Abdominal pain is one of the most common complaints among men and women. Right lower abdominal pain may be caused by many conditions. Most of the causes are either from gastrointestinal conditions, reproductive organ diseases or urinary tract problems.
Gastrointestinal Causes
Acute appendicitis is probably the first thought for most people who experience right lower abdominal (RLQ) pain. The pain of appendicitis often starts in the middle abdomen (around the navel) and then moves to the RLQ. There are often other symptoms associated with the pain, including nausea, vomiting, fever and loss of appetite. Appendicitis is most common in teenagers and young adults.
In children, mesenteric lymphadenitis (ML) is often confused with acute appendicitis. ML is an enlargement of the lymph nodes within the abdomen usually in response to a viral infection. It produces RLQ pain and may cause some nausea and vomiting as well.
Acute cholecystitis (inflammation of the gallbladder) usually presents with pain in the right upper abdomen but occasionally the pain may be experienced in the RLQ as well.
Other less common GI causes of RLQ pain include Crohn's Disease, an inflammatory condition affecting the small and large bowel, right-sided colon cancer and diverticulitis.
Reproductive Organ Causes
In women it may be more difficult to differentiate the specific cause of RLQ pain due to difference in anatomy between men and women. Conditions affecting the ovaries and fallopian tubes must be considered in females with lower abdominal pain. Ovarian torsion, ruptured ovarian cyst, pelvic inflammatory disease and right ectopic pregnancy are some of the conditions that should be pondered. Fortunately, these conditions can be ruled out with simple tests such as an ultrasound and urine pregnancy test.
Urinary Tract Causes
Some diseases of the urinary system may have RLQ pain as part of the symptoms. Urinary tract stones in the right ureter (connects kidney to the bladder) are a frequent cause of pain in the lower abdomen. Other symptoms include nausea and vomiting. Infections of the right kidney or urinary bladder may also have RLQ pain along with painful and frequent urination.
References
- "Sabiston Textbook of Surgery"; Townsend, C. et al; 2007
- "Bailey & Love Short Practice of Surgery"; Russel, R.C.G., Williams, N., Bulstrode, C.; 2009
