Lower right abdominal pain is defined as abdominal pain occurring to the right of an imaginary line drawn from above the pubic bone in the mid-line, up to the level of the belly button or umbilicus. Pain in this area is the most common reason for people going to accident and emergency departments across the world.
The right side of the abdomen internally is different from the left side in at least three ways. There is the presence of the caecum, and the appendix on the right lower abdomen as well as a larger and steeper "right paracolic gutter" - the space surrounding the right half of the colon. These factors make the right lower abdomen more prone to having things go wrong with it than the left side.
Also within this region of the body lies other organs like the:
Damage or disease to these structures and organs can cause pain in the lower right abdomen.
Infection far away in the upper part of the abdomen like from the gallbladder and liver can also track down to cause pain and symptoms in the lower right abdomen. A systematic approach to analysing the characteristics and associated symptoms of a lower right abdominal pain is the solution to understanding what might be causing such pain..
The following are common conditions that cause pain in the lower right abdomen and their individual symptoms.
Are you having pain in the lower right abdomen in the last few days? Did the pain start in your upper abdomen and then moved towards the lower right side? Has the pain become worse in the last day or so? Does it seems to get worse when you move or walk or stand straight? What's your appetite like? Feeling nauseated and not hungry... perhaps you have even skipped having dinner or breakfast? Are you feeling feverish? Does pressing your hand against your lower right abdomen cause this moderate to severe pain in you?
If you have a combination of two or more of the above symptoms, you might be suffering with acute appendicitis, and it is important that you seek urgent medical attention as soon as possible.
Appendicitis is undoubtedly one of the most common causes of lower right side stomach pain. It can occur in anyone and at any age, but:
Pain in the right lower abdomen which has been there for weeks or months will not be an appendicitis, and therefore this pain should also be investigated by a doctor.
The best treatment option for appendicitis will be to have an operation to have the diseased appendix removed. The use of antibiotics alone only buys time.
If you are constipated, you could develop lower right abdominal pain. This will not be difficult to diagnose as you may have noticed that you are not opening your bowel as frequently as you normally would, or that your stool has become harder to pass than usual.
If you have any of the following symptoms in association with a lower right abdominal pain, then constipation may be the cause of your abdominal pain:
If you suspect that you are suffering with constipation, dietary and lifestyle changes like increasing your daily intake of clear fluids, eating more dietary fibre and using laxatives as prescribed by your healthcare provider will be the best way to go.
A urinary tract infection could be a cause of lower right side abdominal pain. This could be due to an infection affecting the right kidney, ureter or bladder. Though this condition more often causes a central lower abdominal pain, it could also lead to pain in the lower right side of the abdomen. Other symptoms of urinary tract infection include:
If you suspect that your lower right side stomach pain may be due to a urine infection, it is important you see your doctor immediately for assessment and possible prescription of an antibiotic for you. Commonly used antibiotics that are more effective for the treatment of urine tract infection include trimethoprim 200mg twice a day for 3 to 7 days; nitrofurantoin 50 to 100mg up to four times a day for 3 to 7 days; co-amoxyclav 625mg three times a day for up to 7 days in more severe cases, or the use of ciprofloxacin. The choice of antibiotics is often governed by local policy and bacteria resistance pattern.
Mesenteric lymphadenitis is a very common cause of lower right side abdominal pain especially in children. It is often be confused with appendicitis but this condition is due to the inflammation of the lymph nodes or glands in the wall of the small bowel.
If your child is having a right lower abdominal pain, the abdominal pain due to a mesenteric lymphadenitis. Symptoms of this include:
If your child has a lower right abdominal ache, the best step is to take them to see the doctor. The doctor will examine the child to determine whether the cause of the abdominal pain is due to acute appendicitis or non-specific mesenteric lymphadenitis.
Irritable bowel syndrome or IBS can cause a lower right side abdominal pain, though it usually causes a left lower abdominal pain rather than pain on the right side. IBS is more common in young people between the ages of 13 to 30, and more common in women than in men.
The symptoms of irritable bowel syndrome include:
If you have any of the above symptoms, with ongoing weight loss, upper abdominal pain after eating, or passing blood in your stool, it is important you let your doctor know immediately.
Self-help measures including keeping a meal diary and eliminating foods which worsen symptoms is a good idea.
Other treatments include the use of special pain killers like amitriptyline, in conjunction with medications like mebeverine or buscopan. If constipation is the dominant feature then laxatives are recommended or loperamide if the problem is diarrhoea.
If you suffer from IBS, then expert care and support is required.
Are you a lady of child bearing age (between 13 to 65 years old) and are you sexually active? When last did you last have your period? Is it running a few days or perhaps weeks late? Could you be pregnant?
If you answer yes to the questions above and you have a lower right abdominal pain, it is very important that you get checked to exclude the presence of an ectopic pregnancy.
Ectopic pregnancy is the presence of pregnancy outside the womb. It is a very common cause of lower abdominal pain in women. If not diagnosed quickly and treated, it could be very serious and many women have lost their life due to this condition.
