Pain in lower right abdomen that comes and goes

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Abdominal Pain: Is It Appendicitis or Something Else?

Several conditions can cause pain in the lower right abdomen and can be difficult to distinguish from the symptoms of appendicitis.

Bloating, gas, and kidney stones are just a few other sources of abdominal pain. Thinkstock

Appendicitis develops when your appendix — a small pouch attached to your large intestine — becomes inflamed.

Sharp pain in your abdomen is the foremost sign of appendicitis, but a pain in your belly doesn’t necessarily mean you have the condition.

Almost everyone will experience abdominal pain at one time or another, because there’s a long list of things that can cause this problem.

Possible Causes of Abdominal Pain, Including Appendicitis

Aside from appendicitis, some of the most common causes of abdominal pain include:

  • Gallstones
  • Ovarian cysts
  • Irritable bowel syndrome (IBS)
  • Urinary tract infection (UTI)
  • Crohn’s disease
  • Indigestion
  • Gas
  • Gastroenteritis
  • Peptic ulcers
  • Kidney infection
  • Lactose intolerance and food allergies
  • Constipation
  • Hernia
  • Ectopic pregnancy

The severity of the pain doesn’t always correspond to the seriousness of the condition that’s causing the pain. Life threatening conditions such as colon cancer may cause only mild pain, while a minor bout of gas may cause painful cramping. (1) Looking at the specific type of pain you’re experiencing can help you zero in on the condition you may have.

For example, cramping abdominal pain is commonly due to gas and bloating. It’s generally not caused by something serious (such as appendicitis), and may be followed by diarrhea. (1)

“Colicky pain,” or abdominal pain that’s severe and comes and goes in waves, is typically the result of kidney stones or gallstones. (1)

If your pain isn’t localized to a specific area, and instead you feel it in more than half of your belly, you may have a stomach virus, indigestion, or gas. Sometimes stress or anxiety causes vague, nonlocalized abdominal pain as well. (1)

If that pain becomes more severe over time, or your abdomen becomes swollen, it could be the result of something obstructing or blocking your large intestine.

On the other hand, if your pain is only found in one area of your belly, it’s possibly due to an issue with one of your organs, such as the gallbladder, pancreas, appendix, or stomach.

The way the pain evolves over time can also be useful in determining what’s causing it. Certain conditions tend to cause acute pain over the course of hours or days, while other conditions cause pain that comes and goes but doesn’t necessarily worsen over time. (2)

Is It Appendicitis Pain or Something Else?

Most often, the pain you feel when you have appendicitis begins as a dull ache around your belly button that shifts to your lower right abdomen, where your appendix is located.

Additionally, appendicitis pain:

  • Begins suddenly; it often wakes people up at night
  • Becomes significantly sharper in a matter of a few hours
  • Starts before other co-occurring symptoms, such as fever, nausea, and vomiting
  • Is associated with loss of interest in eating
  • Worsens when you move around, breathe deeply, cough, or sneeze
  • Spikes when you drive over a speed bump or experience other jarring motions (3)

To diagnose appendicitis, your doctor will perform a physical exam, which will investigate the finer points of your abdominal symptoms.

If you have appendicitis, you will likely: (4)

  • Hurt when someone applies and then quickly releases pressure in your lower right abdomen, a symptom called “rebound tenderness”
  • Experience rebound tenderness in your lower right abdomen when someone applies and quickly releases pressure on the lower left side of your abdomen
  • Unconsciously guard your lower right abdomen when someone tries to touch it
  • Feel pain when someone applies resistance to your right knee as you try to lift that leg up while lying down on your back
  • Ache in your abdomen when you move your bent right knee to the left and right while lying down on your back

Maybe it started off small. Maybe it suddenly came out of nowhere. Whatever it is, you’re having pain in your side. But why? Where did it come from? And should you be worried?

We’re all familiar with pain from stubbing a toe or twisting an ankle, but internal pain is a bit more disconcerting since it’s often tricky to pick out the cause. Pain is your body’s way of sounding the alarm. When you feel pain, your body is trying to tell you to take it easy—something is wrong.

“Pain in your side or in your abdomen is a common complaint, and it’s a common reason for people to visit the emergency room,” explains Dr. Timothy Farrell, a general surgeon at Geisinger Community Medical Center. “If you’re experiencing pain in your side, keep track of the pain, and see what aggravates it. Does it hurt more when you stand or sit? When you breathe in or breathe out? Does it always hurt the same amount or is it off and on? If you notice the pain is severe or interrupting your ability to go about your day get medical attention. Even if it isn’t anything dangerous, it’s still better to be sure.”

Importantly, if you notice you’re having severe pain, fever, swelling and tenderness of the abdomen, bloody stools, yellowing of the skin or persistent nausea and vomiting, see a doctor immediately.

Here are a few things that may be causing that pain in your side.

Gas and constipation
The most common reason for the pain in your side is what you ate or drank.

Gas or constipation is usually the biggest false alarm when it comes to abdominal and side pain. Each can cause fairly severe pain, but they usually aren’t harmful. Normally, gas and constipation pains can be identified by their inconsistency: the pain may come and go, and it will change depending on how you’re sitting or standing. Gas and constipation pain should subside within an hour or shortly after a bowel movement.

Irritable bowel syndrome
Irritable bowel syndrome, or IBS, is a common condition that affects the large intestine by causing spasms.

“Cases of IBS can range anywhere from mild to severe, and it often runs in families,” notes Dr. Farrell. “Factors like food, stress and hormones can trigger IBS, causing symptoms like cramps, pain, bloating, diarrhea and constipation.”

If you’re experiencing IBS symptoms, talk to your doctor. They can diagnose whether you do have IBS and prescribe medication if necessary.

Stones
Stones aren’t just something you find outside—they may show up in your kidneys or your gallbladder, too.

