Causes of Right Side Abdominal (Stomach) Pain

Pain on the right side of the abdomen can be either in the upper part (RUQ ~ right upper quadrant) or lower part (RLQ ~ right lower quadrant). Abdominal pain is a non-specific symptom that can be attributed to a host of conditions. Therefore the presence of other signs and symptoms in association with the pain is important to consider in the differential diagnosis. Modalities may include pain that commences, worsens or eases with change in position, eating, hunger, changes in bowel movements and movement.

The final diagnosis should be done my a medical professional after a thorough case taking and additional diagnostic investigations like an abdominal ultrasound, x-ray, CT scan or MRI. Blood tests and specialized investigative techniques like an endoscopy, colonoscopy or barium enema may also be needed. Broadly, right sided abdominal pain can be attributed to the right lung, diaphragm, kidney, liver, gallbladder, head of the pancreas, small intestine, cecum, ascending colon or transverse colon of the large intestine and peritoneum. The pelvic organs and structures should also be considered in lower right sided abdominal pain. Pain in the abdomen may not originate from this area and can be referred or radiate from the chest, pelvis and back.

UPPER Right Abdominal Pain

Pain in the upper right abdominal region may be superficial or deep. Superficial causes may be attributed to the abdominal wall (skin and muscles), peritoneum, liver and gallbladder. Deeper pain may be due to the liver, bile ducts, stomach, duodenum and kidneys.

LUNGS

Pain may be associated with the lung tissue itself (rare), lining of the lung (pleura) or space around the lung (pleural space). Lung and pleural diseases that may causes right sided abdominal pain include :

  • Pneumonia (bacterial or viral) of the lower lobe of the right lung.
  • Pleurisy or pleuritis (inflammation of the lung membrane) from infection, trauma and so on.

Signs and symptoms may include difficulty breathing, coughing, and pain upon breathing/moving.

LIVER

The liver is an important consideration in upper right abdominal pain as it occupies most of this region. As a large organ with diverse functions, and the central processing unit of nutrients, the liver is prone to a variety of disorders. Liver conditions that may cause right sided abdominal pain include :

  • Enlarged liver due to heart failure, hepatitis, fatty liver, lymphoma, leukemia, etc.
  • Liver cancer or metastases of other cancer into the liver.

Signs and symptoms may include changes in bowel movements and consistency of stool, nutrient deficiencies, jaundice, changes in appetite and weight loss.

GALLBLADDER/ BILIARY TRACT

The gallbladder stores bile that is produced in the liver. This fluid contains various compounds, particularly waste substances and fats, and can emulsify fats in the gut to allow for digestion and subsequent absorption. Bile is passed through the biliary tracts which communicates with the pancreatic duct before emptying into the duodenum, the first part of the small intestine. Conditions of the gallbladder and biliary tree that may causes right sided abdominal pain includes :

  • Gallstones or bile duct stones
  • Gallbladder inflammation (cystitis), mostly due to gallstones.
  • Inflammation or blockage of the biliary tree (cholangitis) (cystic, or common bile duct).
  • Gallbladder and biliary cancer are rare.

Signs and symptoms may include jaundice, fatty stools and episodes of pain that are intense (colicky) and generally arise after eating.

DUODENUM

The duodenum is the first part of the small intestine and an important site for digestion. It receives the partially digested food mixed with gastric acid and enzymes from the stomach and then bile and digestive enzymes from the pancreas. It is often affected with the same pathologies that afflict the stomach, often a combination of infection and the presence of gastric acid in the duodenum for prolonged periods. Some of the conditions of the duodenum that may cause right sided abdominal pain include :

  • Duodenal ulcer
  • Duodenitis – inflammation of the duodenum similar to gastritis (stomach).

Signs and symptoms include severe pain after eating, although the pain may sometimes ease slightly with food, change in bowel movements, excessive belching and bloating.

MUSCLES

The abdominal muscles comprise several groups of muscles that protect the abdominal contents, stabilize the trunk during movement and help with changes in position. Since the abdominal cavity lacks an extensive skeletal protection like the thoracic cavity, the abdominal muscles have to contend with significant impact in trauma. Some conditions affecting the abdominal muscles that may cause right sided abdominal pain includes :

  • Strained muscles – common cause.
  • Hernia
  • Blunt force trauma
  • Rectus sheath haematoma
  • Psoas abscess

Signs and symptoms generally include pain when moving and tenderness on palpation of the affected area.

