Tuesday, June 25, 2024

What Causes Pain In The Lower Right Stomach

Treatment For Abdominal Pain In Adults

Pain in Lower Right Abdomen

Your treatment depends on what is causing your pain, but may include:

  • Pain relief your pain may not go away fully with painkillers, but it should ease.
  • Fluids you may have fluids given into a vein to correct fluid loss and rest your bowel.
  • Medicines for example, you may be given something to stop you vomiting.
  • Fasting your doctor may ask you not to eat or drink anything until the cause of your pain is known.

Causes Of Acute Stomach Pain

  • Eating Too Much. Eating too much can cause an upset stomach and mild stomach pain.
  • Hunger Pains. Younger children may complain of stomach pain when they are hungry.
  • GI Virus . A GI virus can cause stomach cramps as well as vomiting and/or diarrhea.
  • Food Poisoning. This causes sudden vomiting and/or diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
  • Constipation. The need to pass a stool may cause cramps in the lower abdomen.
  • Strep Throat. A strep throat infection causes 10% of new onset stomach pain with fever.
  • Bladder Infection. Bladder infections usually present with painful urination, urgency and bad smelling urine. Sometimes the only symptom is pain in the lower abdomen.
  • Appendicitis . Suspect appendicitis if pain is low on the right side and walks bent over. Other signs are the child won’t hop and wants to lie still.
  • Intussusception . Sudden attacks of severe pain that switch back and forth with periods of calm. Caused by one segment of bowel telescoping into a lower piece of bowel. Peak age is 6 months to 2 years.

See Your Doctor As Soon As Possible If:

  • your pain is no better after 2 hours of home care
  • your abdomen is very painful
  • your pain gets worse over time, or becomes sharper or stronger in one particular place
  • your abdomen feels bloated or sticks out more than usual
  • you cant stop vomiting
  • you havent had a bowel motion or passed wind for 3 days
  • youve lost your appetite
  • there is blood in your vomit, urine or bowel motion, or vaginal bleeding that isnt a period.

You also need to see your doctor if you have other symptoms along with the pain such as fever or dizziness especially if those symptoms get worse over time or new symptoms develop.

Call Healthline if you are unsure what you should do.

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What Is Lower Right Abdominal Pain

Lower right abdominal pain is defined as abdominal pain occurring to the right of an imaginary line drawn from above the pubic bone in the mid-line, up to the level of the belly button or umbilicus. Pain in this area is the most common reason for people going to accident and emergency departments across the world.

The right side of the abdomen internally isdifferent from the left side in at least three ways. There is the presence of thecaecum, and the appendix on the right lower abdomen as well as a larger andsteeper “right paracolic gutter” – the space surrounding the right halfof the colon. These factors makethe right lower abdomen more prone to having things go wrong with it than the left side.

Also within this region of the body lies other organs like the:

  • Right Ureter or tube from the kidney
  • The ascending colon
  • Upper part of the vagina and cervix to the mid line
  • Muscles, ligaments, bones, connective tissues and skin over this region.

Damage or disease to these structures and organs can cause pain in the lower right abdomen.

Infection far away in the upper part of the abdomen like from the gallbladder and liver can also track down to cause pain and symptoms in the lower right abdomen. A systematic approach to analysing the characteristics and associated symptoms of a lower right abdominal pain is the solution to understanding what might be causing such pain..

Ovulation Pain Or Midcycle Spotting

What Causes Abdominal Pain on the Right Side?

Mittelschmerz is a German word that translates as “middle pain.” It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.

Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.

This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.

Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.

Diagnosis is made through patient history.

Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.

Rarity: Common

Top Symptoms: abdominal pain , last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain

Symptoms that always occur with ovulation pain or midcycle spotting: last period approximately 2 weeks ago

Urgency: Self-treatment

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Possible Causes Of Lower Abdominal Pain In Men

1. Constipation

The pain is caused by increased strain that abdominal muscles are under in constipation. The muscle strain is accompanied by increased pressure surrounding them and may make the abdominal pain worse.

2. Appendicitis

Men between the ages of 11 and 40 are at risk of appendicitis. Other symptoms of appendicitis include vomiting, fever and loss of appetite. The first sign of the condition is the dull pain near the navel or the upper or lower abdomen that becomes sharp as it moves to the lower right abdomen. The appendix will be surgically removed before it ruptures and infects the entire system.

3. Hernia

Hernias cause lower abdominal pain in men, specifically on the right side of the abdomen. A hernia is soft tissue that protrudes and hits the wall of the abdomen, causing pain. Pain can also be felt in the groin and upper thigh area.

4. Testicular Torsion

Testicular torsion occurs when a testicle is coiled. In addition to lower abdominal pain, a man may also experience vomiting, nausea and general testicular pain. The pain is usually sporadic, however becomes more constant as the condition becomes more severe.

