23 Causes of Lower Right Abdomen Pain and When to Worry

While we often think of appendicitis when lower right abdomen pain occurs, it is not always the cause.

This article describes 23 causes of lower right abdomen pain and when this issue is a cause for concern.

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Where the Abdomen Starts and Ends

The abdomen is the largest cavity in your body and contains most of your body's organs. Your abdomen lies between your chest and hip bone in your body's anterior—or front. It starts at your diaphragm and ends at your pelvis.

Below is more detail about the abdomen.

Organs Within Abdomen

The organs within your abdomen are involved in many life-sustaining body systems. They include the following.

Organs in the digestive system that help convert food into energy:

Organs in the urinary system that filter blood and work to remove excess fluid:

Organs in the endocrine system that produce hormones to regulate your body's metabolism:

Organs in the male and female reproductive systems that support fertility and procreation:

When Is Pain in the Lower Right Abdomen an Emergency?

Pain in the lower right abdomen should not be ignored. While it can be harmless, sudden severe pain in the lower right abdomen or pain in this area that does not improve within 30 minutes requires emergency care.

Pain in the lower right side is an emergency if any of the following symptoms accompany your pain:

Most Common Causes of Lower Right Abdominal Pain

Lower right-side abdominal pain can occur from either acute or chronic conditions. Acute pain appears suddenly and can worsen over time. It can also disappear without treatment. Chronic pain lasts longer than six months and may vary in its intensity during that time.

Lower right abdominal pain can result from problems that range from mild to serious. Some of the most common causes of abdominal pain include the following conditions:

Abdominal Muscle Strain

An abdominal muscle strain, also called a pulled muscle, can occur from strain, overuse, lifting, or coughing. Symptoms can include soreness or pain on the right side when the muscle affected is on that side. Pain may come and go with the use of the muscle. Rest and stretching exercises may be advised. Healing can take up to six weeks, depending on the severity of the strain.

Appendicitis

Appendicitis is an inflammation of your appendix. This fingerlike pouch is located between the small and large intestines on the lower-right side of your abdomen.

Appendicitis can result from an infection, tumor, or blockage. It typically appears as an acute condition that causes sharp and sudden pain in the lower right abdomen. It can also occur as chronic pain.

Appendicitis requires immediate care because there is a risk of the appendix bursting when it is infected. If this occurs, you can develop peritonitis, a life-threatening infection that can spread in your abdomen.

Constipation

Constipation occurs when you have difficulty having a bowel movement. The problem can make you feel bloated and cause constant pain on the side or across your abdomen because you cannot pass gas or hard stools. It can occur as an acute or chronic condition.

A low-fiber diet, dehydration, lack of exercise, and taking certain medications can contribute to this problem. It may occur as a symptom of another medical condition.

Diverticulitis

Diverticulitis is caused by inflammation of the diverticula, small, bulging pockets that form in the large intestine due to age. Diverticulitis occurs when the diverticula in your colon become infected. This can happen when germs, food, or stool become trapped in one of these pockets.

As the matter grows, it causes an infection. Your body reacts with inflammation, which is your body's natural immune response to damage and disease.

Pain usually occurs suddenly and severely, though it can also occur as a mild ache that develops gradually. About 20% of people have recurrent flare-ups, usually within five years of their first attack.

Food Poisoning

Food poisoning occurs as a result of consuming food that has been contaminated with toxic substances, bacteria, or other germs. The pathogens release toxins that cause diarrhea, vomiting, fever, and headache. These symptoms can also include abdominal pain and cramps. Dehydration is a common complication.

Gallstones

Gallstones are hard pieces of solid material that form in your gallbladder. The stones are usually made of cholesterol or the digestive juice called bile. When gallstones block your bile ducts, they can lead to life-threatening infections of the bile ducts, pancreas, or liver.

You usually will not experience symptoms of gallstones until they become large and the stones begin to block your bile ducts. It can cause steady, severe pain in your abdomen, pain in your back, pain in your right shoulder, jaundice, nausea, and fever. Some people have pain that comes after eating, then disappears.

Gastroenteritis

Gastroenteritis—or the stomach flu—is an infection of your intestines that typically causes:

Abdominal pain or cramping
Diarrhea
Nausea
Vomiting

Sometimes fever also occurs.

The condition is acute. It usually lasts less than a week and improves without treatment.