KIDNEYS/URETER

The kidney is responsible for filtering the blood and forming urine. Electrolytes and water are reabsorbed as necessary and the urine is directed down the ureter to the bladder. The kidney is tucked behind and slightly below the liver on the right side of the abdomen to lie shielded by the back part of the ribcage. Some conditions affecting the kidney and ureter that may cause right side abdominal pain includes :

  • Pyelonephritis (infection of the right kidney).
  • Kidney/urinary stones
  • Renal carcinoma

Signs and symptoms include changes in the urine color and composition, alterations in urinary habits and additional signs like blood in the urine (hematuria).

DIAPHRAGM

The diaphragm is the large concave muscle that separates the thoracic and abdominal cavities. It is the major muscle of respiration and on the right side, it houses the liver immediately beneath it. When contracted, the diaphragm pushes down the abdominal contents to expand the chest cavity. Some of the conditions of the diaphragm that may cause right sided abdominal pain include :

  • Abscess under diaphragm

LOWER Right Abdominal Pain

Lower right abdominal pain may be due to some of the same causes discussed under upper right abdominal pain. With the lower abdominal regions, the continuation with the pelvic cavity means that pathologies of the pelvic organs or structures may also be a cause of pain.

APPENDIX

The appendix are a small outpouching from the cecum of the large intestine. It is believed to be a reservoir for the normal intestinal flora (good bowel bacteria). It can become inflamed, obstructed and or infected. This may be related to the surrounding parts of the intestine or other abdominal structures or occur independently. Some of the conditions of lower right sided abdominal pain include :

  • Appendicitis (inflammation of appendix)

SMALL INTESTINE

The small intestine comprises the duodenum, jejunum and ileum. It is the major site of digestion and absorption. Waste products and undigested material pass into the large intestine. The small intestine is also the longest part of the gastrointestinal tract and prone to various conditions that may be a continuation of pathology in the stomach or large intestine. Conditions affecting the small intestine that may cause right sided abdominal pain include :

  • Crohn’s disease affecting the last part of the small intestine, called terminal ileum.

COLON

The colon is the main part of the large intestine and has been discussed above. The most prominent part lying on the lower right side includes the cecum and ascending colon.

  • Volvulus twisting of the cecum (starting part of large intestine), rare.

FEMALE REPRODUCTIVE ORGANS

Gynecological causes of right sided abdominal pain are an important and common cause. It should always be taken into consideration especially if the pain appears to be associated with ovulation or menstrual cycle or there are any menstrual changes that accompany the onset of the pain. A slight discomfort with ovulation and menstruation and mild, short lived pain during pregnancy is normal.

  • Ovulation (mid-cycle pain, Mittleschmerz)
  • Twisted or ruptured ovarian cyst
  • Ectopic pregnancy
  • Miscarriage
  • Endometriosis
  • Polycystic ovarian syndrome – PCOS; usually affecting both right and left ovary

MALE REPRODUCTIVE ORGANS

Disorders of the male reproductive are unlikely to cause lower right sided abdominal pain with pain in the pelvis or genitalia. Some conditions to consider include :

  • Spermatic cord disorders
  • Testes disorders

ABDOMINAL BLOOD VESSELS

The blood vessels in the abdomen include the large aorta and inferior vena cava, with the various branches and tributaries. These blood vessels are prone to a host of diseases that may be isolated to the cardiovascular system or part of a systemic condition. Some of these conditions include :

  • Hereditary angioedema
  • Henoch-Schönlein-purpura
  • Atherosclerosis of arteries that supply the intestine

BLOOD

  • Porphyria
  • Sickle Cell Disease

SKIN

Conditions affecting the skin may be responsible for upper and lower right sided abdominal pain. Skin lesions or deformities may be present, including a rash, swelling and/or redness. Most skin diseases present with itchiness but pain may be seen in the following conditions.

  • Herpes zoster
  • Dermatitis (eczema) when the skin is broken or there is an infection.

ABDOMINAL MEMBRANE (PERITONEUM)

The peritoneum mainly envelopes the gastrointestinal tract in the abdomen and peritoneal fluid keeps the organs lubricated when making contact with each other. Inflammation, infection and swelling may be associated with peritonitis.

  1. Read more here for a detailed description of right upper (RUQ) abdominal pain.
  2. Read more here for a detailed description of right lower (RLQ) abdominal pain.
About Jan Modric (249 Articles)
Health writer
  • Jan Modric

    Nikibet,

    telling how far (inches) from the middle line and from the lower edge of the rib cage you feel the pain, could help. Also, if you experience any nausea, belching, bloating, gas…and if the pain is relieved or aggravated by meals. Also, is it tender to touch?

  • Jan Modric

    mary1275,

    bloating itself may cause quite some pain. The question is now, if bloating is diet-related or there is some intestinal or other disorder. Telling if the pain is constant, and when did it start, what is your usual diet, and have you changed it lately, could help to understand your condition.

