medical advice.
What organ is under the left rib cage?
The spleen, stomach, part of the pancreas, the left lung, part of the bowel and, toward the back, the left kidney. The heart sits toward the middle.
Can gas cause pain under the left ribs?
Yes. Trapped wind in the bend of the bowel near the spleen can cause sharp or cramping pain under the left ribs.
Is left rib pain a heart attack?
Usually not, but heart pain can be felt there. Pressure-like pain, breathlessness, sweating or nausea need emergency assessment.
How do I know if left rib pain is muscular?
Muscular pain is usually tender to press, worse with movement, twisting or deep breaths, and often follows a strain or cough.
When should I worry about pain under my left ribs?
If it is severe, sudden, follows an injury, or comes with breathlessness, fever, vomiting, fainting or weight loss.
Sources
- NHS · Chest pain
- NHS · Stomach ache
- NHS · Spleen problems and spleen removal
- NHS · Acute pancreatitis
- NHS · Costochondritis
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.