There are several reasons why you might experience pain in your lower right abdomen — also known as the right lower quadrant (RLQ). And though it might be tempting to let your thoughts drift to more serious causes, it’s important to keep in mind that reasons for experiencing pain in the RLQ can range from harmless to severe.

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Below, we’ll talk about what each of these causes entails. But while self-diagnosis could be useful in some cases, nothing replaces the advice of a medical professional.

“Anyone with abdominal pain should seek immediate medical attention if the pain is severe, also felt in the chest, accompanied by fever, bloody vomit or stools, or if the abdomen is hard or swollen.” Stephani Laing, CEO, ACP, an Advanced Care Paramedic at Elite Emergency Response Inc. tells us.

Again, there are many cases where abdominal pain can be the cause of something less severe. Perhaps your lower right abdomen is hurting due to one of the reasons listed below.

1. Appendicitis: the classic culprit of RLQ pain

Appendicitis is perhaps the most well-known cause of RLQ pain. This condition occurs when the appendix, a small pouch located in the lower right abdomen, becomes inflamed and infected.

“The appendix is located in the right lower quadrant (RLQ) but interestingly, the abdominal pain can start on the left side or around the belly button before moving to the right lower abdominal area,” Laing tells us.

According to Laing, the danger with appendicitis is that if an inflamed, infected appendix ruptures, it can spew bacteria into the body and causes sepsis. “Sepsis causes severe illness and can lead to death so it’s important to get appendicitis ruled out by a doctor if you’re experiencing persistent abdominal pain and suspect appendicitis,” she says.

2. Hernia

According to Healthline, a hernia occurs when an internal organ or a part of the body pushes through muscle or tissue that holds it in place and protrudes from the body in an abnormal way. Many types of hernias happen in the abdomen, which is why RLQ pain might be related.

Other symptoms you might experience along with abdominal pain are feeling full or constipated, swelling or bulging at the site, and pain while lifting, laughing or crying, coughing, or straining.

Inguinal hernia

An inguinal (or groin) hernia occurs when part of the intestine bulges through a weak spot in the abdominal wall at the inguinal canal (a passageway near the groin). According to Harvard Health, inguinal hernias are up to 10 times more common in men than in women.

You might not experience any symptoms at first, but if you notice severe RLQ pain or pain in the groin along with a bulge and suspect it’s an inguinal hernia, see your doctor.

Gastrointestinal causes

3. Gas/indigestion

RLQ pain could simply be caused by gas or indigestion.

  • Gas trapped in the intestines or bloating from indigestion can create discomfort in this area. Fortunately, it usually passes in a matter of hours.
  • Constipation can also lead to cramping and pain in the lower abdomen.
  • Gastroenteritis, commonly known as the stomach flu, can cause inflammation of the stomach and intestines, resulting in abdominal pain, diarrhea, and vomiting.
  • Diverticulitis, characterized by inflammation or infection of small pouches in the colon called diverticula, can lead to RLQ pain, along with symptoms like fever, nausea, and changes in bowel habits.

If you’re experiencing indigestion (which may be accompanied by flatulence, heartburn, or other similar symptoms) there’s typically no reason for concern, unless it lasts more than two weeks.

4. Inflammatory bowel disease

Inflammatory bowel disease (IBD) is an umbrella term for two separate conditions: Crohn’s disease and ulcerative colitis. According to the Centers for Disease Control (CDC), IBD is characterized by chronic inflammation of the gastrointestinal (GI) tract and prolonged inflammation could result in permanent damage to the GI tract. 

If your RLQ pain is accompanied by severe diarrhea, weight loss, fatigue, blood in the stool, fever, or reduced appetite, you might be suffering from IBD.

5. Irritable bowel syndrome

Irritable Bowel Syndrome (IBS) is a common disorder that targets the large intestine — it shouldn’t be confused with IBD.