  • Nikibet

    Hello.

    update. It is on the right side about 4-5 inches from the belly button if you were drawing a straight line. and about 2 inches below the rib cage. The pain goes into my back, like someone is stabbing me with a knife in my back and out my stomach. It isnt made better/worse with food. Its not tender but the pain is immobilizing, gets to the point where I have to hunch over. There is no gas, or belching or any thing of that sort or naseua, except today I was almost dizzy from the pain. The pain progressively is getting worse.

  • Jan Modric

    Nikibet,

    I strongly recommend you to answer all relevant questions in this personal medical history form.

    Abdominal adhesions could pull the bowel. Adhesions occur after surgery (even years after), in endometriosis, pelvic inflammatory disease, Crohn’s disease… MRI of the abdomen could show them, but sometimes a laparoscopy is required.

    Other:
    – gallbladder or bile duct related pain (sometimes radiates in te right shoulder, and often causes nausea, not always though).
    kidney pain, from kidney stones or inflammation can be felt both on the back and below the ribs, kidney could be tender when punched slightly.

    X-ray does not show much. Ultrasound is usually the first investigation in abdominal pain. There is small intestine on the spot you’ve described. Gallbladder is a bit upper, duodenum is more to the center, stretched abdominal muscles would be likely tender to touch.

  • ianrapids7

    Hey guys,
    I’m a 17 yr old male. I was playing soccer today when all of a sudden i got a cramp in my side…except it wasnt in a normal spot for cramps…it is a pain inbetween my ribs and hips on my very right side, almost to my lower right back i thought it was just a cramp so i kept playing and its still with me even though i finished playing soccer 4 hours ago…should i be worried

  • Jan Modric

    ianrapids7,

    a stretched muscle or a muscle cramp could be possible; in this case the affected area would be tender to touch. If the pain radiates down to the leg, a pinched nerve in the lumbar spine is likely. In mild cases, symptoms should resolve on its own is some days/weeks. If not, an orthopedist can give an exact diagnosis.

  • Stacy

    Hi Jan
    I was at the Dr last Monday and mentioned my right side abdomen pain to her. She was concerned and felt around my abdomen… none of pressing was painful. She said if it becomes a constant pain or becomes more painful to go in again.
    I’ve still been having the pain most days… noticing it more when i’m in a seated position.
    Is chronic appendicitus painful?
    My backpain (lower back) is worse… which may not be related.

  • Stacy

    Also – is it possible a medication may be causing my right side abdominal pain? I take a birth control pill, generic for wellbutrin and paxil and Claritin D.

  • Jan Modric

    Stacy,

    I don’t know much about chronic appebdicitis. I know it can be diagnosed by a CT. It can cause pain or not, and could be tender to touch or not. I’m not sure if it would cause an obvious lower back pain, though, especially if you yourself are not convinced if abdominal and back pain are connected..

    Pain appearing in both lower abdomen and lower back, changed by body position (agravated by sitting) could be from a pinched nerve in the lumbar spine. Pain would likely resemble sciatica (in characteristics, not distribution). A CT orMRI of the spine would confirm a spinal disorder (like a bulging disc or spinal arthritis)

    If the pain arises from the abdomen, it could be from the colon. Colonoscopy would likely reveal the cause in this case.

  • Rosy

    Hi,

    I am 23 years old and healthy. I had kidney stones but am under doctor’s supervision every 6 months.
    For the past 2 weeks, i had a weird dull ache at the right side. I was bloated; also my bowel movements changed a bit. i went to doctor thinking it might be my appendix but he said its probably nothing. it went away this week, and today I felt the same, little less pain next to my right hip bone. the pain is not bad, it’s just very uncomfortable and feels like aching or itching. my bowel movements are kidns of irregular again. I did feel little nauseas and that made me little stressed. I am going to have an ultrasound to rule out the ovaries, but could it be IBS? the pain is now next to hip bone, more where the ovaries are…in the morning it was at my hip bone. Moving or anything else doesn’t make it worse. its a strange feeling, i don’t have to take any pain killers its not that bad, but it stresses me out.

    Any information would be appreciated,

    Thanks,

    Rosy

  • Jan Modric

    Rosy,

    bloating, pain and nausea may be from a bowel (colon) disorder, like Croh’s disease that often affects the part of the colon located in the lower right abdomen. But there are many other causes of bloating, like lactose intolerance, fructose malabsorption, intestinal parasites, liver or bile duct disease….Not sure what exactly you’ve ment with itching, but all mentioned symptoms can be present in intestinal parasites, for example. Diagnosis is confirmed by a stool test.

    Strictly speaking, nausea is not a part of IBS. Typically in IBS there is an alternation between diarrhea and constipation, symptoms are aggravated by meal and relieved by a bowel movement.

