Pain in the right side of the abdomen refers to pain affecting the right side of an imaginary line stretching down the center of the chest to just above the genitalia.
The Right Side of the Abdomen
The abdomen is therefore the part of the body below the chest and above the pelvis. Aside from skin and muscles, this region also includes:
- Liver and gallbladder
- The first part of the small intestine, called duodenum
- Right adrenal gland and kidney, with its ureter
- Right part of the large intestines
- The appendix
- Right ovary and fallopian tube in females
- Blood vessels in the right side of the abdomen
Pain in the right side of the abdomen can derive from any of the aforementioned structures. However, areas located beyond the abdomen can also cause pain within it, such as the lower part of right lung and tumors in other body parts. This displaced pain is characterized as referred pain.
Common Causes of Right Side Abdominal Pain
When a patient visits a doctor because of right side abdominal pain, he or she will be asked questions concerning the precise location of the pain, the kind of the pain, the duration, and the accompanying symptoms (if any). This information along with physical examination and relevant laboratory tests will enable the physician to make an accurate diagnosis.
The following are the most common causes of pain in the abdomen, starting from the upper right side moving down.
Pain in the upper right side of the abdomen, just below the ribs, may be due to gallbladder disease. Characteristics of this pain include:
- A dull aching pain, sometimes occurring in waves
- Pain that starts after eating a meal
- Severe pain that may spread or radiate to the back
- Pain may be accompanied by vomiting
- Other symptoms like yellowing of the eyes
There are two common types of gallbladder disease that may bring about this type of upper right side pain. The first is called biliary colic due to gallstones. This occurs when a gallstone is trapped in the gallbladder or anywhere along the passages that drain the gallbladder. Pain usually starts as a severe crushing pain in the upper right side of the abdomen, which may be gripping, with episodes of sharp pain. This may spread to the back or right arm and typically lasts for a few hours. Vomiting may be an accompanying symptom.
The second common type of gallbladder disease is cholecystitis, which is inflammation of the gallbladder. Patients who are diagnosed with this disease are usually fair-skinned females who are in their forties or fifties, overweight or obese, and fertile. However, even males can have it. It is due to an infection of the gallbladder and produces a similar type of pain and symptoms as biliary colic.
A very severe and sudden onset of right side abdominal pain is characteristic of kidney stones. This type of pain usually starts in the upper side of the right abdomen and spreads down towards the umbilicus or towards the genitals. The pain comes in waves and patients usually pace around to find a position of comfort. They may also experience nausea and sweating.
Symptoms may vary depending on the size of the stones. Small stones may pass through the urine relieving the pain. However, bigger stones may become lodged in the ureters, the passageway of the urine from the kidney to the bladder, causing painful obstruction.
Appendicitis is the most common cause of pain in the lower right side of the abdomen, requiring immediate surgery. It is caused by an inflammation of the appendix, a small pouch of the large intestine located in the lower right abdomen.
Appendicitis is most common among males, often occurring between the ages of 9 and 39. However, anyone of any age may be affected.
There are two ways one may experience the pain related to appendicitis. The first type starts with a dull pain in the upper part of the abdomen or around the belly button (umbilicus), which later moves to the right lower side of the abdomen. The pain may last a few days and is usually associated with loss of appetite, nausea, occasional vomiting, fever, and a general feeling of discomfort. The second type of pain starts directly in the right lower side of the abdomen, becomes increasingly severe, and worsens with movement. It is also accompanied by fever, nausea, and vomiting.
In females, a right ovarian cyst may suddenly twist or rupture, causing a sudden, moderate to severe lower right side pain. The pain may spread from the abdomen to the right thigh and may be accompanied by nausea and vomiting.
When pregnancy occurs outside of the uterus and the embryo or fetus lodges anywhere in the ovary or fallopian tube (the passageway from the ovary to the uterus), an ectopic pregnancy results. Pregnancy cannot be sustained, so the fetus may rupture at the site of implantation. This causes a severe pain in the right lower abdomen, associated with vaginal bleeding and dizziness. The pain may radiate to the right shoulder tip. A woman who has missed her period and is experiencing these symptoms within ten weeks since her last menses must seek immediate medical attention. This could potentially become a life-threatening situation.
An enlarged lymph node in the abdomen is a very common cause of right-sided abdominal pain in children. The affected child typically acquires a cold or sore throat a few days or up to two weeks before experiencing abdominal pains. The neck glands may also become enlarged. This type of pain is often confused with appendicitis due to location. The difference, however, is that the child with mesenteric lymphadenopathy retains his or her appetite and is not as sick as one who has appendicitis.
Constipation is a common cause of lower right side pain. The pain is usually mild to moderate and is relieved upon bowel movement. It is fairly easy to recognize, especially if an individual has not moved his or her bowels at least three times in a week and is passing hard stools. This may be brought about by a lack of fluid intake or insufficient fiber in the diet. However, individuals who are over 50 years old should consider going to the doctor for evaluation since this may have more serious causes like cancer.
Muscle related pain is another common cause of pain in the right side. A sprained muscle in this region, due to over exertion in exercise or other physical activity, may cause this type of pain. Trauma induced pain is an obvious diagnosis, especially if it occurred recently. A fracture in the lower right rib can also cause upper right abdominal pain.
Abdominal pain is usually caused by gases trapped in the intestines. This causes varying degrees of abdominal pain at different sites, but is usually relieved spontaneously. Gas may be trapped in the digestive system after being swallowed while eating or breathing too fast. They may also result from the fermentation of poorly digested food in the gut (indigestion).
Trapping of gas is usually harmless, although it may be very uncomfortable. However, it may also be a symptom of other less common diseases like irritable carcinoid syndrome, irritable bowel syndrome, or bowel obstruction.