Right Lower Abdominal Pain

Right lower abdominal pain is called “right lower quadrant pain” in medical terms, and indicates that organs located in this area (part of the bowel, the appendix, the urinary tract and, in women, the right ovary) are affected.

To understand the cause of this pain, it is very important first of all whether it began suddenly (acute) or has been going on for a long time and strikes from time to time (chronic).

1. The Most Urgent Conditions (Those Needing a Doctor Straight Away)

• Appendicitis: The first and most critical cause that comes to mind with right lower abdominal pain. It usually begins as a dull ache around the navel, settles in the lower right within a few hours and becomes sharp. The pain worsens with coughing, walking, or pressing on the area and letting go. Nausea and a mild fever usually accompany it.
• Ectopic pregnancy (in women): If the pregnancy implants in the right tube instead of the womb, sudden, very severe pain in the lower right abdomen and vaginal bleeding occur. It is life-threatening.
• Twisting of the ovary or testis (torsion): The right ovary (in women) or the right testis (in men) twists around itself and its blood supply is cut off. It causes sudden, very severe, stabbing pain and vomiting.

2. Causes Arising from the Digestive System

• Trapped wind and constipation: A build-up of wind or hardened stool in the bowel stretches the bowel wall and can cause cramping pain, particularly in the lower right. It usually eases after passing wind or opening the bowels.
• Irritable bowel syndrome (IBS): The bowel working irregularly without any structural disorder. It shows itself with abdominal pain that worsens with stress, bloating, and bouts of diarrhoea or constipation.
• Inflammatory bowel disease (Crohn’s disease): Crohn’s disease most often affects the area where the small intestine joins the large intestine — exactly in the lower right abdomen. It causes chronic pain, diarrhoea, weight loss and fatigue.

3. Urinary Tract and Kidney Causes

• Kidney stone or gravel: A stone passing from the right kidney through the urinary channel (ureter) causes very severe pain that comes in waves (colic), striking the lower right abdomen, the groin and even the back. Burning or blood in the urine may be seen.
• Urinary tract infection: When the infection spreads to the bladder or the right ureter, it causes an ache in the lower right abdomen, a feeling of needing to pass urine often, and a burning sensation when passing urine.

4. Other Causes Specific to Women

• Ovulation pain (Mittelschmerz): Right in the middle of the menstrual cycle (around day 14), the egg released from the right ovary causes a slight leak of tissue fluid. This can cause a mild to moderate ache in the lower right abdomen lasting 1–2 days; it is entirely natural.
• Ovarian cysts: Growth, stretching or rupture of a cyst in the right ovary can cause a constant dull pain or sudden cramps in that area.

Which Symptoms Mean You Should Go to the Emergency Department Without Delay?

If any of the following accompanies your right lower abdominal pain, you should not wait at home but go to the nearest emergency department:

• Pain that begins suddenly and is so severe it does not even allow walking
• High fever and persistent vomiting
• A board-hard abdomen that is too tender to touch
• Blood in the stool or urine
• Dizziness, a feeling of fainting or a sudden drop in blood pressure