    Bloating and changed stool speak for a digestive problem rather than ovarian disorder, so you may want to discuss with your doctor about having stool tests (ordered by a gastroenterologist) before other tests.

  • tommybruin

    Yesterday I experienced a wrenching pain in the stomach that eventually moved to the lower right quadrant of the abdomen. This was also paired with a grumbling in the stomach. I have not experienced any vomiting, fever, or nausea. There is a very dull pain in the lower abdomen area, but is much more prevalent in the lower right side now. Sometimes movement like walking aggravates the pain and grumbling. I’ve tried the quick release of pressure, but it hurts more to press on it than to release it. I also suspect I unknowingly ate a piece of raw pork. I am a 35 year old male.

  • Jan Modric

    tommybruin,

    pain from food poisoning from a raw pork would be likely accompanied with diarrhea. Some other food “incident”, like eating a lot of fruits or beans at once could cause gas built in the lower right colon and symptoms you’ve described.

    In acute appendicitis, there is often some nausea, and pain is felt when you release the pressure after pressing, but there are a lot of untypical appendicuitis cases. The pain is initially felt around the belly button, then it moves to the right. Another possible cause is intestinal hernia. Possible causes differ in males and females and with age…

  • tresb26

    I have a pain in my lower right abdominal area, an inch below the top of my right hip and an inch or two towards my belly button area. I dont have loss of appetite, vomitting or diarrhoea. The pain is not sharp or knife like but is sore when i press on it or am moving. Any ideas?

  • Jan Modric

    tresb26,

    additional info that can narrow down possibilities:
    – male or female, age?
    – any lump felt?
    – when and how did the pain start?
    – do you think it could be a physical injury?
    – any back pain or does pain spread to the groin or leg or anywhere else?

    Appendicitis and intestinal hernia are two possible causes.

  • izzyh

    Hi, I am a 20 year old female who plays sports and eats healthily, and not over weight. For many years I have had slight pain in the lower right abdominal area, it comes and goes, and sometimes is very painful.

    When I was younger around the age of 16 I went to the doctors and they just said it was growing pains, however last week I went to the doctors to have a regular check and she pressed down on where I said I was in pain and it made me flinch with a little scream of pain. Since then there has been this dull pain and today I was standing making tea and I suddenly got sharp, stabbing pain in the same place. This also happens when I am driving and even when I haven’t been driving for any length of time.

    I can point out the area where the pain is, it 6cm across from belly button 1cm down, it’s always there, just a very dull pain, and sometimes for a few minuets is a sharp pain. When I press down on right side I have sharp pain, but on left side I have no pain. I remember this one very bad night where the pain was so bad I couldn’t sit still, do anything to make the pain stop or sleep it was a nightmare. Since then every night I have my hot water bottle on my back which seams to help with the dull pain.

    Also every morning I have diarrhoea, the doctor said this may just be my normal bowel pattern. Since Christmas 2009 I have nearly lost a stone and a half but I don’t know how? I am eating the same and playing the same sports (which I stopped in April as season had ended) I was 10 stone 4 ish, now I am 8 stone 13 ish.

    I have had this problem for years but it seems to be getting worse. I asked if the doctor felt anything and she said no and had no answer for why I was in pain.

    Izzy

  • tresb26

    im 21, the pain seems to have eased a bit today, although not totally gone. it started about 40 hrs ago, the pain never got worse and worse, it was just an uncomfortable pain as opposed to sharp and mainly affected me when i moved. No back pain and no lump. Perhaps it could be a muscle injury but im not sure, i am quite active in sports

  • Jan Modric

    Izzy,

    first, finding a doctor (gastroenterologist) who will take you seriously is important. Many years of pain is not just growing pain, and diarrhea is never a normal bowel pattern. It’s possible you have lost weight because of nutrients loss due to diarrhea. A gastroenterologist can say, if and which stool tests should be done.

    In the area you’ve described there are:
    – appendix (chronic appendicitis would be possible, not sure how likely is this…)
    – first part of the ascending colon (typically affected in Crohn’s disease; rarely this part could be twisted – volvulus of the colon)
    – small intestine (intestinal hernia would be possible – a bowel loop can be pinched by abdominal muscles every now and then, and this could cause sharp pain; try to check if you can feel any lump under fingers at any time – the lump may appear and disappear with time)

    In endometriosis, patches of the uterine tissue may appear anywhere in the abdomen, and resulting fibrous tissue can connect various organs and bowel loops and pull them (this causes pain) – these are abdominal adhesions. Sometimes a laparoscopy – an endoscopy of the abdominal cavity – is required to make a diagnosis.