5. Ulcerative Colitis

Ulcerative colitis occurs in the large bowel. The pain is concentrated on the lower right side of the abdomen. Ulcerative colitis is typically accompanied by weight loss and bloody stool. You may also have rectal pain and bleeding. You may be unable to defecate despite the urgency to do so.

6. Kidney Stones

7. Food Poisoning

Lower Left Abdominal Pain

Abdominal pain in the lower left side is more commonly noticed than in the right side. The various organs and structures present in the lower left abdomen include:

  • Left ureter
  • Left ovary and fallopian tube
  • Some part of urinary bladder and the descending bowel .
  • Blood vessels, nerves, muscles and skin covering the left abdominal wall.

Any disease or disorder in these structures or organs can generate lower left abdominal pain.

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C Criteria For Diagnosing Each Diagnosis In The Method Above

Appendix and ileo-cecal junction

Acute appendicitis

  • Most frequently a disease of young and healthy individuals.

  • Acute onset crampy abdominal pain usually begins in periumbilical area and then migrates to RLQ in pelvic appendix dysuria, urinary frequency, diarrhea or tenesmus may be prominent symptoms.

  • Nausea and vomiting usually follow the onset of pain.

  • Low-grade temperature high fever may be a sign of a perforated appendix.

  • Exam:

    McBurneys point of maximum tenderness 2/3rds the distance from the umbilicus to the anterior superior iliac spine

    Obturator sign in pelvic appendix and psoas sign in retrocecal appendix

  • Labs:

    White blood cels may be elevated in approximately 70% patients 95% will have a left shift

    Urinalysis useful for ruling out a urinary tract infection

    Urine -HCG to rule out pregnancy and the possibility of an ectopic gestation.

    Cervical cultures if PID suspected

  • Imaging of choice CT abdomen and pelvis findings:

    Thick appendiceal wall

    Stranding of adjacent fatty tissue

    Note: Non-visualization of appendix does not exclude appendicitis

    Note: Air in the appendix or a contrast-filled appendiceal lumen without other abnormalities on CT virtually eliminates a diagnosis of appendicitis.


Infectious enterocolitis

Irritable bowel syndrome

  • Rome III criteria

    Recurrent Abdominal pain or discomfort at least 3 days/month in the last 3 months associated with 2 or more of the following:

    Improvement with defecation


What Else Could It Be

Causes of lower right abdominal and genital pain – Dr. Ravindra B S

These lists of possible causes for RLQ are by no means exhaustive and there are many other conditions that can cause pain in the RLQ. Problems in your spine or back could be ‘referred’. Referred pain in this situation means that it is coming from your back but you are feeling it around the front. Muscular pulls and sprains can also affect you in the tummy area. If this is the case, moving the particular muscle would make the pain worse, whereas if you were to lie completely still, it wouldn’t hurt.

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Mesenteric Lymphadenitis In Children

Mesenteric lymphadenitis is a very common cause of lower right side abdominal pain especially in children. It is often be confused with appendicitis but this condition is due to the inflammation of the lymph nodes or glands in the wall of the small bowel.

If your child is having a right lower abdominal pain, the abdominal pain due to a mesenteric lymphadenitis. Symptoms of this include:

  • An episode of a cold including a runny nose, coughing or tonsillitis
  • Pain in the right lower abdomen or anywhere around the umbilicus
  • Pain which moves from one spot to another, as the bowel moves around inside the abdomen
  • General sense of feeling unwell, other than from complaining of abdominal pain
  • Often able to eat with a good appetite

If your child has a lower right abdominal ache, the best step is to take them to see the doctor. The doctor will examine the child to determine whether the cause of the abdominal pain is due to acute appendicitis or non-specific mesenteric lymphadenitis.

Vague Upper Abdominal Pain Associated With Nausea And Belching

Sometimes stomach pain is hard to identify or comes with multiple symptoms. Vague pain in the upper and mid-abdominal area that is linked to nausea, burping, or belching could be signs of a heart attack, particularly in older patients. Physicians say tests like an ECG or cardiac markers can be lifesaving. They also warn that vomiting with back or jaw pain and shortness of breath can also be a sign of a life-threatening emergency.

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Should I See A Doctor

Yes, if you have a pain which doesn’t settle, you will probably need to see a health professional to help you figure out the cause. See a doctor urgently if you:

  • Have very severe pain.
  • Feel giddy, light-headed, faint or breathless.
  • Are bringing up blood or have blood in your poo .
  • Have a change from your usual bowel habit. This means you may open your bowels more or less often than usual, causing bouts of diarrhoea or constipation.
  • Could be pregnant.

Common Causes Of Lower Abdominal Pain

Causes of abdominal pain by area

The common causes of lower abdominal pain are the menstrual cycle, urinary tract infection and constipation. The common symptoms include:

  • cramping
  • painful urination
  • painful sex

The management of the associated pains with the above symptoms can typically be accomplished with over-the-counter pain relievers or antacids. A person should seek medical attention at an urgent care center in New Braunfels, Texas, if any symptom does not improve within three days, or at the first indication of painful urination.