Kidney stones are deposits of salt and minerals that can form and harden in your kidneys. Gallstones are deposits made from cholesterol and bile.

“Kidney stones and gallstones can cause excruciating pain,” says Dr. Farrell. “Kidney stones may be passed naturally, but in more severe cases, they may require surgery. Talk to your doctor if you experience severe, radiating pain that lasts for more than a day.”

Appendicitis
“One of the most serious reasons for abdominal pain is appendicitis,” explains Dr. Farrell. “Appendicitis, or an infection of the appendix, can be a life-threatening condition. Appendicitis is considered a medical emergency, and surgery is required to remove the appendix.”

If you notice pain (especially on your right side), fever, vomiting and loss of appetite, get emergency medical attention.

Next steps:

Request an appointment with Timothy Farrell, MD

Learn more about surgery services

9 Possible Reasons For Pain In Lower Right Abdomen In Women

Have you ever experienced pain in your tummy? Now you may wonder what kind of a weird question this is.

Of course, you have. Who hasn’t?

Tummy pain or abdominal pain is one of the most common types of pain that people experience in their day to day lives. Usually, it goes as it comes and is relieved by rest or medication. No one really notices how big of a deal abdominal pain can become until one day, they actually experience a sharp-shooting or severely aching pain in their abdomen.

Then and there, abdominal pain becomes no longer just a mere excuse to take an off from work or college, but it turns into something so severe that it needs medical attention.

Difference Between Stomach Ache & Abdominal Pain

Yes, there is a difference, and it’s a big one.

The abdomen is the area between your chest and pelvis, and as a whole, it’s a home to many organs like liver, pancreas, spleen, appendix, intestines etc. Just like these organs, the stomach is also an organ located in your abdomen.

The stomach is located in the upper left part of your abdomen. It is an organ that participates in the process of digestion by liquefying and churning the food. Pain, arising only in the stomach is known as a stomach ache. However, pain in abdomen is a very broad term.

Pain in the abdomen isn’t something which is just limited to stomach ache, but it also indicates towards pain in any of the organs located in the abdomen as a whole. Therefore, stomach ache and abdominal pain should not be treated alike.

What Causes Abdominal Pain?

Abdominal pain can be caused due to a variety of reasons – inflammation, infection, obstruction, altered bowel movements and menstruation are some common causes of abdominal pain.

Abdominal pain can be achy, dull, crampy, colicky, intermittent or sharp. No matter how mild, severe or intense that abdominal pain is, don’t ignore it. Informing your doctor is a necessary and important step in order to avoid it from progressing into a more serious complication.

Lower Right Abdominal Pain In Women

Pain, specifically on the lower right side of the abdomen, can indicate towards a series of problems in females. These issues can be minor or major depending on what is causing the pain. The lower right part of the abdomen is home to many organs like –

  • Cecum.
  • Appendix
  • Ascending Colon
  • Right Ovary
  • Right Fallopian tube
  • Right ureter

Development of inflammation, obstruction, infection etc in any of these organs can contribute towards the build-up of discomfort and pain in the lower right side of the abdomen.

9 Common Causes Of Lower Right Abdominal Pain In Women

Less Serious Causes

#1. Menstrual Cramps

Periods don’t scare you but cramps do. No one likes period pain. There is absolutely nothing to like about it. It makes you dull, sad and cranky. Sometimes, it even makes you cry.

You bundle up into a sad ball of pain with hot pads and pillows around you hoping that it will go away. And when it finally does, it is the best feeling, isn’t it? Menstrual pain usually doesn’t require any serious medical attention. A little bit of heat around the lower abdomen, massage, rest and healthy food take care of it.

Menstrual pain may take a few hours or a few days to completely go away. However, if the pain becomes intolerable and very severe, informing your doctor about it is very important so that your doctor can help you feel better.

#2.Indigestion & Intestinal Gas

Turns out that your decision of having that extra serving of your favourite food didn’t work out well for you. After that much-enjoyed food adventure, you’re here, holding your stomach praying for the pain to go away. Don’t worry, it will.

Pain caused due to indigestion usually goes away in a few hours or a day and is relieved by over the counter medications. If food isn’t digested properly, there can be a build-up of gas in the intestines.This can cause bloating, discomfort and pain.

Pain due to gas usually subsides in a few hours if you move around and walk a little to release the extra gas out of your system. However, if you are experiencing nausea, vomiting, diarrhoea and severe pain along with a lot of abdominal discomforts, you should meet your doctor immediately to ensure that your pain is taken care of properly.

More Serious Causes

#3. Ovarian Cyst

Sac-like fluid-filled or solid formations called cysts can develop on the ovaries. They can cause irregularities in the menstrual cycle. They may cause heavy or light periods and can also cause bloating.

If the ovarian cysts are small, they are usually harmless. However, if they get bigger they can also cause a dull aching pain in the abdomen along with other symptoms like:

  • Sharp pain in lower abdomen
  • Pain during sex
  • Irregular menstruation
  • Increase in urination
  • Swelling of the abdomen
  • Bloating

Most ovarian cysts do not cause infertility, however, if they become infected due to pelvic inflammation, they can scar the fallopian tube and cause infertility. See your doctor right away if you are experiencing the symptoms mentioned above.

#4. Ovarian Torsion

It is the twisting or rotation of ovary. In ovarian torsion, the blood supply in ovarian artery/vein is occluded and blood flow is compromised due to the twisting of ovary around its ligamentous support. As a result, the blood flow to the fallopian tube and the ovary is reduced. This can even lead to necrosis and death of tissue.

Women can experience crampy or dull pain in their abdomen for days to weeks until a sudden sharp pain arises because of the twisting and untwisting of the ovary. Such a pain should immediately be reported to the doctor so that a proper treatment can be provided.