Hepatitis

Hepatitis is inflammation of the liver. Viruses, toxins, heavy alcohol use, and certain medications can cause hepatitis. Symptoms include:

Abdominal pain
Dark urine
Light-colored stools
Joint pain
Jaundice
Fever

Symptoms of acute infections can occur from two weeks to six months after exposure. It can take decades for symptoms of viral hepatitis to develop.

Inguinal Hernia

An inguinal hernia occurs in an area of the lower abdominal wall called the inguinal canals, which exist on each side of your groin. An inguinal hernia occurs when the intestine pushes through a weak spot in the abdominal wall. It is more likely to form on the right side than on the left.

Symptoms include a bulge in the groin and pain or burning on the affected side. Pain may worsen when you lift, cough, or strain. Inguinal hernias occur up to 10 times more often in men than women.

Inflammatory Bowel Disease (IBD)

"Inflammatory bowel disease" (IBD) is an umbrella term that includes Crohn's disease and ulcerative colitis. These two chronic disorders cause inflammation of the gastrointestinal tract. They can cause:

Bowel changes
Persistent diarrhea
Periodic abdominal pain

Symptoms of Crohn's disease and ulcerative colitis can become worse over time and cause problems throughout your body without treatment.

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that results in abdominal pain, cramping, and diarrhea. While the cause is unknown, having a previous bowel infection or an overgrowth of bad gut bacteria may increase your risk of IBS.

IBS can cause recurring belly pain with bowel movements. Changes in the appearance of bowel movements, stool consistency, gas, or bloating can also occur.

Kidney Infection

A kidney infection, called pyelonephritis, occurs when bacteria from your bladder move up into your kidneys. It is common to get a kidney infection if you have a urinary tract infection (UTI).

The bacteria trigger inflammation in the kidneys, causing pain in the lower back that can move around to the lower side of the abdomen. Other symptoms include fever, chills, vomiting, and nausea.

Kidney Stones

Kidney stones are hard, solid objects that form crystals from certain substances that are eliminated naturally in your urine. Crystals form when your urine contains too much of a waste substance in too little liquid. Stones develop as the crystals join together with other elements and form a solid mass.

Kidney stones often cause pain as the stone travels through your ureter, urethra, and bladder. Symptoms include extremely severe back pain that can creep forward to your abdomen's right or left side. If you have one kidney stone, you have a higher risk of developing others either simultaneously or later.

Pancreatitis

Pancreatitis is an inflammation of the pancreas. The pancreas is a gland near your stomach and liver that makes digestive enzymes to help you absorb and digest food. Gallstones, heavy alcohol use, genetic disorders, and certain medicines can cause this condition.

Symptoms of acute pancreatitis include abdominal pain, rapid heart rate, nausea, fever, and vomiting.

How to Handle Pain Without a Known Source

It can be frustrating to experience pain without clearly diagnosing your lower right abdomen pain. It's possible to have a misdiagnosed or missed condition, especially if you are pregnant or immunocompromised.

If you're dealing with an inconclusive diagnosis or unremarkable imaging, advocate for yourself by taking the following steps:

Listen to your body if you feel something isn't right. Remember, pain is not normal.
Use your patient portal to gain access to your test results, labs, scans, and biopsies if you want to seek out a second opinion from another healthcare provider.
Advise your healthcare team about current medications and conditions which could alter an inflammatory response and your diagnosis.
Don't be afraid to be assertive when interacting with your healthcare provider. Ask someone you trust to advocate for you if you are uncomfortable doing so.
Consider using another provider at your practice or changing to another practice if you feel your current provider isn't responsive to your situation.

Emergency Appendicitis Symptoms

Acute appendicitis is one of the most common surgical emergencies. Emergency appendicitis symptoms include the following:

Appendix pain that begins near the navel and moves to the right lower abdomen
Sharp pain in the right side
Intense pain that suddenly awakens you from sleep
Pain that worsens with movement, deep breathing, coughing, or sneezing
Abdominal rigidity or stiffness
Severe pain that feels different from other types of pain
Dull pain in the lower right area that becomes worse over a few hours

Emergency appendicitis pain may include the following symptoms:

Loss of appetite
Nausea
Vomiting
Low-grade fever
Swollen abdomen

If you experience this type of pain, call 911 or seek immediate medical care.

Possible Causes in Females

Abdominal pain on the right side in females can often involve pelvic pain caused by problems related to the following gynecological conditions:

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg grows outside your uterus. Almost all ectopic pregnancies occur in a fallopian tube. As the pregnancy grows, it can cause the fallopian tube to burst and cause major internal bleeding. The situation is a life-threatening emergency.