    Maybe some doctor will want to diagnose you with irritable bowel syndrome (IBS). Weight loss is NOT a symptom of IBS, so I recommend you not to accept this eventual diagnosis initially. Also think if you ever had nausea, fever (even slight), is the stool sticky, floating…

  • Jan Modric

    tresb26,

    stretched or ruptured abdominal wall muscle would be tender to touch and obviously related to body movements. Streched muscle usualy resolves on its own with time. Besides abdominal wall muscles, some deep muscle, like psoas maior/minor could be affected. A pinched nerve in the lumbar spine (for example, caused by a bulging or herniated disc) can cause pain in the lower abdomen. If pain does not go away you might want to visit an orthopedist.

  • izzyh

    Hi Jan

    I went to a walk in centre, as I could not get an appointment and they diagnosed me with having Coeliac which now when I thing about all my symptoms fit this condition. I am having a screen test next week.

    Thank you for your help

    Izzy

  • monka888

    Hi there im 32 male and i have a question pls help me… 4 days ago i got sharp pain close to my bellyb like a patch for 30 sec and stoped after couple min the spot felt like sunburn later that day i got same thing on my back but not a pain just a spot like sunburn when u touh it .. after two days when i woke up i had my lower back numb and after the third day tere is like red patches with pimples from my back to my belly on the left side only and i hve pain on my rib likd pulled muscle … and also hve hartburn early when i wake up … all my skin where the rahses are gets numb and the pain wich is mild goes on back to my first rib or on the side right now… pls help me

  • monka888

    Oh i frgot to add i have no urge to urinate no vomiting no diarreha just numbness and litle pain feel like u were runing and u feel pain on ur side..

  • Jan Modric

    monla888,

    a rash spreadinf from the back to the belly button can be from shingles – a reactivation of Herpes zoster virus in the spinal nerve. A dermatologist can confirm a diagnosis.

    I don’t know if heartburn is related, but this is from the gastric acid moving up the esophagus. A gastroenterologist can check this.

  • Britt_Hippie

    So yesterday morning i woke up with a cramp in my lower right abdomin, right next to my hip bone. With a constant urge to pee when nothing’s there, with a kind of sort of burning feeling near the end of peeing. Today i woke up with the same thing just now the cramped up feeling is my whole entire stomach?

  • Britt_Hippie

    Now the discomfort is moving up my sides and into my back, as well with it still being in my abdomin.

  • Jan Modric

    Britt_Hippie,

    this sounds like an urinary tract infection (UTI) or something other within the urinary tract, like urinary stone. A doctor can confirm the cause by an urinary test. Untreated UTIs may lead to complications…

  • helen

    i have been having side pains in my lower stomach for a few hours, stabbing pains sort of and find it hard or impossible to stand up straight. i feel very light headed and every so often i feel like i may throw up.. also this is not the first time i’ve had it, it was every few months or so aswell. i am not nearing my period.
    any help?

    thanks

  • Jan Modric

    helen,

    knowing where exactly is the pain, is the spot tender to touch, any bloating, diarrhea, burning urination..could help.

  • AMY72

    37yr female rh side pain started 4 days ago inline with naval on rh side pain radiats upward to ribcage. have been taking gas-x and tylenol pain is extremly bad no rh ovary was remove 2 yrs ago gallbladder 10 yrs ago, have tried walking to relieve gas pressure with no results pain is constant day and night

  • Jan Modric

    AMY72,

    if your abdomen is distended, then the pain may be from gas, and this can build up in the colon from several reasons:
    – food related causes:
    — ingesting large amount of dietary fiber (beans, oats…)
    — bacterial food poisoning – this usually heals on its own within a week
    — parasitic food poisoning – this can be diagnosed by a stool test and treated with prescribed medications
    — lactose intolerance, fructose malabsorption, celiac disease – these would cause chronic problems…
    – abdominal disorders:
    — inflammation of the colon

    It is importtant to say, if you have any nausea, fever, diarrhea, rash…

    If your abdomen is not distended, it can be urinary tract infection (burning at urination, cloudy urine…)

  • George

    I’m an overweight 40 yr old male who has been experiencing right side abdominal and back pain for over a year’s time. First it felt like a stabbing pain in my lower back and lower abdomen, so my doctor thought it could be kidney stones. Tests and ultrasounds came back negative. Then the stabbing pain began to spread up to just above and to the right of my navel and the lower right pain is now a constant dull pain. No nausea, vomiting, constipation or diarreah. There’s an area just above and to the right of my navel that is always very sore and tender and bruises easily but no real bulge like I’ve been told it would be if there was a hernia. My gallbladder was removed years ago and this pain doesn’t feel anything like the gallstone pain that I had. At this point I’m stumped. Any ideas?