#5. Endometriosis

Endometriosis is a condition where the tissue which lines the uterus grows outside the uterus. It can cause:

  • Pain in lower abdomen
  • Menstrual irregularities
  • Pain during sex
  • Abnormally heavy or light periods
  • Pain during bowel movements
  • Rectal pain
  • Nausea and constipation

Endometriosis also contributes towards infertility.

#6. Pelvic Inflammatory Disease

PID is caused due to the spread of infection in the organs of the female reproductive system. Uterus, ovaries, fallopian tubes and cervix are affected. The pelvic inflammatory disease is usually caused due to sexually transmitted infections like chlamydia and gonorrhoea.

Symptoms of PID are often left unnoticed in the early stages, however as the infection spreads, the following symptoms can be seen –

  • Heavy unpleasant discharge from the vagina
  • Burning pain while urination
  • Fever and chills
  • Pain in lower abdomen near the pelvis
  • Pain during sex
  • Bleeding between periods

PID can cause serious problems if left untreated. The pelvic inflammatory disease can cause persistent pain in your lower abdomen. It can even lead to infertility. Treating a sexually transmitted infection is very important in order to reduce the chances of developing PID. Meet your doctor right away if you are experiencing any of the symptoms mentioned above

#7. Ectopic Pregnancy

An ectopic pregnancy occurs when the embryo implants itself outside the uterus, usually in the fallopian tube. It happens within the first few weeks of the pregnancy. Ectopic pregnancy may lead to fallopian tube rupture, causing intense pain in the lower abdomen.

First symptoms are usually light vaginal bleeding and pelvic pain. Other symptoms are:

  • Sharp abdominal pain
  • Nausea and vomiting
  • Abdominal cramps
  • Weakness and dizziness

Since the embryo cannot survive outside the uterus, usually medication is given or surgery is advised to rectify the problem. Inform your doctor right away if you experience bleeding and pain during pregnancy.

#8. Miscarriage

Losing a pregnancy can be highly emotional and a very traumatizing experience for a woman. Loss of pregnancy before the 20th week is known as miscarriage or spontaneous abortion. Almost 80% of all miscarriages occur in the first few months of pregnancy.

Symptoms of a miscarriage include –

  • Pain in lower part of the abdomen
  • Heavy bleeding
  • Back pain
  • Severe cramps
  • Fever

Miscarriages can occur due to infections, trauma, uterine problems and hormonal issues in pregnant women. If you are experiencing bleeding with fever, chills and severe pain during your pregnancy, contact your doctor right away.

#9. Urinary Tract Infection

Urinary tract infections, or UTIs, are also one of the most common causes of lower abdominal pain in women. It is the infection of the urinary system involving the kidneys, bladder and the urethra. Fever, lower abdominal pain, blood in urine, burning urination and an increase in the frequency of micturition is commonly seen in UTI.

Other symptoms are –

  • Pain in groin and pelvis
  • Foul smelling urine
  • Cloudy urine
  • Dark urine
  • Blood in urine
  • Cramping
  • Vaginal irritation and itching

Call or visit your doctor immediately if you are experiencing the symptoms listed above. UTI requires proper medical care and attention for the pain to be managed and the infection to be treated properly with the use of antibiotics.

When To See A Doctor?

Abdominal pain in the lower right side may or may not be a cause of concern depending upon the symptoms associated with it. Usually lower right abdominal pain is relieved with basic home care like taking rest, sleeping, relaxing, massaging and using a heating pad.

At times, this pain may also require the use of some over the counter medications to reduce and manage the symptoms. However, sudden sharp and persistent pain or pain that is associated with bleeding, chills or fever can indicate towards more serious causes that require proper medical attention.

Symptoms That Require Immediate Medical Attention

If your abdomen is sensitive to touch, visit your doctor immediately or call for medical help. Other symptoms that require medical intervention are –

  1. Pain in the abdomen with high fever (over 102°F).
  2. Severe concentrated pain in the right lower part of the abdomen.
  3. Bleeding during pregnancy
  4. Bloody urine
  5. Blood in stool
  6. Uncontrollable vomiting
  7. Blood in vomiting
  8. Rectal bleeding

What Can I Do?

If you are experiencing pain, no matter how mild, severe or persistent it is, never ignore it. Don’t wait for the pain to subside or go on its own. Always inform your doctor if you feel that something isn’t right or normal. Seek help if you are in immense pain and discomfort.

  • Call/ visit your doctor and share your symptoms in detail.
  • Request for an ambulance if you cannot visit the hospital.
  • Remain calm and try to breathe.
  • Wait for the help to reach you.

Make it a point to get routine checkups done in order to avoid any health related issues or complications. Maintain a healthy lifestyle. Eat a balanced diet and perform physical activities. Try to avoid stress as much as possible.

Things To Remember

Pain demands attention. It is an indication that something isn’t right with your body and this message from your body should never be ignored or taken lightly.

Pain in the lower right side of the abdomen can turn out to be a more complicated or severe problem than you can imagine. If are ignoring the frequent, but light and bearable pain that is persistent and currently subsiding on its own, then you are inviting bigger problems.

Visit the doctor or seek medical attention immediately if you feel uneasy because of your abdominal pain. It’s better to be safe than sorry.

