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Pain below the left rib cage can be caused by a variety of conditions. It can even be caused by disease processes and injuries on the right side of the torso that are felt on the left, although this is relatively unusual. Here are just some of the possible causes of pain in this location:

  • Heartburn is by far the most common cause of pain under the left rib cage. Heartburn is a buildup of acid in the stomach that can be caused by eating too many acidic foods, such as tomatoes and citrus juices. It can be aggravated by Aspirin or the asthma medication theophylline (Theo-Dur). Hot peppers don't actually cause heartburn, but they increase the sensation of pain when it occurs. Contrary to mainstream advice, it is large meals without fatty foods that are more of a problem than large meals with fatty foods. Fat coats the stomach, while protein requires more stomach acid to be digested. At least in the short term, heartburn can be corrected by antacids. Heartburn pain is, as its name suggests, more of a burning pain than a pressure pain or a stabbing pain.
  • Stomach ulcers cause burning pain underneath the left side of the rib cage that radiates up to the shoulder blade. This pain may be continuous or occasional. It may cycle throughout the day, or be worse when the stomach is empty, at night.
  • Gas in the colon can cause pressure that is felt under the left rib cage. Sometimes gas in the colon is a reaction to plant lectins, soap-like compounds that are found in beans, peas, and many tropical fruits. Bloating can result from eating too many fermented foods with live bacteria, such as kimchi, cold-packed pickles, or sauerkraut. Sitting up straight in a chair usually relieves this pain, often with loud flatulence. This pain is a pressure pain rather than a burning or stabbing pain.
  • Costochondritis results from the inflammation of the cartilage joining the ribs with the breastbone. This results from injury to the ribs or viral infection. It can cause almost-unbearable pain during heavy breathing. Requiring medical treatment, costochondritis produces a pain like that of being punched or kicked, only continuously.
  • Broken rib or ribs causes an "explosive" pain on the side of the chest where it occurs. This has to be diagnosed by x-ray.
  • Irritable bowel syndrome can cause intense pain under the left rib cage, usually about an hour after eating. There may be an intense urge to defecate, but difficulty with bowel movement. Irritable bowel syndrome can also cause its sufferers to break out in a sweat and to experience difficulty breathing with a slowing of the heart rate. This pain is an intense pressure pain.
  • Ruptured spleen is a medical emergency. Caused by a severe blow, it causes pain in the left upper quadrant of the abdomen that may radiate up to the shoulder. Pressing the skin will cause tenderness. If bleeding in the spleen results in loss than more than about 5 percent of the body's total volume of blood (all of it internal, without visible bleeding), there can be rapid pulse, rapid breathing, and sudden loss of blood pressure. This is never a condition you should try to treat on your own. It is always a condition to be treated in a hospital.
  • Colonoscopy can cause punctures in the lining of the colon or damage to the spleen that shows up as pain on the left side beneath the rib cage.

Sudden and sharp pain underneath the rib cage is often a medical emergency, even if it was not clearly caused by an discernible injury. Sudden and sharp pain underneath the rib cage that is caused by an injury you remember may be a sign of injury to your internal organs requiring immediate medical attention. Pain cause by digestive disturbance sometimes can be relieved by changes in diet and simple, over the counter medications, but when in doubt, see a doctor.

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