Anyone who has ever experienced left side abdominal pain during exercise or in general certainly knows how unpleasant it can be. In this article, we will explore together the many reasons behind this annoying pain, offering valuable information on how best to manage it. From an analysis of the organs located on the left side of the abdomen to specific conditions such as “spleen pain” during exercise and Exercise Related Transient Abdominal Pain (ETAP), we will look in detail at all the possible origins of this bothersome symptom.

The main goal of our article is to offer you a brief and clear guide to understanding, managing, and, if necessary, coping with left hip pain while always emphasizing the importance of consulting a medical professional to get an accurate diagnosis.

What organs are found on the left flank?

The left flank of the body houses a number of vital organs that play crucial roles in maintaining health and bodily functions. Among them, the spleen plays a vital function in the immune system, while the left side of the transverse colon and the left flexure of the colon contribute to digestion and nutrient absorption. The pancreas, which is responsible for the production of digestive enzymes and insulin, is also located in this area along with part of the stomach, which is essential for the initial phase of digestion.

Left kidney, located in the upper part of the left flank, is involved in the process of filtering blood and regulating blood pressure. Left ureter transports urine from the kidneys to the bladder, while the left lung contributes to breathing and maintaining gas balance. The left adrenal, left lobe of the liver, heart, and aorta also occupy this region, although their position is more nuanced.

In the low left flank, we find the continuation of the left kidney, descending colon and sigmoid colon, which actively participate in digestion and waste elimination. The bladder, arterial and venous vessels, and in women, the fallopian tubes and the left ovary, complete this anatomical area.

Left abdominal pain during physical activity

Left abdominal pain during physical activity is a phenomenon that often afflicts those who participate in sports, particularly aerobic activities such as running. This discomfort, commonly known as “spleen pain,” is localized under the left costal arch, in the region where the organ is located.

Spleen pain during physical activity, commonly associated with young athletes, could result from several factors, including lack of warm-up, high exercise intensity, and poor fitness level. Although pain is often temporary and benign, there are some preventive strategies such as proper warm-up, stretching exercises, and gradual intensification of training. Attention to diet, avoiding large meals just before exercise, can also help prevent spleen pain.

ETAP: Exercise Related Transient Abdominal Pain

One possible cause of left side abdominal pain during physical activity is Exercise Related Transient Abdominal Pain (ETAP), also known as exercise-related transient abdominal pain. ETAP is a common phenomenon during physical activity, often mistakenly associated with “spleen pain.” This transient abdominal pain is characterized by sharp twinges in the hypochondrium region that occur during or after exercise. Although the term “spleen pain” is often used, ETAP more commonly involves the abdominal muscles rather than the organ itself. Athletes, especially young people and those in disciplines with repetitive upper body movements, such as running or horseback riding, are more susceptible. The exact causes of ETAP are not fully understood, but factors such as lack of warm-up, high-intensity exercise and fitness levels can contribute to this transient but often annoying phenomenon.

ETAP: A deeper analysis

One study (PubMed) found that exercise-related transient abdominal pain (ETAP) is a common condition in many sports activities, especially those involving repetitive torso movements in an extended position, such as running and horseback riding. It is often called “stitch” and is characterized by localized pain, usually in the sides of the midabdomen along the costal border, but can occur in any region of the abdomen. This pain can be sharp or stabbing when severe and cramp-like, painful or pulling when less intense.

ETAP is more common in young people but is not related to gender or build. Well-trained athletes can also experience this condition, although less frequently. There are several theories to explain the mechanism responsible for the pain, including ischemia of the diaphragm, stress of the visceral supporting ligaments, gastrointestinal ischemia or distension, cramping of the abdominal muscles, ischemic pain resulting from compression of the celiac artery, aggravation of the spinal nerves, and irritation of the parietal peritoneum.

Among these theories, irritation of the parietal peritoneum seems to best explain the characteristics of ETAP, although further investigation is needed to confirm this hypothesis. Strategies for managing pain are largely based on personal experience, as the exact cause is still not completely clear. Suggested prevention strategies include avoiding large volumes of food and drink before exercise, improving posture, supporting the abdominal organs through core training or the use of a support belt.

In general, ETAP is a phenomenon that has received more attention in the past 15 years, although its management and prevention continue to be studied.

Other common causes of left side abdominal pain

Left side abdominal pain can result from several causes, requiring careful consideration to identify the source of discomfort. Diverticulitis is one possible explanation, as inflamed intestinal sacs can cause fever, nausea and diarrhea. Excessive gas accumulation in the digestive system or indigestion may also cause pain in the left lower abdomen. Hernias, both inguinal and abdominal, may present with swelling and pain, requiring prompt medical evaluation.

For women, conditions such as endometriosis or an ectopic pregnancy can be a source of lower abdominal pain. Ovarian torsion, caused by ovarian cysts, and pelvic inflammatory disease (PID) are other possible culprits, requiring prompt consultation with a physician. In the case of males, testicular torsion is a medical emergency requiring immediate attention.

Additional symptoms such as fever, vomiting, bloody stools, unexplained weight loss, or signs of shock should be monitored closely, as they may indicate more serious conditions. If such signs are present, it is advisable to seek medical attention without delay. Only a professional can provide an accurate diagnosis and an appropriate treatment plan to manage left side abdominal pain effectively.

When to worry about left side abdominal pain?

Left side abdominal pain in the abdomen can result from a variety of causes, and it is critical to understand when to pay attention and consult a physician.

Although mild pain may be normal and temporary, it is important to pay attention to additional symptoms such as fever, vomiting, bloody stools, unexplained weight loss, or signs of shock. If such signs are present, it is advisable to seek immediate medical attention. Remember that only a professional can provide an accurate diagnosis and an appropriate treatment plan to manage left side abdominal pain.

This article was originally written in Italian and translated English via deepl.com. If you notice a major error in the translation you can write to [email protected] to report it. Your contribution will be greatly appreciated