PMC

DISCUSSION

Foreign body ingestion is usual in pediatric patients, but rare in adults. Prisoners and patients with mental disorders constitute this group.13 The prevalence of appendicitis caused by foreign body is roughly 0.0005%.14 Various objects including sewing needles, retained shot pellets, tongue studs, endodontic files, drill bits, dog hair, toothbrush bristle, toothpicks, fishing lines, mercury (after ingestion of the bulb of a thermometer), condom fragments, vegetable seeds, fruit seeds, pits, and worms are trapped in appendiceal lumen.6,15 It has been reported that needles, pins, screws and buckshots were the most common foreign bodies causing appendicitis.10-12 These radiopaque objects are heavier than gastrointestinal (GI) contents and because of the position of cecum and its low motility such foreign bodies tend to trapped in this part. The entry to appendiceal lumen is affected by some factors including the orifice of appendiceal lumen and anatomical position of the appendix. Considering the upward position of retrocecal appendix, entry of foreign material into the lumen is almost impossible which may be related to partial kinking or narrowing of its orifice. The complicated or uncomplicated appendicitis depends on shape, size, and nature of foreign bodies trapped in the appendix. Foreign bodies can be divided into high-risk and low-risk groups based on their physical characteristics. The high- risk group consists of sharp, elongated, or pointed objects that usually cause perforation, appendicular abscess, and peritonitis while the other group includes objects with blunt or round borders that cause obstruction of the appendiceal lumen and remain dormant for a long time.10 In one investigation of 256 patients with foreign body induced appendicitis over 10 years, the researchers concluded that in patients with sharp, stiff, or metallic foreign bodies in the appendix, 93% were symptomatic, and inflammation and perforation was seen in 88% and 77% of the patients, respectively. However, only 66% of the patients with blunt or round firm foreign bodies with smooth border in the appendix showed symptoms. Klinger and co-workers reported that appendicitis caused by high-risk objects was seen in about 75% of the patients, while less than 12% of patients had low-risk foreign bodies in their appendix.10 Since most foreign bodies trapped in the appendix are radiopaque and detectable in serial plain abdominal radiography and can be observed as hyperechoic lesion with shadows in sonography, the suspicion of appendicitis for physicians will be easy. Other symptoms contributing to the recognition of appendicitis are inflammation following at least partial obstruction and Mc–Burney tenderness in asymptomatic patients. Therefore, no more work-up would be necessary in this situation. Most patients with high-risk foreign bodies in the appendix showed obvious symptoms. Therefore, prophylactic appendectomy is considered as a feasible treatment for such patients. It was mentioned that even blunt objects that are usually enclosed by fecal material would lead to the obstruction of appendiceal lumen in the long-term and subsequent sub-acute or chronic appendicitis or occasionally mucocele.15 Also, poisoning is another complication of buckshot foreign bodies in the appendix. According to these problems, regardless of the type and nature of the foreign bodies and whether or not the patients are symptomatic, all patients should be appendectomized.8,10 In some publications, there are various recommendations including fluoroscopy-guided colonoscopy and laparoscopy to remove the foreign body contained in appendix before the final decision for appendectomy.11,16

In one case report of a 20-year-old man with signs and symptoms of appendicitis with abnormal laboratory tests, a metallic foreign body was found in abdominal radiography, which was confirmed as a needle by computed tomography. During laparoscopic exploration, a slightly thickened and inflamed appendix was found, most likely because of the erosion of the needle close to the neck of the appendix. The patient was discharged with no post-operative complications.15

Antonacci and colleagues reported a 45-year-old man with a history of eating marrowbone approximately 15 years prior to the time of admission who presented with lower right-side abdominal pain. Abdominal radiography and computed tomography respectively revealed radio-opaque formation and a massive round filling defect in the iliac fossa. Laparoscopic appendectomy was performed and the patient was discharged 2 days later with no complication.17

Appendicitis caused by eating geese hunted by lead pellets from a shotgun was reported in an 8 year-old boy. During laparoscopic appendectomy 57 lead pellets were recovered in the lumen of the appendix.18

We reported a case of appendicitis caused by colon transit time study as a complication of this diagnostic method. Since this patient had chronic constipation and was prone for impaction of radio-opaque markers in the appendiceal lumen and subsequent appendicitis, we believe that long-term follow-up after colon transit time study and taking plain abdominal radiographs a few days later can be feasible. On the other hand, recently, radio nucleotide study has been considered as a beneficial alternative with no recognized complication.

Colon transit time study is a simple method for evaluating colon motor disorders, but it can be dangerous. The position of the appendix and its wide orifice can be a threatening factor for trapping the markers. Long-term observation and use of nonmetallic markers can be suitable.

Appendicitis

November 2, 2016

DESCRIPTION

Appendicitis is a swelling or inflammation of the appendix and is one of the most common causes for emergency abdominal surgery. The function of the appendix is unknown but there are no long term consequences of removing the appendix. Appendicitis is considered a medical emergency, prompt diagnosis and surgery for removal are very important. If left untreated, an inflamed appendix eventually will burst, or perforate, spilling infectious materials into the abdominal cavity.

In the United States, one in 15 people will get appendicitis. Although it can occur at any age, appendicitis is rare under age 2 and most common between ages 10 and 30.

Symptoms

Appendicitis is sometimes referred to as the “Great Masquerader” because the symptoms and location of pain can vary greatly. It can be difficult to diagnose appendicitis in young children, the elderly, and women of childbearing age.

The most common symptom of appendicitis is a dull pain near or around the belly button. The pain may be mild at first and become sharper as it moves to the lower right abdomen. Loss of appetite and nausea or vomiting occur soon after the pain begins. There may be fever, abdominal swelling and bloating. It may be difficult to pass gas. As the swelling in the appendix increases, the pain tends to move into your right lower abdomen. It focuses right above the appendix at a place called McBurney’s point. This pain may occur 12 to 24 hours after the illness starts. Other symptoms may include pain anywhere in the upper or lower abdomen, back or rectum. Pain can vary from dull to sharp. Constipation or diarrhea with gas and cramping are also symptoms that can occur.

