Right lower abdominal pain | Abdominal pain in the lower abdomen

Right lower abdominal pain

Right lower abdominal pain can have various causes. Some possible causes are listed below: Appendicitis (inflammation of the appendix): The popularly known as appendicitis is typically accompanied by stabbing, right-sided lower abdominal pain. However, it is actually not the appendix itself (caecum) that is inflamed, but only its appendage, the appendix.

Typically, the pain begins in the upper abdomen and, over time, migrates to the right lower abdomen. Fever, nausea and vomiting may also occur. The diagnosis can be made by means of an ultrasound examination, among other things.

However, the inflammation is not always clearly visible. During the clinical examination various tests can support the diagnosis of appendicitis. For example, there are two points in the right lower abdomen (McBurney’s and Lanz’s point), which can be very painful when pressure is applied.

The contralateral release pain (Blumberg’s sign) can also be positive in appendicitis. To do this, the doctor presses in the left lower abdomen and then suddenly lets go, causing pain in the right lower abdomen in appendicitis. Furthermore, the large intestine can be spread from end to end, which can also cause pain (Rovsing’s sign).

The flexion and internal rotation of the right leg, as well as lifting the right leg against resistance can be painful (obturatorius and psoas test). In case of acute appendicitis, the appendix must be surgically removed early. Otherwise, the appendix may break through (perforation) with emptying of intestinal contents into the free abdominal cavity, resulting in inflammation of the peritoneum (peritonitis) and possibly blood poisoning (sepsis).

The operation is now a routine procedure and is generally considered to be low-risk. Crohn’s disease: Like ulcerative colitis, Crohn’s disease belongs to the group of chronic inflammatory bowel diseases. In Crohn’s disease, however, the lower small intestine and the large intestine are mainly affected.

The inflammation also progresses discontinuously, i.e. healthy sections of the intestine may lie between inflamed sections of the intestine. In contrast, ulcerative colitis progresses continuously. Crohn’s disease develops mainly in young people between the ages of 15 and 35, and in older people over 60.

The disease is caused by a genetic predisposition, as it often occurs in families. Further influences that favour the disease are discussed. Overall, Crohn’s disease is considered an autoimmune disease.

Typical symptoms of the disease are pain in the right lower abdomen, especially after eating or before bowel movements, as well as fever, loss of appetite, weight loss, nausea and vomiting. Sometimes bloody diarrhoea also occurs. Patients often develop fissures and fistulas, also in the anal region, as well as abscesses, which often have to be surgically removed.

Therapy is carried out with anti-inflammatory drugs, among other things, as well as immunosuppressive drugs, which are intended to suppress the destructive activity of the immune system against the intestine. Some diseases can cause pain in the lower abdomen on both the left and right sides, as the organs that are possible causes are paired and can be affected on one or both sides. Gynaecological diseases: In women who complain of left or right lower abdominal pain, a gynaecological cause of the complaints must always be considered.

An inflammation of the endometrium (endometritis) or its appendages (ovarian or fallopian tube inflammation (pelvic inflammatory disease)) can also cause such complaints. The pain is usually acute and unilateral, but can also occur on both sides. They often begin after menstruation or at the time of ovulation.

Endometritis and pelvic inflammatory disease are usually caused by pathogens that ascend through the vagina into the uterus (e.g. chlamydia) and trigger an inflammatory reaction there. From the uterus they can then continue to rise up the fallopian tubes. Lower abdominal pain can also occur on both the right and left side of the abdomen during normal menstruation.

The pain is caused by the contraction of the uterus and subsides at the end of the menstrual period at the latest. Some women also feel a pulling in the active ovary during ovulation. Urological diseases: Left and right lower abdominal pain can also be caused by urological disorders.

For example, kidney stones or ureteral stones can trigger these symptoms. Kidney stones can have various causes. Insoluble salts or crystals are precipitated, for example due to metabolic disorders or an excessively salty diet.

The stones can remain symptomless if they are small in size. However, if they are larger or migrate into the ureter (ureteral stone), they can cause severe pain. Small stones up to 6mm in size can go off without symptoms.

Larger stones may cause the ureter to move. The ureter begins to contract cramp-like, which causes colicky pain in the lower abdomen (depending on the position of the stone). Frequently, sweating, nausea, vomiting or even fever also occur.

There is often blood in the urine. If the stones are not too large, an attempt can first be made to expel the stone by increasing the fluid intake. If this does not succeed, a medicinal expulsion can be attempted.

Sometimes a painkilling painkiller is sufficient to relax the ureter and allow the stone to pass through. Stones up to 2.5 cm in size can be shattered by ultrasonic wave irradiation, so that the smaller fragments are then spontaneously flushed out through the urine. If all these measures are not successful, surgical removal of the stones is indicated.

Otherwise, the congestion of the urinary drainage system can lead to urinary congestion in the kidney, resulting in inflammation of the renal pelvis (pyelonephritis) and possibly blood poisoning (urosepsis). Irritable bowel syndrome: In patients suffering from irritable bowel syndrome, no other cause for their symptoms can be found. Those affected complain of recurrent abdominal pain, hyperthyroidism, diarrhoea or constipation and flatulence.

Irritable bowel syndrome is often triggered by stress; many sufferers suffer from psychological problems. In general, the disease is not associated with a reduced life expectancy, as there is no serious cause, but the quality of life of those affected is often severely restricted. The therapy is tried out in various ways, for example using antispasmodic drugs, peppermint oil and a diet rich in fibre.

Invaginations and hernias: Invaginations and hernias can also cause abdominal pain. In an intussusception, one part of the bowel is turned inside out. This can lead to partial or complete displacement of this part of the intestine (mechanical ileus).

The bowel reacts with cramp-like contractions, which can manifest themselves as severe pain in the affected area. Invaginations occur mainly in previously completely healthy infants and can develop again even after the operation has been corrected. In contrast, hernias also occur more frequently in adults.

Here, intestinal loops emerge through a weak point in the abdominal wall and become visible and palpable as a hernial sac. There are different types of hernias, which can cause different symptoms depending on their location, e.g. inguinal hernias, diaphragmatic hernias, umbilical hernia. Malignant diseases: Tumours of the small and large intestine can in principle also cause pain in the lower abdomen.

Depending on the location of the tumour, the symptoms occur on the left or right side. In the early stages, however, bowel cancer usually does not cause any specific symptoms. Initially, unspecific symptoms occur, such as weakness, loss of appetite, night sweats, weight loss and which are later replaced by symptoms such as blood in the stool, diarrhoea and constipation, as well as abdominal pain.

In case of changing stool behaviour with blood admixtures a doctor should be consulted. In addition, a colonoscopy (colonoscopy) is recommended from the age of 55 for the prevention of colon cancer, which should be repeated every ten years if the bowel is inconspicuous.