Right lower abdominal pain is common and may or may not represent serious disease. This kind of pain may originate from the gastrointestinal, urinary, cardiovascular or reproductive system. More specifically, within each of these organ systems, there are common and uncommon conditions that can cause right lower abdominal pain. There are several warning signs related to right lower abdominal pain that should prompt you to seek urgent medical evaluation.
Most of the organs in your abdomen belong to the gastrointestinal system. So it's not surprising that right lower abdominal pain frequently has a gastrointestinal source. Most commonly, the pain is not a result of anything dangerous and may occur with excessive gas or constipation. Less common but more serious causes of right lower abdominal pain include appendicitis, which may be associated with nausea, vomiting, fever and loss of appetite. A bowel obstruction can also cause pain in this area and occurs when your intestines become blocked. Other less common causes of right lower abdominal pain include colon cancer as well as Crohn disease and ulcerative colitis, inflammatory diseases that may cause recurrent abdominal pain.
Urinary System Causes
Your right kidney and its ureter -- the tube that drains urine from the kidney into your bladder -- are located on the right side of your abdomen. Problems here can cause right lower abdominal pain, most commonly due to a kidney stone. Kidney stones cause pain when they become stuck between the kidney and bladder, preventing urine drainage. This pain is typically intense, accompanied by nausea and may come and go. Less commonly, an infection in the kidney may cause right lower abdominal pain. Other symptoms of a kidney infection include a fever, back pain and pain when you urinate. In all cases, a urine test and blood tests can help clarify the diagnosis.
Reproductive System Causes
Components of the male and female reproductive system can produce right lower abdominal pain. If you're a woman, ovarian cysts are a common cause. An ovarian cyst is a small, fluid-filled structure that can be found on the surface or within an ovary. If it's large or ruptures, it may cause pain. Less common but more serious causes of right lower abdomen pain in women include abnormal twisting of an ovary on its blood supply, called ovarian torsion, and ectopic pregnancy. With this condition, a pregnancy occurs in an inappropriate location, most often in the tube leading from the ovary to the uterus. If you're a man, testicular torsion -- twisting of the testicle, can cause abdominal pain because the nerves that pick up pain in the testicles may "refer" it to the abdomen.
Although there are no common cardiovascular causes for right lower abdominal pain, an uncommon but serious diagnosis should be considered. An abdominal aortic aneurysm is an abnormal dilatation of the aorta, the largest blood vessel in your body that runs through the abdomen. A large aneurysm may rupture or tear, which can be life-threatening. Even if it does not rupture or tear, an aortic aneurysm may cause pain as it grows. This condition is more likely if you're an older man, particularly if you smoke.
There are many possible causes of right lower abdominal pain. Pain that is mild and goes away quickly is generally not cause for concern. However, all unexplained right lower abdominal pain that doesn't go away in a day or two needs to be evaluated by a medical professional. Additionally, there are some red-flag symptoms that should prompt you to seek medical attention right away. These include, but are not limited to: -- worsening or severe pain, especially if it came on suddenly -- pain associated with fever, nausea or vomiting -- pain associated with weight loss, change in bowel habits or blood in your stool -- pain associated with vaginal discharge or bleeding, or testicular swelling
Reviewed by: Tina M. St. John, M.D.
- Tintinalli's Emergency Medicine: A Comprehensive Study Guide, Seventh Edition; Judith Tintinalli, M.D., et al.
- Current Diagnosis & Treatment in Family Medicine, Third Edition; Jeannette South-Paul, M.D., et al.
- Harrison's Principles of Internal Medicine, Eighteenth Edition; Dan L. Longo, M.D., et al.