  • Jan Modric

    George,

    I recommend you to visit an experienced gastroenterologist. Hernia does not always result in a palpable bulge, but there could be something else, like abdominal adhesions, which are starnds of scar tissue that sometimes develops (even years) after abdominal surgery. Ultrasound and even MRI can easily miss adhesions, so a gastroenterologist should tell which investigation to use.

  • rodj

    i have this lower back pain starting from the left part. i had this for the past 3 months. my left lower abdomen hurts too, it feels bloated. i checked my urine and the results say that i have UTI. they gave me prescriptions but i stopped taking antibiotics coz it constipates me and it doesnt go away even if i drink lots of water. ive noticed that the pain moves from right to left,sometimes it radiates to my neck and shoulders. im not sure what this is, i hope its not serious either.im kinda scared coz its been here for too long and its not going away..

  • Jan Modric

    rodj,

    I suggest you to have an urine test again, and if positive, have a full course of antibiotics – and to do this soon. Pains on both sides of abdomen can be from kidney infection, which can irritaete the diaphragm, what can result in shoulder and neck pain. Diet high in fiber can prevent constipation.

  • jennysue101

    I’m 36 Female and I started to have pain on my right side starting from the outside turning to the left side above my ovary and toards my belly button. The pain started about a week ago. I have been spotting still after my period and feeling like I’m having slight cramps. I’m not pregnant. I started a gluten free diet 6 weeks ago and most of my stomache symptoms had disappeared. Last year I went to the ER for stomache pain thinking it was my appendix and it wasnt. They didnt know what else it could be. Had my ovaries checked and it wasnt that either. My stomache symptoms have improved with the gluten free diet but some pain/discomfort has returned this week. Last week I did have an episode where I left like I had mild food poisening. I had diaherra and very bad cramps and got very sweaty. My stomache pains now feel like something is pulling inside and is harder on the right side. It feels like the large intestine is inflammed. I feel a little bloated.

  • Jan Modric

    jennysue101,

    food poisoning can be from bacteria, which usually heals on its own in a week, or parasites, which can last for weeks or months, so antiparasitic medications are often needed. A stool test for parasites exist.

    If you ever suspectd, fruits may irritate you, you can try a 4 days low-fructose diet. If you think, dairy foods irritate you, you can try lactose free diet or combination of both, which is a low-FODMAP diet.

    If nothing of above helps, a pelvic inflammatory disease (PID), Crohn’s disease, endometriosis or abdominal adhesions can be considered and discussed with a gastroenterologist.

  • Abby

    I’ve been sick with what I believed was just a bad summer cold, sinus problems, heavy chest congestion, a really bad cough, etc..but after about a week i started to get a really aweful pain in my lower right abdomen, it feels like my stomach area is swollen and it gives me an uncomfortable feeling against my right hip and rib like it’s pressing out against them. it gets much worse when I’m laying down and increases After eating or drinking. a few days after this started I started getting throbbing pains shooting down my leg into the inside joint of my left knee and foot, followed by pains in my right arm and side if my face. now it throbs all the time in my lower back like someones forcing me to bend backwards too far. when this starts I feel nauseous and dizzy. disoriented. I can’t sleep hardly at all and feel clammy, sometimes the sleep deprivation gets so bad I hallucinate, any ideas what’s causing this??

  • Jan Modric

    Abby,

    this should be checked by a neurologist as soon as possible. Symptoms appearing on one side of the body may arise from the brain. The doctor will want to know a detailed history of your symptoms, here’s a questionnaire that may help.

    Your chest problems were probably from a respiratory infection (but it is important to say have you coughed up any mucus or had a runny nose). Stomach swelling was probably from gas built in the intestine, and this could be from a partial bowel paralysis, which may be related to your limbs/face symptoms.

  • KARTHIK

    Hi,

    I am feeling Mild pain in right side stomach while taking Long breath. The pain is not sharp. what could be the things… pls help..

  • Jan Modric

    KARTHIK,

    where exactly do you feel the pain? Pain below the right rib cage could be from gas built in the trannsverse colon, or inflammation of the lung membrane (pleuritis), for example.

  • Iriswigman

    Hi,

    I’m 13 and it hurts right below my rib and it feels sort of sharp and like a pinch but then sometimes it hurts and then it’s gone and later it goes back again. It doesn’t really hurt a long time but it goes back and forth. I also have pain lower but that feels different it doesn’t feel sharp. Is this two whole different things or is this the same thing but goes to other places in my body? or can the lower one also just being nervous or something else (I already had my period and I have this quite a long time, just don’t know how long)

  • Jan Modric

    Iriswigman,

    pains appearing below the rib cage and also at some lower site may all arise from the colon, as this travels from the right lower abdomen, then along the right side and then horizontally below the rib cage. Such pains could be caused by some foods that release gas (like beans, certain fruits, high in fructose, like prunes or other dried fruits, also apples or pears, or dairy products, mostly milk…). But there could be many other causes, so I recommend you to speak with your parents, who can decide if you need to see a doctor.