Common Symptoms

  • Dull pain near the navel or the upper abdomen
  • Loss of appetite
  • Nausea and vomiting soon after abdominal pain begins
  • Abdominal swelling
  • Fever of 99-102 degrees Fahrenheit
  • Inability to pass gas
  • Dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum
  • Painful urination
  • Vomiting that precedes the abdominal pain
  • Severe cramps
  • Constipation or diarrhea with gas

Causes, incidence, and risk factors

Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor. There is no known prevention of appendicitis.

WORK-UP/TESTS

If you have appendicitis, your pain will increase when the doctor gently presses on your lower right belly area. If you have peritonitis, touching the belly area may cause a spasm of the muscles. A rectal exam may find tenderness on the right side of your rectum.

Doctors can usually diagnose appendicitis by:

  • Your description of the symptoms
  • The physical exam

Lab tests

  • Complete blood count may show elevated white blood count
  • Liver function tests
  • Kidney function

Diagnostic studies

  • Abdominal CT scan
  • Abdominal ultrasound
TREATMENT

The treatment for appendicitis is surgical removal of the appendix as soon as possible. The tests used to diagnose appendicitis are not perfect, sometimes the operation will show that your appendix is normal. If this occurs, the surgeon will remove your appendix and explore the rest of your abdomen to look for other causes of your pain.

If a CT scan shows that you have an abscess (a walled off pocket of infection) from a ruptured appendix, you may be treated for infection with intravenous antibiotics before surgery. You will have your appendix removed after the infection and swelling have gone away.

EXPECTATIONS (PROGNOSIS)

If your appendix is removed before it ruptures, you will likely recover quickly after surgery. If your appendix ruptures before surgery, your recovery may take longer. People with compromised immune systems like diabetes may have a longer recovery process or more complications.

Complications
  • Abnormal connections between abdominal organs or between these organs and the skin surface (fistula)
  • Abscess
  • Blockage of the intestine
  • Infection inside the abdomen (peritonitis)
  • Infection of the surgical wound
  • An infection can spread to bloodstream
  • Death
When to call your healthcare provider

Call your healthcare provider if you have abdominal pain in the lower-right portion of your belly, or any other symptoms of appendicitis.

Also call your doctor for:

  • Severe, sudden or sharp pain
  • Fever along with pain
  • Vomiting blood or bloody diarrhea
  • Abdomen is hard and tender to touch
  • Inability to pass stool, especially if you are also vomiting
  • Chest, neck, or shoulder pain
  • Dizziness or light-headedness
  • Nausea and a lack of appetite with your pain
  • Yellowing of your eyes or skin
  • Bloating for more than 2 days
  • Diarrhea for more than 5 days, or your infant or child has had diarrhea for 2 days or vomiting for 12 hours (call right away if a baby younger than 3 months has diarrhea or vomiting)
  • Abdominal pain lasting more than 1 week
  • Burning with urination or frequent urination
  • Worsened pain when taking antacids or eating something

Susan Puckett, PA-C, ENT and Internal Medicine

Abdominal pain is the main symptom of appendicitis. The pain starts out as diffuse, meaning it is difficult to localize the area of pain. Most people say the initial pain of appendicitis occurs around the middle portion of the abdomen. As the inflammation of the appendix progresses, the pain becomes localized to one area. Once the peritoneum (lining tissue of the abdomen) is inflamed, the pain of appendicitis is characteristically located at a point between the navel and the front of the right hip bone. Anatomically, this is referred to as McBurney’s point.

Another frequent symptom of appendicitis is loss of appetite. Over time, this can worsen, resulting in nausea and vomiting. Other symptoms that can occur are swelling of the abdomen, the inability to pass gas, constipation or diarrhea with gas, and a mild to moderate fever.

Some people with appendicitis have atypical symptoms. They may not have the classic pain localized in the lower right abdomen. Sometimes, affected people report experiencing rectal or back pain. Painful urination has also been reported. The nausea and vomiting may precede the onset of abdominal pain in certain cases.

Causes of appendicitis

The cause of appendicitis is believed to be an infection of the wall of the appendix that begins with blockage (by stool, cancer, or foreign body) of the opening from the appendix into the cecum of the large intestine. At other times, the lymphatic (immune response) tissues in the appendix swell and block the opening. When the blockage occurs, bacteria that are normally found within the appendix begin to grow and infect the wall of the appendix, leading to inflammation.

Other symptoms and signs of appendicitis

  • Abdominal Pain
  • Abdominal Swelling
  • Abdominal Tenderness
  • Back Pain
  • Chills
  • Constipation
  • Diarrhea
  • Fever
  • Inability to Pass Gas
  • Loss of Appetite
  • Malaise
  • Nausea
  • Painful Urination
  • Rectal Pain
  • Vomiting

Related Symptoms & Signs

Main Article on Appendicitis Symptoms and Signs

  • Appendicitis is an inflammation of the appendix. Appendicitis often causes sings and symptoms such as abdominal pain in the…

IMAGES

Appendix Illustration Browse through our medical image collection to see illustrations of human anatomy and physiology See Images

What’s Causing Pain in My Lower Left Abdomen?

Some causes of lower left abdominal pain only affect women. These conditions may be more serious or need medical attention. Pain can also develop on right side of your abdomen in these cases.

Menstrual cramps (dysmenorrhea)

Cramps usually occur before and during your menstrual period. Although the pain can range from a minor annoyance to something that interferes with your daily activities, menstrual cramps usually aren’t serious.

See your doctor if:

  • your cramps interfere with your daily activities
  • your symptoms get worse over time
  • you’re older than age 25 and your cramps have started to get more severe

Check out: Home remedies to relieve painful menstrual cramps “

Endometriosis

With endometriosis, tissue that typically lines the inside of your uterus also grows outside of the uterus. This can cause abdominal pain and lead to infertility.

Some other symptoms are:

  • painful menstrual cramps that may get worse with time
  • pain with sex
  • painful bowel movements or urination
  • heavy menstrual periods
  • spotting between periods

The cause of endometriosis is unknown. It’s time to see your doctor when your symptoms are severe and interfere with your daily activities.

