Lower right abdominal pain is one of the most common causes of patient visits to the emergency department. The lower right abdominal region is located below an imaginary horizontal line drawn under the lower right ribs and to the right of an imaginary vertical line running along the belly button.
Abdominal pain in this area is usually acute, and can be spontaneous or chronic. It can be a dull or sharp, localized or diffuse.
Accompanying symptoms include nausea and vomiting, tenderness, constipation, diarrhea, loss of appetite, bloating and gas, and fever.
There are many structures in the lower right abdominal region in which pain can originate.
The internal structures in this area include parts of the large intestine called the cecum, the appendix, and ascending colon, portions of the small intestine, the right ovary and the fallopian tube, and the right ureter.
Any abnormality or disturbance of one or more of these structures can cause pain in the lower right abdomen.
The most common cause of lower right abdominal pain is appendicitis. This occurs when there is an infection or blockage that leads to swelling and inflammation of the appendix.
If you notice the following symptoms, it is important that you get a quick diagnosis.
Most of the time the first symptom is a dull, aching pain around the belly button; over several hours this pain will continue to become more intense and the area around the pain will become tender to touch.
You may even experience nausea, diarrhea or constipation, and a low fever.
Pain associated with ovulation or Mittelschmerz may occur either in the right or left side of the lower abdomen. This usually does not require medical attention.
However, it is sometimes confused with the symptoms of appendicitis due to the location of pain.
Ovulation pain occurs about two weeks before the next menstrual period, when an egg is released from the ovary. This may be a dull, cramp-like pain or a sharp, sudden pain.
This pain is not usually severe, but it may be accompanied by vaginal spotting or bleeding. It is often relieved by rest and pain relievers, but if it is accompanied by fever and nausea, infections such as appendicitis must be considered.
When you are unable to pass regular stools due to constipation, you may have lower right abdominal pain. While constipated, it is common to have straining, bloating, and rectal pressure until you have a bowel movement.
Once you have a bowel movement, the pain in the lower right abdomen should be alleviated. You may consume over-the-counter stool softeners or laxatives to help with regular bowel movement.
A change in diet will often help if you suffer from constipation often.
Infection of the Right Kidney
When you experience pain in the groin, back pain, and lower abdominal pain, you may have an infection in the right kidney. The kidney may become inflamed and painful from a urinary tract infection.
With an infected kidney, you may constantly feel the urge to urinate. The urine may also be painful or contain blood and pus. A fever is also a common accompanying symptom.
If left untreated, it may lead to damaged kidneys, it is important that you visit your doctor once you have any of the symptoms.
Right Ovarian Cysts
The ovary sometimes produces fluid filled sacs on the surface, which may grow large and produce discomfort. Although they are usually harmless and can resolve on their own, they may become enlarged and get twisted, producing lower abdominal pains.
They can produce dull, aching, pelvic pain that is persistent or intermittent, and may radiate to the lower back and thigh. Pelvic pains may be experienced near the beginning or end of a menstrual period. Menstrual periods may be irregular.
Lower abdominal pain may also be associated with heaviness or fullness of the abdomen, nausea, vomiting and pressure on the bladder or rectum.
Although most ovarian cysts resolve on their own, you should see a doctor if there is a sudden, severe lower abdominal or pelvic pain that is associated with fever or vomiting.
A chronic inflammation of the intestines, often associated with ulcers and fistulae is commonly known as Crohn’s disease. Most of the time it affects young and middle aged adults.
The most common symptom is lower right abdominal pain, but is also accompanied by nausea, fever, diarrhea, bloody stools, a rash of the skin, or ulcers in the mouth.
A doctor is able to make the diagnoses based upon the results of a colonoscopy, blood and stool tests, and an examination of the small or large intestinal lining.
Another common cause of lower right (or left) abdominal pain is constipation. This occurs when you are unable to regularly pass stools with ease, and instead, may pass hard stools less than 3 times a week. Straining, bloating, and pressure in the rectum accompany the pain.
The pain usually disappears with bowel movement and may not be accompanied by additional symptoms. This is often relieved by modifying the diet and taking stool softeners or laxatives.
When a fertilized egg is implanted outside of the uterus, an ectopic pregnancy results. The fertilized egg may lodge in the right ovary, fallopian tube, or in the abdominal cavity, causing severe pain. If it occurs on the right side then it may be mistaken for appendicitis.
However, it is often recognized because it is usually associated with a missed period, symptoms of early pregnancy, and vaginal bleeding.
Immediate medical consultation must be sought because a fallopian tube may rupture and cause heavy bleeding, which can be life threatening.
A slow growing tumor that is mostly discovered in older adults is a carcinoid. Even though this is rare, it may cause pain in the lower right abdomen if it grows on the appendix or cecum.
Nausea, diarrhea, and hot flashes may also accompany the pain. Using blood tests and a CT of the appendix, a doctor can make the diagnosis.
Lower right abdomen pain caused by ovulation may sometimes be mistaken for appendicitis.
However, unlike appendicitis, there’s no need to seek medical attention for this pain as it will go away on its own or with the aid of over-the-counter pain medicationssuch as aspirin, acetaminophen, naproxen sodium or ibuprofen.
You may experience this pain about two weeks before your menstrual period begins. When the egg is discharged from the ovary, it may cause a dull cramp or a sharp cramp.
Sometimes you may even have vaginal bleeding with severe cramping.
When to worry
Some lower right abdominal pain may go untreated; however, there are some red flags that need immediate medical attention:
When the pain is severe, especially if it was sudden, you need to seek medical attention.
It is also important to seek medical attention if the pain is accompanied by fever, nausea, vomiting, weight loss, irregular bowel movements, bloody stools, or bloody urine.
Women also need to seek immediate medical attention if they notice pain accompanied by a vaginal discharge or bleeding.