    Saying are you bloated or constipated or have loose stools, and is your abdomen tender to touch when you feel pain is also important.

  • Judy

    Am 57 yr old female, surgical menopause.
    Several months of fatique, general malaise, and occasional sensation of heat and fullness in RUQ. In Feb.2010,
    began having GI problems with indigestion, belching, bloating, nausea, occasional vomiting. Then onset of diarrhea. As diarrhea worsened (and pain in RUQ also worsened), my FP began exploring. Admitted in May with C. difficile. However, the CT’s and US’s showed cirrhosis, with portal hypertension,splenomegaly already present. Gastroscope showed early esophageal varices. Colonsocopy with 3 polyps removed, a few diverticula. Liver Bx revealed no cause for the cirrhosis, and the gastroenterologist believes I have NASH, just a fatty liver gone cirrhotic. I have been taken off all meds except a b/p pill and metformin for NIDDM. I continue to have a burning sensation and “fullness” that fills my entire right side at times but more so in the URQ. At times, it feels like GB pain, but my gall bladder has been removed. Biliary obstruction has been ruled out. My dr. says that cirrhosis has no pain. Some web sites contradict that, and most report that there can be pain with fatty liver. The discomfort that I have is incapacitating at times, pain level that I would score 7-8 over 10. I have been unable to relate the pain to any certain foods, activity, or other. Am not allowed to take Tylenol, and no ASA as I have secondary thrombocytopenia. I need to return to work, as I have no income. But this pain and discomfort are getting in the way. Also, from what I have read, diverticula are typically in the large intestine. Wouldn’t that be the left side, not the right? My dr. just doesn’t respect the discomfort I have, says it is probably some neuritis. But this is a deep, burning pain. Can you help me???

  • Jan Modric

    Judy,

    fatigue and malaise could be from a liver disorder.

    Belching and burning suggests gastritis or duodenitis, which could be caused by Helicobacter pylori infection (Dx is by blood or breath test) or by biliary reflux from some reason – I would not exclude bile duct disorder. Besides bile duct obstruction, there can be biliary dyskinesia or sphincter of Oddi dysfunction (SOD). If the bile duct is intact, there could be a problem with small biliary ducts within the liver (due to cirrhosis…). This could be detected with HIDA scan – if a gastroenterologist would find this test appropriate.

    Fullness on the right side could be from gas in the ascendent colon, and this could be again connected with abnormal delivery of bile in the intestine. In this case, fats would not be absorbed properly and would appear in the stool (whitish, foamy stool) and detected with a stoll fat test.

    Yes, diverticles usually appear in the last part of the descending colon (LLQ), but they could also occur in other parts.

    One important thing – the heat sensation – can you detect it with the hand as an actual localized hot area?

  • George

    Followup to my June 18th message… can it be biliary stones (Sphincter of Oddi dysfunction)? If so 1)What are the chances that an ultrasound would miss them since i’ve had two done that covered my kidney, liver and pancreas? 2)Do things like Chanca Piedra actually work to help dissolve them or is this just more internet misinformation?

  • Jan Modric

    George,

    pain from bile duct stones or SOD would be located just below the right rib cage, about 5 inches from the middle line. Ultrasound can miss both conditions, but you’ve said your pain is around the navel and the spot is sore and tender to touch; these are not characteristics of bile duct disorders or urinary stones.

    I don’t know what Chanca Piedra can or can not do. Stones dissolving may take months or years, and stones can recur. Without even knowing are there any stones or not, I myself would not try it. It has some side effects, like hypotension and hypoglycemia.

  • Judy

    Hi again, and thanks for your response. I was tested for H.Pylori and that was negative. There is no external heat when I feel the burning pain. No fat in my stools. Aside from the pain in my side, I have terrible indigestion and reflux, but the dr. does not want me to take any anti-reflux meds because of the liver disease. Yesterday, I notced that I am getting these “white heads” (like pimples)in several different areas. Could that also be related to liver issues?