Ovarian cyst

An ovarian cyst is a sac filled with fluid inside or on the surface of an ovary. These are part of a woman’s normal menstrual cycle.

Most cysts don’t produce symptoms and go away without treatment in a few months. A large cyst can cause discomfort. It may also press on your bladder and cause you to urinate more often.

A cyst that ruptures (breaks open) can cause some serious problems, such as severe pain or internal bleeding.

See your doctor or get medical help right away if you’re experiencing:

  • sudden, severe abdominal pain
  • pain with fever or vomiting
  • signs of shock, such as cold and clammy skin, rapid breathing, lightheadedness, or weakness

Ovarian torsion

Large ovarian cysts may cause the ovary to change position in a woman’s body. This raises the risk of ovarian torsion, a painful twisting of the ovary that can cut off blood supply. The fallopian tubes may also be affected.

Ovarian torsion is more likely to happen with pregnancy or the use of hormones to promote ovulation.

Ovarian torsion isn’t common. When it does happen, it’s usually during a woman’s reproductive years. See your doctor if you feel a sudden severe pain in your abdomen with vomiting. Surgery is often needed to untwist the ovary or remove it.

Ectopic pregnancy

With ectopic pregnancy, a fertilized egg implants itself before it reaches the uterus. This usually happens inside the fallopian tubes connecting the ovary to the uterus. You may or may not have symptoms with an ectopic pregnancy.

In addition to abdominal pain, symptoms can include:

  • a missed period and other pregnancy signs
  • vaginal bleeding
  • watery discharge
  • discomfort with urination or bowel movements
  • shoulder pain at the tip

See your doctor if you have these symptoms and you believe you may be pregnant, even if your pregnancy test is negative and it’s still very early.

An ectopic pregnancy that ruptures (breaks open) is serious and needs surgery to repair the fallopian tube. Get medical help right away if you’re:

  • feeling sick or dizzy
  • feeling faint
  • looking very pale

Pelvic inflammatory disease (PID)

PID is an infection of the reproduction system in women. It’s commonly caused by sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, but other types of infections can also lead to PID.

You may or may not have symptoms with PID.

In addition to abdominal pain, symptoms can include:

  • fever
  • vaginal discharge with a bad odor
  • pain or bleeding with sex
  • a burning sensation with urination
  • bleeding between periods

See your doctor if you think you or your partner have been exposed to an STD or if you have any genital symptoms, such as an unusual sore or discharge.

What causes pain in the lower left abdomen?

There are several possible causes of lower left abdomen pain. Some causes are more common and benign, while others can be serious and require medical attention.

1. Diverticulitis

Share on PinterestLower left abdomen pain can have many causes.

Diverticulitis is one of the most common causes of lower left abdominal pain. Diverticulitis occurs when diverticula (small pouches) in the intestinal wall become infected and inflamed.

Diverticula form in weak areas of the large intestine, which is often referred to as the colon.

Diverticula are present in many adults. As a person ages, the number of diverticula increases, making it more likely that one will tear or swell. As a result, diverticulitis tends to be more common in older adults, although younger people can still develop the condition.

Diverticulitis pain tends to increase while a person is eating or shortly after a meal.

Additional symptoms of diverticulitis may include:

  • tenderness in the abdomen
  • fever
  • nausea
  • vomiting
  • feeling bloated

2. Celiac disease

Celiac disease is a chronic condition that occurs in the digestive tract when a person cannot digest gluten. Gluten is a protein found in wheat and is present in several foods and healthcare products.

When a person has celiac disease, their immune system attacks portions of the intestine, causing a range of digestive problems and vitamin deficiencies.

Symptoms of celiac disease may include:

  • pressure and gas
  • bloating
  • pain in the abdomen
  • fatigue
  • weight loss
  • diarrhea

Children with undiagnosed celiac disease may also suffer from malnourishment and growth impediments as a result of the condition.

3. Gas

Gas is often trapped in the digestive tract when a person swallows air while eating, as well as through natural digestion processes.

Typically, gas is not anything to worry about and will pass through either the rectum or esophagus. Gas that is temporarily trapped in the digestive tract can cause pain and discomfort until it moves out of the system.

Gas can be caused by:

  • digesting foods that are prone to releasing gas
  • swallowing air
  • smoking
  • chewing gum
  • overeating
  • undigested foods
  • bacteria

If the gas pain is frequent or accompanied by additional symptoms, a person may wish to speak to a doctor. Other symptoms include:

  • unexplainable weight loss
  • constipation
  • blood in stool or when wiping
  • vomiting or diarrhea
  • heartburn

4. Lactose intolerance

A person who is lactose intolerant has trouble digesting milk and milk-based products, such as cheese and yogurt. This is because the person lacks sufficient amounts of an enzyme called lactase.

Lactase breaks down the lactose in milk, which consists of the simple sugars glucose and galactose.

Share on PinterestLactose intolerence may be a cause of lower left abdomen pain.

When a person has high levels of lactose in their bloodstream, they may develop symptoms associated with lactose intolerance. These symptoms include:

  • loose stool or diarrhea
  • pain in the abdomen
  • bloating
  • gas pain
  • nausea
  • a growling or rumbling stomach

5. Inflammatory bowel diseases

Crohn’s disease and ulcerative colitis are chronic conditions that can cause painful inflammation anywhere in the digestive tract.

Crohn’s disease is most common in the small intestine, and ulcerative colitis is most common in the colon.

It is still not known what causes Crohn’s disease or ulcerative colitis. The most common symptoms include pain in the abdomen and bloody diarrhea. It can also cause fever and unexplainable weight loss.

