Lower Right Abdominal Pain
Lower right abdominal pain is pain in the region where an imaginary horizontal line is drawn below the lower right ribs till the right side of another imaginary longitudinal line along the umbilicus. Pain occurring in the lower right abdominal region is often acute. Lower right abdominal pain can occur abruptly or can be chronic in nature. The pain can be of any nature, i.e. sharp or dull, diffuse or localized. Other symptoms accompanying lower right abdominal pain include: Nausea, vomiting, constipation, tenderness, diarrhea, gas, bloating, loss of appetite and fever.
Organs or Structures in the Lower Right Abdominal Region
Structures located in the lower right abdominal region, which can be a source of pain due to some problem in them:
- Some regions of large intestine (cecum)
- Ascending colon
- Some parts of small intestine
- Right ovary
- Right fallopian tube
- Right ureter.
- Lower pole of the right kidney
- A part of the uterus.
- Lymph nodes, blood vessels, bones, muscles and skin in that area.
Any problem, infection, injury, inflammation, twisting, wind retention, cancer or tumors in the above mentioned structures causes lower right abdominal pain. We will look at some of the common causes with symptoms, investigations and treatment for pain in the lower right abdomen.
What Can Cause Lower Right Abdominal Pain?
6 Most Common Causes of Lower Right Abdominal Pain are:
Lower Right Abdominal Pain Caused Due to Appendicitis
Appendicitis is a condition where the appendix gets inflamed and this is the most common cause for right lower abdominal pain.
Symptoms: Pain which is achy in nature and starts around the umbilicus and then moves to the lower right abdominal region. The pain worsens and becomes more acute after some hours with tenderness to touch. Other symptoms include: Nausea, vomiting low-grade fever, loss of appetite and constipation or diarrhea.
Investigations: Blood tests, urine tests, abdominal x-ray and CT scan.
Treatment for Lower Right Abdominal Pain Caused Due to Appendicitis: Appendectomy is done to remove the inflamed appendix surgically.
Lower Right Abdominal Pain Caused Due to Stones in the Right Kidney
Stones in the right kidney causes pain in the lower right abdominal region.
Symptoms: Extremely severe pain occurring beneath the right ribs, back and the right side. Pain caused due to right kidney stone may radiate towards the lower right abdominal region and groin. The pain can be spasmodic in nature and can vary in intensity. Other symptoms are: Pain when voiding, frequent urination, brownish/ pinkish/reddish colored urine, cloudy/ foul-smelling urine, nausea, vomiting and fever with chills.
Investigations: Urine tests, blood tests, x-rays, CT scan and intravenous pyelography.
Treatment for Lower Right Abdominal Pain Caused Due to Right Kidney Stone: Treatment comprises of drinking lots of water. Pain killers help in relieving pain. For large stones, treatment comprises of extracorporeal shock wave lithotripsy (SWL), which breaks the stones into tiny pieces so it can pass via urine. Surgical procedures such as percutaneous nephrolithotomy can be done to remove larger stones.
Lower Right Abdominal Pain Caused Due to Infection in the Right Kidney
Infection in the bladder or any part of the urinary tract can extend to kidneys resulting in kidney infection causing pain and inflammation.
Symptoms: Pain is present in the lower abdomen, back, flank, or groin. Patient feels a constant need to urinate. Other symptoms are: Painful urination, blood or pus in the urine and fever.
Investigations: Urine test is done and culture and sensitivity (C and S) test.
Treatment for Lower Right Abdominal Pain Caused Due to Kidney Infection: Antibiotics are given to treat the infection. Painkillers are given for relief from pain.
Lower Right Abdominal Pain Caused Due to Cysts in the Right Ovary
Cysts are the fluid filled sacs on the ovary's surface which can grow larger and cause pain and discomfort, especially if they get twisted.
Symptoms: Pain in the lower right abdomen, which can be dull and achy in nature, pain in the pelvis which radiates towards the thigh and lower back. Other symptoms are: Feeling of fullness or heaviness in the abdomen, nausea, vomiting and pressure sensation on the rectum or bladder.
Investigations: Pregnancy test, laparoscopy, pelvic ultrasound, and CA 125 blood test.
Treatment for Lower Right Abdominal Pain Caused Due to Ovarian Cyst: OCPs are given. Surgery is done if the cyst is large.
Lower Right Abdominal Pain Caused Due to Ectopic Pregnancy
Ectopic pregnancy is a condition where the fertilized egg gets implanted outside the uterus, e.g. fallopian tube, ovary or in the abdominal cavity. If it gets implanted in right ovary or tube, then it causes severe lower right abdominal pain.
Symptoms: Severe pain on the lower right abdomen (can be misdiagnosed as appendicitis), missed period, vaginal bleeding and other symptoms of pregnancy.
Investigations: Pelvic exam, blood tests and ultrasound.
Treatment for Lower Right Abdominal Pain Caused Due to Ectopic Pregnancy: If the ectopic pregnancy is detected in early stages, then methotrexate injection is given to halt the growth of the cells and disintegrate the remaining cells. Otherwise surgery is needed for later stages of ectopic pregnancy.
Lower Right Abdominal Pain Caused Due to Constipation
This is again a common cause of right (and even left) abdominal pain.
Symptoms: Patient is not able to pass stools easily and often passes hard stools a couple of times a week. Symptoms other than abdominal pain are: Bloating, straining, rectal pressure and pain when defecating.
Investigations: Barium enema x-ray, defecography, sigmoidoscopy, colonoscopy, anorectal manometry, colorectal transit study or marker study.
Treatment for Constipation Causing Lower Right Abdominal Pain: Pain gets relieved after a bowel movement. Increasing dietary fiber benefits a lot in constipation. Other than this, you can try taking laxatives or stool softeners.
So, there are many causes for lower right abdominal pain. Patients should consult their doctor immediately for severe and persistent pain in the lower right abdominal region. After testing and evaluation, treatment can be started after cause of the pain is identified.