As the ectopic pregnancy grows or the fallopian tube ruptures, symptoms may include:

Sudden, severe pain in the abdomen or pelvis
Shoulder pain
Weakness
Dizziness
Fainting

Endometriosis

Endometriosis is when uterine lining cells travel outside the uterus and begin growing on other organs like the right ovary or fallopian tube. Swelling, bleeding, and pain on the lower right side, especially before and during the menstrual period, can occur.

Menstrual Pain

It is possible to have pain in one or both ovaries on certain days during a normal menstrual cycle. Dysmenorrhea is the cramping pain that is experienced during or just before menstruation. It occurs due to the release of prostaglandins. This hormone-like substance contracts muscles in the uterus. The pain may come and go with contractions.

Ovarian Cysts

An ovarian cyst is a fluid-filled sac in either ovary. It may cause intermittent pain and discomfort on the lower right side if the cyst is located on the right ovary. Bleeding and menstrual irregularities can occur.

The most common types of ovarian cysts include follicular cysts, which form a follicle that does not release an egg during ovulation. Corpus luteum cysts develop if a normal follicle does not dissolve as intended right after ovulation.

Ovarian Torsion

Ovarian torsion occurs when your fallopian tube, which connects your ovaries to your uterus, twists around the tissues and blood vessels and cuts off the blood supply to the organs. The most common symptom is intense lower abdominal pain, more commonly on the right side. It is a medical emergency that requires immediate care to save your ovary and reproductive organs.

Ovulation

Ovulation pain, also called Mittelschmerz, can occur as a periodic dull ache, severe pain, or sharp cramp on the right or left side of the pelvis. It tends to happen about two weeks before the start of your period when the ovary releases the egg. While it may feel like a serious problem, it is considered normal.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is inflammation and irritation of reproductive organs. It can be a complication of an untreated sexually transmitted infection (STI). Pelvic inflammatory disease causes pain in your lower abdomen, an unusual discharge, irregular bleeding, and burning during urination.

Possible Causes in Males

Causes of lower right abdomen pain are outlined below.

Prostatitis

Prostatitis is inflammation of the prostate gland, which is part of the reproductive system. The prostate is a small gland between the bladder and the penis. A bacterial infection causes acute and chronic bacterial prostatitis.

Some types of chronic prostatitis may relate to nerve damage in the pelvic area or chemicals in urine. Pain in the lower abdomen, urinary frequency, fever, and pain during urination occurs most often with bacterial prostatitis.

Testicular Torsion

Testicular torsion occurs when the testis twists on itself. The result kinks the blood supply that delivers oxygen necessary for the testis to survive. It happens most often to newborn boys and boys going through puberty.

Symptoms include pain and swelling in the lower portion of the abdomen, though newborns usually don't have pain. It is a surgical emergency that requires immediate care.

Easing Right-Sided Abdominal Pain

The severity of pain is based on its duration, location, and intensity. Sudden and severe lower right abdomen pain requires a medical assessment for appropriate treatment. Treating your condition with home remedies may delay or interfere with an accurate diagnosis. When your condition is properly diagnosed, pain medicine, antibiotics, or surgery may be necessary to relieve your pain and prevent complications.

Less serious causes of mild lower right abdomen pain may improve with the following strategies:

Sip water or other clear liquids.
Avoid solid food for the first few hours of symptoms.
Eat small amounts of mild foods like applesauce, rice, or crackers.
Try antacids to relieve pain that occurs after eating.

When to See a Healthcare Provider

Symptoms of severe abdominal conditions may start subtly before they cause severe pain and require emergency care. Don't ignore persistent right-side pain that comes and goes. Early diagnosis and treatment can give you the best chance of preventing serious complications.

Consult your healthcare provider if you have any of the following symptoms:

Abdominal pain of any intensity that lasts for more than a couple of days
Fever with your abdominal pain
Abdominal pain that goes away then returns
Digestive symptoms like nausea, diarrhea, or vomiting that don't go away after a couple of days
Changes in the number of times (more or less) you usually urinate daily or burning with urination
Unintended weight loss

Summary

There are many causes of lower right abdomen pain. While it can signify a severe problem like appendicitis, lower right abdomen pain can also result from benign problems like gas or spicy food.

Since there are so many causes of this type of pain, it can be hard to know the source of your problem. Learning how severe problems affect your body can help you find the cause and decide when to seek treatment.

Avoid or treat lower right abdomen pain with a wait-and-see approach. Contact your healthcare provider if you have pain that persists without improving. If you have symptoms that align with a health crisis, call 911 or seek care right away.