6. Indigestion

Indigestion is caused by a buildup of acid after eating. For most people, indigestion pain occurs in the upper part of the abdomen. While rare, indigestion can occur in the lower part of the abdomen.

Typically, most cases of indigestion are mild. Symptoms of indigestion include a burning sensation, slight pain or discomfort, heartburn, bloating, or gas.

There is an excellent selection of indigestion relief products that may be purchased online with thousands of customer reviews.

7. Shingles

Shingles is caused by the same virus that causes chickenpox. Once a person has had chickenpox, the virus stays dormant in the body for their entire life. Sometimes, the virus reappears, causing pain and a rash that wraps around one side of the abdomen.

Vaccines are available to help reduce the risk of a person developing the disease later in life.

Symptoms of shingles include:

  • pain when touched
  • itching
  • tenderness on the skin
  • rash
  • blisters that may break open and scar

A person may feel tenderness and itchiness on one area of the skin before the rash appears. They may also experience a fever or general malaise. Once the rash appears, the pain can be severe.

8. Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that a doctor may only diagnose once they have ruled out other probable causes of a person’s symptoms.

Symptoms of IBS may include:

  • abdominal pain
  • pressure
  • constipation or diarrhea
  • gas
  • bloating

9. Hernia

A hernia occurs when an organ or other body part pushes through the abdominal wall. Sometimes, a lump may appear in the midsection or near the groin.

Different types of hernias can occur, and they vary according to the underlying cause. Because hernias can cause additional problems, it is essential to see a doctor as soon as possible.

Some additional symptoms of hernia complications include:

  • pain when lifting an object
  • pressure
  • increasing pain
  • increasing size of a bulge
  • a general feeling of fullness

10. Constipation

Share on PinterestConstipation may be caused by a lack of exercise and a poor diet.

Constipation occurs when a person cannot pass a stool. It is often caused by poor diet and lack of exercise. Improving diet and increasing exercise are two of the most effective treatments.

Some symptoms of constipation include:

  • straining when passing stool
  • needing to apply pressure to the abdomen to help push out a stool
  • a lumpy or very hard stool
  • feeling like the rectum is blocked
  • feeling like not all the stool has passed
  • having fewer than three bowel movements in a week

11. Kidney stones

Most stones are formed from calcium buildup and can form in either the right or left kidney.

A person may develop a kidney stone and not realize they have it until the stone causes problems, such as blocking part of the kidney or causing great pain as it passes.

Typical symptoms of kidney stones include:

  • abdominal pain
  • pain when urinating
  • nausea or vomiting
  • blood in the urine
  • fever
  • frequent urination

12. Intestinal obstruction

When a blockage occurs in the intestine, food cannot pass through the digestive tract. This results in a painful back-up that needs immediate medical attention.

Intestinal obstructions are more common in older adults and are typically caused by other conditions, such as diverticulitis or colon cancer.

Common symptoms of an intestinal obstruction include:

  • abdominal pain
  • inability to pass stool
  • distention
  • vomiting
  • constipation

What are the ways to describe abdominal pain?

There are three general categories that are often used to describe abdominal pain:

  1. The location of pain,
  2. The quality or type of pain and
  3. The intensity of the pain.

Other qualifiers and questions are often used to describe these features:

  • Does the pain radiate anywhere?
  • Does the pain come and go?
  • What makes the pain better or worse?

The health-care professional will ask the patient many other questions about the abdominal pain they are experiencing.

Abdominal pain is common, and a person can help their doctor diagnose the source of abdominal discomfort or pain by simply focusing on the location, type, and intensity of pain. Moreover, there are a variety of the reasons why some causes of abdominal pain are often difficult to diagnose initially. It is important to understand that although many times abdominal pain does not represent a serious problem, at other times the pain indicates a medical emergency. Discerning the difference between serious and non-serious causes of abdominal pain is sometimes a difficult challenge that you and your doctors face.

First, to understand the complexity of the diagnosis, a basic knowledge of the abdomen and its contents is needed. The illustration below is a diagram of the abdomen and most of its contents (diaphragm, pelvis, genitals, mesentery and retroperitoneal space are not shown). The diagram also shows the various areas of the abdomen that help define the location of pain and discomfort.

Location of the Pain

The abdomen can be roughly subdivided several ways; all of these ways (terms) have appeared in the medical literature:

  1. Upper abdomen (horizontal line about the level of the umbilicus), lower,
  2. Right upper and lower,
  3. Left upper and lower, and
  4. Pelvis (right and left).

Using the illustration, most of the organs in the abdominal area can be seen. Those that are not shown can be localized easily (for example, the kidneys, ureters and bladder located mainly in the lower abdomen, both left and right kidneys in the retroperitoneal space, behind the intestines with the bladder located in the central pelvis area in front of the lower intestines). Using this type of diagram, you and your doctor may more easily localize abdominal pain and its potential source.

Type of Pain

The type of pain may also give some clues as to the cause of abdominal pain. Unfortunately, sometimes the pain is diffuse; this can complicate the diagnosis. However, there are some types of pain that can help narrow the diagnosis.

There are several types of pain:

  • sharp,
  • dull,
  • stabbing,
  • tearing,
  • cramps,
  • twisting,
  • pressure, and
  • bloating.

Some individuals may describe many other types of pain. The type of pain may be further described as:

  • constant,
  • intermittent,
  • variable, and
  • modified by movement, eating, bowel movements, walking, or
  • changed by other situations like stress or certain medications.

Intensity of the pain

The doctor often enquires about the intensity of the pain, usually on a scale of 1 to 10, with 10 as the most pain (causes crying and inability to function or move, for example). Just as the type of pain may be further described, the intensity of pain may be characterized as constant, intermittent, variable, and changed by movement, eating, bowel movements, walking, or modified by other situations like stress or certain medications.

SLIDESHOW

Appendix Pain? Appendicitis, Surgery, and More See Slideshow

What’s Causing Pain in My Lower Right Abdomen?

