Introduction
Causes of right lower abdominal pain
There are a number of different diseases and reasons for the occurrence of right lower abdominal pain. Especially obvious are reasons that are related to the intestine. However, diseases of the sexual organs or the urinary tract can also be responsible for the complaints.
Acute lower abdominal pain, which typically occurs first in the middle of the abdomen and is then felt in the right lower abdomen, indicates the presence of acute appendicitis. Chronic inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis can also be accompanied by right lower abdominal pain. It should also be clarified whether an infectious intestinal disease is present.
A hernia can also cause complaints in the region of the lower abdomen. Inflammations or tumors of organs in this region also typically lead to lower abdominal pain. Particularly in women, diseases of the genital organs should be excluded as a cause, since e.g. ovarian cysts or other diseases are relatively common here.
More detailed description of symptoms and accompanying symptoms
The exact description of the symptoms can often help to narrow down which disease is involved in an individual case. The main symptom is right-sided pain in the lower abdomen. This pain can be stabbing, pulling, dull, throbbing or cramping.
The intensity of the pain, which is usually given on a scale of 1-10, also helps the treating physician to assess how acute the individual clinical picture is and in what condition the affected person is. It is also essential to mention if other symptoms besides pain occur. These can be signs of inflammation such as fever or a weak general condition as well as diarrhoea, flatulence, constipation, nausea or vomiting.
Bloody stool, urine or vaginal discharge can also help to narrow down the clinical picture. A tense abdomen or a pressure or release pain in the lower abdomen is also common. Even symptoms which at first glance appear to have nothing to do with the pain in the lower abdomen should not be concealed from the examining physician in order to give the best possible overall impression and to find out the causative disease as quickly as possible.
For example, back pain can radiate into the lower abdomen and be the cause of the complaints. Lower abdominal pain, which is accompanied by diarrhoea, can be an expression of different diseases. The most common cause of lower abdominal pain and concomitant diarrhea is infectious intestinal diseases.
Different bacteria and viruses can be responsible for this type of illness. In addition to diarrhoea, fever and a weakened general condition often occur. Food allergies can also be accompanied by diarrhoea and pain.
It should be noted that appendicitis can also be accompanied by diarrhoea and right lower abdominal pain is a leading factor in this diagnosis. Chronic inflammatory bowel disease is also a possible cause of both lower abdominal pain and accompanying diarrhea. Particularly if it concerns slimy-bloody diarrhea, the person affected should be examined for the presence of these diseases.
Rare causes which can be accompanied by pain and diarrhoea are intestinal protrusions called diverticula or the so-called irritable bowel syndrome. Pain in the lower abdomen can be accompanied by a number of different digestive disorders. Constipation can be another symptom of the disease causing it as well as the cause of right lower abdominal pain.
If other symptoms such as fever and vomiting occur in addition to constipation and pain, an intestinal obstruction (ileus) could be responsible for the symptoms. Since intestinal obstruction is a surgical emergency, the symptoms should be clarified as soon as possible. More often, however, the constipation is caused by medication, unbalanced diet, diseases of the nervous system or psychological stress.
If lower abdominal pain and constipation occur at the same time, it should first be clarified whether treatment of the constipation could possibly lead to elimination of the pain. The constipation can often be treated adequately with swelling agents or an increased fluid intake. Flatulence (flatulence) refers to the increased formation of gases in the intestine, which lead to discomfort and a feeling of fullness.Intestinal gases are produced during the natural digestive process and most of them diffuse into the bloodstream and are then excreted through the lungs.
However, some of the intestinal gases do not enter the bloodstream, but remain in the intestine and are called intestinal gases (flatulence). If the intestinal gases cannot escape, in some cases they lead to cramp-like abdominal pain. Accordingly, they can also occur in the right lower abdomen.
Patients often experience direct symptom relief when the intestinal gases escape rectally as body wind (flatus). The cause of flatulence is often food or food intolerances. Lactose intolerance (lactose intolerance) or histamine intolerance are particularly frequent causes of intestinal gas formation.
Pulses also contain many components which cannot be utilized in the small intestine and thus lead to gas formation. Also a high consumption of onions, celery, cabbage, sauerkraut and watermelon can lead to increased gas formation and flatulence. The therapy usually consists of abstaining from or reducing the intake of foods that cause gas.
If there is an actual food intolerance such as lactose or histamine intolerance, a diet should be followed if the symptoms are severe. Some forms of menstrual pain can lead to monthly lower abdominal and back pain. As a rule, menstrual pain is caused by strong muscular contractions of the uterus.
These are usually harmless and occur as part of the mucous membrane rejection during menstruation. To be sure that the pain is harmless, it should be examined by a doctor. In this way, diseases of the uterus such as endometriosis can be ruled out.
If the menstrual pain is harmless, heat, exercise and antispasmodic drugs such as butylscopalamine often help to relieve the symptoms. If the pain is very severe, the contraceptive pill can regulate the cycle and thus relieve the monthly discomfort. Spinal diseases can also cause pain in the lower abdomen.
If an abscess has formed in the lower spine due to an inflammation, it can spread along the muscles to the lower abdomen and cause pain. Such an inflammation is rare and can be caused by a pathogen settling out of the blood or during surgical procedures on the spine. The pain is usually hardly characteristic and can easily be mistaken for a herniated disc.
For this reason, imaging procedures and blood tests are necessary to make the correct diagnosis. If an inflammation of the vertebral body with abscess formation is present, it must be surgically removed immediately and the patient treated with antibiotics. Pain that radiates into the leg is characteristic of a nervous impairment.
If the pain radiates into the leg, it should always be examined whether a herniated disc could be responsible for the symptoms. In addition to the leg pain, this can also cause complaints in the right lower abdomen. Especially if paralysis of the leg or foot is added, it is important to think of a herniated disc as a possible cause. Muscle tension in the back can also affect nerves and cause pain in the stomach and leg. Finally, infectious diseases such as shingles can also affect nerves and cause leg pain.
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