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Diagnosis Of Abdominal Pain In Adults

If examinations and tests are needed, these may include:

  • a rectal exam to check for hidden blood or other problems
  • if you are a man, the doctor may check your penis and scrotum
  • if you are a woman, the doctor may do a pelvic exam to check for problems in your womb , fallopian tubes and ovaries, and do a pregnancy test
  • a blood test to look for infection or bleeding
  • other blood tests may look at enzymes in the liver, pancreas and heart to sort out which organ may be involved
  • a urine test to look for a urine infection or blood
  • an ECG to rule out a heart attack
  • other tests, including x-ray, ultrasound or CT scan
  • sometimes you may be referred to another doctor to help find the cause of the problem.
  • endoscopy is an examination where a flexible tube with a light and video camera at the tip is used to examine some internal organs without the need for surgery. Different names are used depending on which organ is being looked at.

If you do have tests, the doctor will explain the results to you. Some results may take a number of days to come back and these will be sent to your local doctor.

Which Medicines Can Cause Abdominal

Some medicines can cause abdominal pain as a side effect. Common examples include:

If you, or someone you are caring for, has an episode of abdominal pain that you think may be related to a medicine, talk to your pharmacist or doctor. There may be an alternative medicine that is better for you.

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Historical Information Important In The Diagnosis Of This Problem

1. When did the pain start or how long have you had the RLQ pain?

Acuity, intensity and duration of pain may be helpful in assessing severity of disease. A sudden onset of pain suggests a serious intra-abdominal event such as an organ perforation or Ischemia or obstruction of a small tubular structure .

A more gradual onset of symptoms suggests an infectious or inflammatory cause , or obstruction of a large tubular structure .

2. Has the pain changed location?

The pain of acute appendicitis may start in the periumbilical area and then a few hours later localize in the RLQ as the peritoneum overlying the inflamed appendix gets affected .

3. Any recent trauma to this area? Any recent abdominal surgery?

Rule out trauma as the cause of pain.

4. Have you ever had this problem before?

A positive response would suggest a chronic intermittent problem e.g. inflammatory bowel disease , diverticulitis, nephrolithiasis.

5. Any history of diverticulitis, Crohns disease or ulcerative colitis, hernias or nephrolithiasis? Any family history of IBD? Any prior abdominal surgeries specifically appendectomy, bowel surgery and in females prior history of salpingo-oopherectomy?

This line of specific questioning helps rule out certain possibilities and make some more likely.

Any intra-abdominal medical devices e.g. ventriculoperitoneal shunts presence raises index of suspicion for intra-abdominal infection .

6. Is the pain dull and constant or is it colicky in nature?

12. Any fever or chills?

What Is The Outlook

What’s Causing My Lower Abdomen Pain?

Again this depends entirely on the cause of the pain. Some conditions settle very quickly on their own , or with the help of antibiotics . Others can be cured with surgery, such as appendicitis or torsion of the testicle . Some are long-term conditions, for which there is no cure although there are treatments, such those used for people who have Crohn’s disease. Your doctor should be able to give you an idea of the outlook once a diagnosis has become clear.

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Sudden And Severe Onset Stomach Pain

When mid-abdominal pain occurs suddenly especially in people with a history of peptic ulcer disease or in those who take excessive amounts of aspirin or NSAIDs it may be a sign of a perforation that could require emergency surgery. A tear could leak air and gastric content which can lead to a condition called peritonitis, and eventually, septic shock. Surgery would be required to seal the perforation.

Polyps Or Diverticular Disease

Diverticular disease can affect the lower left side too, or can cause more generalised pain. Polyps are small wart-like lumps in the bowel, and diverticular disease is a condition where the bowel forms tiny pockets that become inflamed and painful.

Diverticulitis and polyps can both cause diarrhoea and sometimes bleeding in the bowel. If you notice , its important to speak to a doctor straight away.

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What Other Tests Might Be Needed For Right Lower Quadrant Pain

Next it will depend on what the examination and the tests above have suggested. In some cases no further tests will be needed – if, for example, your doctor is confident you have constipation or shingles.

If a problem with your large bowel is suspected, you may need an examination with a tube with a camera put into your large bowel . A computerised tomography scan or an ultrasound scan may be helpful to look for diverticula and to look at your kidneys. These tests are also used in women to look at the ovary and tubes. In some cases an X-ray of the tummy may be useful. Further tests include other ‘scopes’ and other scans scan).

If it is thought you have appendicitis, an ectopic pregnancy or a torsion of your testicle – men, you may only have one or two of these tests before having emergency surgery to treat your problem.

Nobody will need all these tests, and some people may not need any.

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