These causes are the most common reasons you may experience pain on either side of the lower abdomen. Although you may feel discomfort on the right side, this pain can also occur on your left.

Gas

Intestinal gas is air found in your entire digestive tract. It’s often caused by food that’s not broken down completely until it reaches your colon.

The more undigested food present, the more gas your body will produce. As gas builds up, it can cause abdominal pain, bloating, and a “knotted” feeling in your stomach.

Burping and farting usually provide relief. In fact, it’s typical for a person to expel gas up to 20 times a day.

However, excessive gas may be a sign of a digestive disorder, such as diabetes or lactose intolerance.

Other causes for intestinal gas include:

  • swallowing more air than normal
  • overeating
  • chewing gum
  • smoking

Indigestion

Indigestion (dyspepsia) typically develops after you eat or drink something. Pain usually occurs in the upper abdomen, though it may still be felt lower down.

Symptoms of indigestion also include:

  • heartburn
  • bloating
  • early or uncomfortable fullness
  • feeling sick
  • burping
  • farting
  • food or bitter-tasting fluids coming back up

Mild indigestion will go away fairly quickly and can be treated by over-the-counter medications. But if symptoms persist for more than two weeks, you should see your doctor to rule out underlying digestive issues.

Hernia

A hernia happens when a body part or internal organ pushes through tissue or muscle that holds it in place. There are several types of hernias, most of which happen in the abdomen. Each type can cause pain or discomfort in the affected area.

Other common symptoms include:

  • swelling or bulging at the site
  • increased pain
  • pain while lifting, laughing, crying, coughing, or straining
  • a dull ache
  • feeling full or constipated

Kidney infection

A kidney infection is caused by bacteria that usually come from your bladder, ureters, or urethra. One or both of your kidneys could be affected by the infection.

Although you may feel pain in your lower abdomen, discomfort from a kidney infection more often occurs in your back, sides, or groin.

Other symptoms include:

  • fever
  • chills
  • nausea
  • vomiting
  • frequent urination
  • feeling the need to urinate, even if you just went
  • pain or burning when urinating
  • pus or blood in your urine
  • urine that’s cloudy or smells bad

When untreated, kidney infections can cause permanent damage. If you notice any of these symptoms, you should see your doctor right away.

Kidney stones

Kidney stones are a hard buildup of minerals and salts that form inside your kidneys. You may not feel any pain until the kidney stones begin to move around or pass into the tube that connects your kidney and bladder.

When this happens, you’ll feel severe pain in your back and side, below the ribs, and throughout your lower abdomen and groin. The intensity and location of the pain may change as the kidney stone shifts and moves through your urinary tract.

Other symptoms include:

  • painful urination
  • pink, red, or brown urine
  • urine that’s cloudy or smells bad
  • nausea
  • vomiting
  • feeling the constant need to pee
  • frequent urination
  • fevers and chills, if infection is also present

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common, chronic disorder that affects the large intestine.

IBS causes:

  • cramps
  • bloating
  • gas
  • diarrhea
  • constipation
  • abdominal pain
  • a change in bowel movements
  • mucus in the stool

Doctors don’t know what causes irritable bowel syndrome, though some factors have been identified. This includes stronger-than-normal intestinal contractions or abnormalities in your digestive nervous system.

Inflammatory bowel disease

IBS shouldn’t be confused with inflammatory bowel disease (IBD). IBD is a group of debilitating digestive disorders that cause changes in bowel tissue and increase your risk of colorectal cancer.

Ulcerative colitis and Crohn’s disease are the two most common causes of IBD. Both chronic conditions cause inflammation within your digestive tract, which can lead to abdominal pain.

IBD may also cause:

  • severe diarrhea
  • fatigue
  • weight loss
  • fever
  • blood in your stool
  • reduced appetite

IBD can lead to life-threatening complications if left untreated. You should see your doctor immediately if you notice any of these symptoms.

Pelvic pain

Long-term pelvic pain

If you’ve had pelvic pain for 6 months or more that either comes and goes or is continuous, it’s known as chronic pelvic pain.

Chronic pelvic pain is more intense than ordinary period pain and lasts longer. It affects around 1 in 6 women.

See your GP if you have chronic pelvic pain. They’ll investigate the cause and arrange any necessary treatment.

Common causes of chronic pelvic pain

The most common causes of chronic pelvic pain are:

  • endometriosis
  • chronic pelvic inflammatory disease – a bacterial infection of the womb, fallopian tubes or ovaries, which often follows a chlamydia or gonorrhoea infection and needs immediate treatment with antibiotics
  • irritable bowel syndrome – a common long-term condition of the digestive system that can cause stomach cramps, bloating, diarrhoea and constipation

Less common reasons for chronic pelvic pain

Less common causes of chronic pelvic pain include:

  • constantly returning ovarian cysts – these are fluid or blood-filled sacs that develop on the ovaries
  • a urinary tract infection that keeps coming back
  • lower back pain
  • prolapse of the womb – where the womb slips down from its normal position and usually causes a “dragging” pain
  • adenomyosis – endometriosis that affects the muscle of the womb, causing painful, heavy periods
  • fibroids – non-cancerous tumours that grow in or around the womb; fibroids can be painful if they twist or deteriorate, but uncomplicated fibroids aren’t usually painful
  • chronic interstitial cystitis – long-term inflammation of the bladder
  • inflammatory bowel disease (IBD) – a term used to describe 2 chronic conditions, ulcerative colitis and Crohn’s disease, which affect the gut
  • a hernia – where an internal part of the body pushes through a weakness in the surrounding muscle or tissue wall
  • trapped or damaged nerves in the pelvic area – these may cause sharp, stabbing or aching pain in a specific area, which often gets worse with certain movements

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