Abdomen is the anatomical region in our body that is bounded on all its sides. The upper part of the abdomen is bound by ribs and diaphragm, while the lower part is bound by pelvic bone and on the either side flanks are present. Abdominal pain is a very common thing across all ages. It can happen due to various reason starting from infection causing inflammation (swelling) of the abdomen to pain due to colitis. It may vary from being acute or chronic and diffused or centralized.
Abdominal pain is commonly observed globally and can be severe, requiring immediate hospitalization. The abdomen consists of many organs and the area of the pain indicates problems in the specific organ that lie in the position within the abdomen. Right lower quadrant abdomen pain is one such pain experienced by many for different reasons. Let us understand the reason of right lower quadrant abdomen pain and how to treat it.
Overview of Right Lower Quadrant Abdominal Pain
Abdominal pain when occurs in the lower right side of abdomen it is called as Right lower quadrant abdominal pain. The pain in the right lower quadrant of abdomen is due to problems in the organs present within the cavity of abdomen such as the stomach, pancreas, liver, gall bladder, small intestine, colon and spleen. Right lower quadrant abdominal pain also occurs due to the pain occurring in pelvis, urinary bladder and rectum. When abdominal pain is due the problem in reproductive system, it is observed that in males it is due to prostate gland while in females it is due to ovaries, fallopian tubes and uterus related problems.
What Can Cause Right Lower Quadrant Abdominal Pain?
There are different causes of acute and chronic right lower quadrant abdominal pain.
Causes of Acute Right Lower Quadrant Abdominal Pain:
Acute right lower quadrant abdominal pain is the one which arises and lasts for short period of few seconds to few weeks. The causes are as follows:
- Appendicitis: The infection of appendix results in inflammation (swelling) called as Appendicitis. This results in dull acute right lower quadrant abdominal pain which gradually increases and becomes intense. One experiences nausea, constipation or diarrhea as the symptom.
- Inguinal Hernia: The protrusion of the part of the small intestine through cleft in the muscle of abdominal wall may lead to right lower quadrant abdominal pain.
- Acute Right Lower Quadrant Abdomen Pain Caused Due to Volvulus: In some children there is a twisting of the cecum which causes right lower quadrant abdominal pain.
- Constipation: It results when there is a problem in passing the regular stools, which leads to the pain in the right lower quadrant of abdomen. It is also associated with other symptoms such as straining, bloating and rectal pressure.
- Reproductive System Related Right Lower Quadrant Abdominal Pain: In females, reproductive organ related pain in the right lower quadrant of abdomen occurs due to ovulation or ruptured ovarian cysts, twisting of the fallopian tube, ectopic pregnancy or miscarriage. While in males, reproductive organ related right lower quadrant abdomen pain occurs due to right testis torsion, spermatic cord and testicular veins disorder.
- Acute Cholecystitis: It is also called as biliary colic which takes place in the gallbladder resulting in right lower quadrant abdominal pain.
- Acute Pancreatitis: This results from the autodigestion of the pancreas by the pancreatic juice containing digestive enzymes, which causes inflammation of pancreas, thus leading to severe pain in right lower quadrant of abdomen.
- Right Lower Quadrant Abdominal Muscle Pain: This result due to muscle strain or trauma, muscular infection or presence of Lyme’s disease and Tabes Dorsalis.
- Diverticulitis: This pain results due to the inflammation of colonic diverticuli.
Causes of Chronic Right Lower Quadrant Abdomen Pain: (H3)
Chronic right lower quadrant abdominal pain is the one which arises and lasts for long time i.e., from few months to years.
- Crohn’s Diseases: It takes place in young adults and is a chronic inflammation of the intestine associated with ulcers and can cause chronic right lower quadrant abdominal pain.
- Carcinoid: It is a slow growing tumor in appendix or cecum of old aged people. Although it is rare, it causes a lot of pain in the right lower quadrant of abdomen.
- Endometriosis: This medical condition occurs in females and involves an abnormal growth of endometerium on other parts of reproductive system such as the fallopian tubes and uterus. The pain happens mostly before and during menstruation.
- Polycystic Ovarian Syndrome: It is a medical condition which involves the presence of multiple cysts (fluid filled sacs) in the ovaries and cause discomfort and pain in right lower quadrant of abdomen. Most of the times, they go away without any treatment. However, if the ovaries get twisted due to over-inflammation, it results in abdominal pain, increased blood pressure and breathlessness requiring immediate hospitalization.
- Kidney Infection: When there is a pain in the groin, back pain, or lower abdominal pain, it may indicate kidney infection. This also results in frequent and painful urination.
- Kidney Stone: The presence and passage of the crystalline deposits from the kidney, results in intermittent right lower quadrant abdominal pain of varying severity.
Symptoms Associated with Right Lower Quadrant Abdominal Pain
The commonly observed symptoms along with pain in the right lower quadrant of abdomen are as follows:
- Gas production
- Loss of hunger
- Colored and smelly urine in case of kidney stones.
In some case the symptoms of right lower quadrant abdominal pain are very severe as:
- Blood in stools
- Weight loss
- Swelling of the abdomen
- Skin appears yellow.
Diagnosis of Right Lower Quadrant Abdominal Pain
The doctor performs the physical examination by auscultation, percussion and palpation to know the location of pain. This is followed by blood analysis and urinalysis.
- Diagnosis of appendicitis and hernia are done by physical examination. Blood tests are recommended for appendicitis which shows increase in the white blood cells.
- The diagnosis of Volvulus is done by X-ray with barium swallow.
- Crohn’s disease is diagnosed using colonoscopy to check for ulcers in small and large intestine. Further blood and stool tests are also performed.
- Endoscopy of abdomen is done in case of ulcers.
- In case of polycystic ovarian syndrome, transvaginal ultrasound is used for diagnosis.
- For Carcinoid, CT scan of appendix is done with blood tests for checking the levels of histamine or serotonin.
- In case of endometriosis, ultrasound along with diagnostic hysteroscopy is done to confirm the diagnosis.
How is Right Lower Quadrant Abdominal Pain Treated?
The treatment options depend on the cause of right lower quadrant abdominal pain. Some treatment options include:
- Surgery is the only treatment for appendicitis causing right lower quadrant abdominal pain.
- Ingestion of Laxatives or stool softeners helps in regular bowel movement. A change in diet also helps in overcoming constipation which can cause right lower quadrant abdominal pain.
- Smaller kidney stones can be broken down with drinking of plenty of water and with medicines to get rid of right lower quadrant abdominal pain due to kidney stones.
- Treatment with different antibiotics helps to remove infection.
- In cases there is presence of carcinoid or bigger stones in the kidney, surgical correction is needed to treat right lower quadrant abdominal pain caused due to tumor or kidney stone.
Right lower quadrant abdominal pain is caused due to different factors and show variable symptoms. Hence it is necessary to ascertain the cause properly so that appropriate treatment can be given. There should not be delay in the treatment since it can result in mortality and morbidity.