Symptoms of ectopic pregnancy include:
If you have any of the above symptoms and if there is a chance that you could be pregnant, it is very important that you get emergency medical attention. The best treatment option for ectopic pregnancy will depend on the site, size of the gestation sac, the progress and complications at the time of assessment.
Treatment options include:
Do you have a lower right side abdominal pain that started in last few hours or days? Does the pain spread to your lower back? Did you say the pain starts in your right hip and then moves to the upper thigh and down your leg?
Do you always have the pain there but does it also come in waves with periods of severe exacerbation?
When did you last have your period - are you in the middle of your menstrual cycle?
You may be suffering with ovarian cyst symptoms and if this is the case you will need to be assessed by your healthcare provider.
An ovarian cyst can become twisted, causing severe sudden onset of lower abdominal pain, colicky. Or it could become ruptured, causing a continuous lower abdominal pain spreading to the thigh or sometimes, you could bleed into the cyst, also leading to continuous pain, like in corpus leutum cyst. Treatment will depend on what has happened and the type of cyst.
Endometriosis is a very common cause of chronic abdominal or pelvic pain in women. It is estimated that pain in as much as 80 percent of ladies of child bearing age who suffer with a long standing abdominal pain may be due to endometriosis.
But what is endometriosis?
If you have a long standing lower right abdominal pain that seems to get worse around the time of your period, why not discuss with your doctor about the possibility of endometrosis?
Treatment will depend on site, severity and level of disruption to your life, and options for this include the use of simple pain killers, or mirena coil, or special kind of hormone medication, or even surgery.
Pelvic inflammatory disease can cause a right lower abdominal pain in the form of a right salpingitis (infection in the right fallopian tube) or outright complete inflammation of the whole of the vagina, cervix, womb and tubes.
Could your lower right abdominal pain be due to pelvic infection? Do you have a right lower abdominal pain with:
Also, are you sexually active, with perhaps more than one sexual partner?
If you answer yes to most of the above, then it is likely that the cause of your lower right abdominal pain is due to a pelvic infection. It is a relatively easy condition to diagnose by doctors and treatment is readily available too, in form of antibiotics. Please speak with your doctor. Delay in treatment could lead to infertility and many other complications.
Crohn’s disease is one of the inflammatory bowel diseases. It could cause a chronic or intermittent right side lower abdominal ache. The problem with Crohn’s disease is that it mimics so many other causes of abdominal pain. It is usually however a chronic problem, and other symptoms associated with Crohn's include:
Use of medications to control symptoms can be very successful, though in some cases, surgery may be required.
A hernia is an out pouching of the bowel, or part of the bowel, through a weakness on the wall of the abdomen. You could also have other materials apart from the bowel inside a hernia.
There are common hernias, such as the groin hernias (inguinal and femoral hernia) where there is an obvious swelling with severe abdominal pain and vomiting.
Other types of hernias are less visible, causing intermittent abdominal pain, on the right or on the left lower abdomen. Such hernias include:
If you suffer with a long standing lower right abdominal pain which is worse on movement, or on turning in the bed or during sports, why not discuss with your doctor the possibility of a hernia. Treatment is usually by surgery.
Psoas muscle abscess is uncommon in the western world, and more a problem in regions where infections and tropical diseases like tuberculosis exist. Some infection for example, in the kidney could track down to the muscle on the floor of the lower right abdomen called the psoas muscle, leading to swelling and lower right abdominal pain. The sufferer may lose weight, develop poor appetite, have night sweats, and a mass may be felt in the lower right tummy.
Before you panic about the "c-word", know that bowel cancer should not be the first thing to spring into your mind if you are having a lower abdominal pain.
Only worry about bowel cancer if:
If you've gone through all the other causes of lower right abdominal pain above, you will clearly notice that many of the symptoms mentioned for bowel cancer are also included in the symptoms for some other conditions. Do not be confused. If you have a combination of any of these symptoms described here under bowel cancer, it is important to discuss these with your doctor for a complete assessment and advice.
9 Most Common Causes of Lower Right Abdominal Pain - EnkiVillage, http://www.enkivillage.com/lower-right-abdominal-pain.html (Accessed: September 2016)
Med-Heath.net, Lower Right Abdominal Pain, http://www.med-health.net/Lower-Right-Abdominal-Pain.html (Accessed: September 2016)
WebMD, Understanding Appendicitis, http://www.webmd.com/digestive-disorders/understanding-appendicitis-symptoms (Accessed: September 2016)
Have you had experience with a lower right abdominal pain recently? How did it go? Was there any difficulty with the diagnosis? What about treatment and recovery? We would love to hear your story.
If you have pain in lower right side of your tummy or abdomen and want help with identifying what might be causing it, also feel free to post a very detailed description of your symptoms here and get a free online medical consultation. The more you write about your condition, when it all started, how it has progressed, how it is affecting you, your age, and medical history, the more the chance of getting help with identifying what might be causing your abdominal pain.
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Last Updated: 26th November 2012