According to the U.S. Department of Health and Human Services, along with RLQ pain, IBS could cause gas, bloating, cramps, diarrhea/constipation, or both. Doctors aren’t sure what causes IBS, according to the organization.

Renal and urological disorders

6. Kidney stones

A more severe cause of RLQ pain might be kidney stones. This is when salts and minerals build up in the kidney into hard lumps that can vary in size.

Sometimes kidney stones that are smaller in size will simply pass through the urinary tract. But larger stones may become stuck, resulting in significant pain.

Along with pain, an individual might experience blood in the urine, persistent urge/pain when urinating, and nausea or vomiting, according to Medical News Today.

7. Kidney infection

If bacteria spread from the uterus, bladder, or urethra, it could result in kidney infection. One or both of the kidneys may be affected, and though abdominal pain may be a symptom, an individual more typically experiences pain in their sides, back, or groin.

If you suspect your RLQ discomfort is caused by a kidney infection and you’re also experiencing fever, chills, nausea or vomiting, increase in urination frequency or increased urge to urinate, cloudy, painful, or pussy/bloody urination, seek medical attention immediately.

8. Renal cysts

Renal cysts are benign fluid-filled sacs that develop in the kidneys, may occasionally cause discomfort if they become large or if they rupture. However, lower right abdominal pain is not the most common symptom associated with this condition since the pain is typically located in the flank area rather than the lower abdomen. However, in some cases, larger renal cysts or cysts located in specific areas of the kidney may cause pressure on surrounding structures, leading to referred pain in the lower abdomen. This pain may be dull, aching, or intermittent, and it might be accompanied by other symptoms such as urinary urgency, frequency, or blood in the urine.

9. Pyelonephritis

Pyelonephritis, a bacterial infection of the kidneys, can present with flank pain that can sometimes radiate to the lower abdomen (especially if the infection is localized to the right kidney), along with fever, chills, fatigue, pain or discomfort during urination, cloudy or foul-smelling urine or blood in the urine.

Pain in lower right abdomen near hip bone in females: gynecological conditions

In females, several gynecological conditions can cause lower right abdominal pain, especially near the hip bone.

10. Pelvic inflammatory disease

According to the Centers for Disease Control and Prevention (CDC), pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs and is often caused by some STDs, like chlamydia and gonorrhea. However, PID can also result from other infections that are not sexually transmitted.

If you have PID, other symptoms you might experience in addition to RLQ pain would be fever, unusual/odorous vaginal discharge, burning during urination, or pain/bleeding during sex.

11. Ovarian cysts

Ovarian cysts are fluid-filled sacs in the ovary and are a very common part of ovulation. Many women with ovarian cysts don’t experience symptoms; the cysts are harmless and go away on their own, Womenshealth.gov explains. However, there are some cases where large cysts rupture and lead to severe pain. In this case, it’s important to see your doctor.

12. Ectopic pregnancy

“In women of childbearing age, an ectopic pregnancy can also cause RLQ pain,” says Laing. “An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube.”

Women who suffer ectopic pregnancies often don’t know yet that they’re pregnant, explains the paramedic, and this would require emergency surgery. This is due to the fact that if an ectopic pregnancy causes rupture of a fallopian tube, the result can be severe internal bleeding, shock, and possibly death.

13. Endometriosis

Endometriosis, a condition in which tissue similar to the lining of the uterus grows outside the uterus, can cause pelvic pain that radiates to the lower abdomen, including the right lower quadrant. Endometriosis may be associated with menstrual irregularities, painful intercourse, and infertility.

RLQ pain in males

14. Testicular torsion

Testicular torsion is a serious condition in which a man’s testicle twists and loses its blood supply, and according to Clevland Clinic, this condition requires emergency care.

If the blood supply is not returned to the testicle within six hours, the testicle may need to be surgically removed. If you experience swelling of the scrotum along with RLQ pain, fever, nausea, vomiting, or uneven testicle position, seek medical attention.

Article updated on March 28, 2024.

•March 28, 2024