  • Jan Modric

    Judy,

    white heads could be acne or folliculitis – this is usually caused by staphylococcal infection. OTC aintibiotic ointments exist, and if no effect, a doctor can prescribe oral antibiotics. It could be related to lowered immunity due to a liver disorder…

    By “indigestion” what exactly do you mean? Burping and reflux clearly indicate something is happening in the stomach causing overproduction of gastric acid. The original cause can be:
    – stress from the disease, resulting in overproduction of the gastric acid
    – gastroparesis – insufficient relaxation of the stomach exit (pylorus)
    – biliary reflux – reflux of bile from the duodenum into the stomach – in this case you could have a bitter taste in the mouth

    In liver cirrhosis, not only small veins within the liver are compressed (resulting in portal hypertension), but also small biliary ducts are compressed what could at least partly reduce delivery of bile into the duodenum and cause poor fat digestion. If this is the case, low fat diet could greatly reduce bloating. If stool fat test confirmed no fats, then I’m not sure if this scenario is likely.

    If you have reflux, the doctor has to find a solution how to reduce it, since it can cause ulcers in the stomach and duodenum. According to my knowledge, there is no contraindications for an acid lowering drug Prilosec (omeprazole), except hypersensitivity. In a liver disease, a lower than normal dose should be used, anyway, a gastroenterologist should know this well. There are various types of anti-acid drugs, and I’m sure one should be ok for you.

  • Yolande

    Hi Jan,

    I am a 44 yr old female, 2 kids. Early 2008 I started getting a sharp stabbing pain just under my ribs on my right side, always at night for maybe 2, max 3, nights in a row, once a month. It would wake me up and I would have to change position (turn on my other side or on my back) for it to subside and I would be able to go back to sleep. I thought it might be gall stones, but ultrasound and blood tests ruled that out. Then went for a colonoscopy, also clear. Was told it was IBS (and when looking it up on the net, I don’t believe it is that at all).

    The pain then seemed to ‘move’ to the lower regions just in and up from my hip bone, similar stabbing pain every now and then during the night while I was sleeping (at most about 2 or 3 nights per month, skipping a month here and there), waking me up, and turning over would have it almost gone and I could go back to sleep. Sometimes the pain would be higher up as well. Nothing really during the day.

    At the same time I had CIN2 result pap smear and had cervical laser treatment, and the gynea checked my right ovary at the same time and said it seemed fine, as I was worried about ovarian cysts.

    I do apparently have polycystical ovaries, but apparently this should not cause any pain like what I am experiencing.

    This has been a fairly regular thing, sometimes every month, or every 2nd month, since then and seemed to be around ovulation. So my GP then suggested that maybe I am suffering from painful ovulation.

    I have also found that I could be a little bit bloated around this time (not always), and a bit ‘burpy’.

    This carried on through 2009, and beginning of this year I went through a period of not having these pains for a while, but just under two months ago I was woken again one night with the same stabbing pain, about around ovulation, and since then I have had a permanent dull achy/throbbing type pain just in and up from my hip bone, day and night. Occassionaly I can also feel the pain higher up again (in the region of my gallbladder).

    Not sure if this is at all related, but 3 or 4 times during the last 2 months (and once or twice in the previous year) I had a quick burst of diarrhea about half an hour after eating an unusually large meal when entertaining friends or going out for a meal (compared to my normal eating habits). I usually have bowel movements every 2 or 3 days, been like that all my life.

    The pain now seems to also refer on to my lower back on the right (since about 2 weeks ago), and I get the occasional very short stabbing pain (about twice a day or so, much milder than the pain I would get at night while sleeping) in the same area (in the region of my appendix), but it lasts only for a few seconds. None of the different pains are really bad enough to take pain killers, but enough to be uncomfortable. And most of the pain I get at night does go away when I turn over.

    The new GP I am seeing (we just moved to another country end of last year) sent me for ultrasound as she suspected it might be endometriosis, but she didn’t even really check to see exactly where the pain occurred, so I am not so sure about that either. So – I went for pelvic ultrasound this morning, and he said there isn’t a cyst on my right ovary, couldn’t see anything abnormal, but did confirm that the pain I am experiencing seems to be in the region of my appendix.

    I have no nausea related to the pain at all, no fever, etc.

    Any suggestions would be most welcome.

    Yolande

  • Jan Modric

    Yolande,

    ultrasound cannot 100% rule out endometriosis; another resembling condition are pelvic/abdominal adhesions. In both endometriosis and adhesions, scar-like threads develop; pains appearing around ovulation time suggest that the right ovary is involved. Ovary and appendix could be connected with such adhesions, pull them and cause pains. Such adhesions could loosen a bit when you change the sleeping position, so this would explain pain relief. Adhesions also often develop between the diaphragm and nearby abdominal organs – this would explain pains around gallbladder. A MRI of the abdomen, and as a last resort, laparoscopy could reveal adhesions.

    Bloating and burping could be from slowed bowel transit, for example, from a mild, temporary gastroparesis, and, if it seems to be related with your other problems. Large meals triggering diarrhea can be isolated events, or your bowel is a bit more sensitive because of eventual adhesions.