Pain in the lower abdomen on the right - pain on the right side of the lower abdomen: causes, treatment

Diseases of the biliary tract

Biliary colic may manifest itself as pain in the abdomen on the right. The pain is localized in the right hypochondrium and epigastrium (upper abdomen), sometimes radiating to the scapula 1, 2. It is worth noting that if biliary colic occurs, it is important to consult a doctor who will diagnose and prescribe treatment.

Biliary colic is one of the main manifestations of acute cholecystitis against the background of cholelithiasis1. The cause of cholecystolithiasis is gallstones from cholesterol crystals, salts and other substances that block the cystic duct of the gallbladder. This leads to increased pressure in the biliary tract and the occurrence of spasms. In addition, stones and crystals can irritate the lining of the bladder and bile ducts6, 17, 18.

The result is a pain syndrome that ranges from mild to severe. Sometimes it is accompanied by nausea and vomiting, but symptoms of intoxication (fever, weakness) are often absent6. The pain occurs suddenly and lasts from 15 minutes to several hours. The frequency of attacks also varies: from daily to once a year or even less often6.

For pain associated with spasm in diseases of the biliary tract, taking antispasmodic drugs can help1. For example, the active component of the drugs No-shpa® and No-shpa® forte, drotaverine, helps relax the smooth muscles of internal organs (including the biliary tract), helping to relieve pain7, 22.

Pain in the right hypochondrium can be associated not only with cholelithiasis, but also with other diseases of the biliary tract, for example, cholecystitis or papillitis1.

Causes of pain

If you have pain in the lower abdomen and lower back
, this may be a symptom:

the beginning of menstruation (may be normal);
inflammatory process localized in the pelvic organs, including infectious ones (chlamydia, mycoplasmosis, gonorrhea, trichomoniasis, etc.);
endometriosis;
uterine fibroids or other pelvic tumors;
hyperplastic conditions of the endometrium;
adhesions in the pelvis;
ovarian cysts;
tuberculous lesions of the reproductive organs;
increasing the tone of the piriformis muscle, located between the sacrum and the femur;
incorrect location of the uterus - congenital or acquired due to weakening of the muscles of the abdominal wall;
diseases of other organs located in the pelvis - intestines, urinary system, etc.;
long-term sexual dissatisfaction and other conditions.

Pancreatic diseases

Pain usually occurs when this organ becomes inflamed and can be felt in several places. For example, when the head of the gland is affected, it is felt in the right hypochondrium, sometimes taking on a encircling character1. Some people are bothered by nagging and aching pain in the back1.

Pain from pancreatic disease may be worse when a person is lying down, but usually gets better when sitting because the tension on the pancreatic capsule is reduced1.

Pain due to diseases of the pancreas can be constant and painful. Their intensification can be provoked by the nature of the food and drinks taken: with alcoholic pancreatitis, complaints become more intense after eating spicy and sour foods, and with inflammation of the pancreas associated with damage to the ductal system - after eating fatty foods8.

Pancreatic pathology is also characterized by weakness, irritability, insomnia, and decreased performance. From the digestive tract, nausea, vomiting without a feeling of relief, bloating, alternating diarrhea and constipation may occur8.

Recently, the incidence of pancreatitis has been steadily increasing due to alcohol consumption8.

Irritable bowel syndrome (IBS)

This condition is not associated with changes in the structure of organs and systems. However, pain with irritable bowel syndrome is almost always observed and is a common symptom overall. Women usually suffer from IBS more often than men. Pain (from moderate to severe) can cover the lower abdomen, including the right side, but is most often localized on the left9. IBS often develops against the background of psychoemotional disorders10.

Symptoms of the disease usually subside in the evening and do not bother patients at night. The pain in some cases spreads to the upper abdomen, radiating to the rectum and epigastric region9-11. An important role in the formation of complaints is played by impaired intestinal motility, accompanied by spasm. As part of complex therapy for IBS, antispasmodics (for example, No-shpu® and No-shpu® forte) can be used, which helps reduce pain7, 12, 22.

Effective treatment methods

For the treatment of pathologies such as peritonitis or ectopic pregnancy, there are no other methods other than surgery. If stabbing pain is combined with fever, discomfort in other parts of the abdomen, vomiting and bowel irregularities, it is better not to delay calling an ambulance.

In other cases, for example, with enteritis or hepatitis, drug therapy is prescribed. It is also used during the recovery period after operations:

take antibiotics against inflammation;
NSAIDs and antispasmodics are used to relieve pain;
to normalize microflora, drink probiotics;
Diuretics are used to treat the kidneys and urinary system.

Also, for successful treatment, it is important to follow other rules - engage in physical therapy as prescribed by a doctor and follow a strict diet.

Urinary tract diseases

Pain on the right side may be caused by urolithiasis. If the right ureter is affected, there may be pain on the right in the abdomen and lower back1, 2. When the stone moves, the pain on the right can move to the lower abdomen, radiate to the genitals, and the inner thighs. If the stone is located in the lower third of the right ureter, the person is bothered by a constant painful urge to urinate2, 13. The pain is usually wave-like in nature, and for spasms in diseases of the urinary tract, the use of antispasmodics, for example No-shpa®, may be indicated or No-shpa® forte7, 13, 16, 22. The passage of stone or sand from the ureter is often manifested by pain and blood in the urine13.

Nature of pain and possible causes

When pain in the lower abdomen occurs, an important factor in determining the cause that provoked it is a description of the nature of the pain syndrome:

With cramping pain, colic, which patients describe as strong, cutting, spasms of the smooth muscles of the “tubular” organs are often diagnosed.
Aching pain of a chronic nature occurs with cholecystitis or urolithiasis.
When pain appears suddenly and is immediately severe, appendicitis, diverticulitis, severe intoxication, intestinal obstruction or infection are suspected.
If the pain is characterized as gradually increasing, which becomes quite severe over time, inflammatory processes of various localizations are suspected.
Severe pain that subsides after urination occurs due to inflammatory processes in the urinary system.
If the pain is characterized as acute and widespread throughout the lower abdomen, and the discomfort disappears after defecation, irritable bowel syndrome is suspected.

When contacting a doctor, it is important to remember any details related to the pain syndrome: when it started, under what conditions, other accompanying symptoms, etc. Only in this case will a specialist be able to quickly make a diagnosis and prescribe appropriate treatment, which will allow you to get rid of it in the near future pain.

Pain in the lower abdomen on the right side in women

On the right side of women are the right appendages of the uterus: fallopian tube and ovary. With inflammatory diseases of the pelvic organs, there may be pain in the lower abdomen on the right. Pain during the chronic process is aching, spreads to the lower back and suprapubic region, and is often combined with urinary disorders. Exacerbations may be accompanied by chills, nausea, sometimes vomiting, and discharge from the genital tract2, 14.

If the pain in the lower abdomen on the right begins suddenly and sharply, it may be a rupture or torsion of the cyst leg, or an ectopic pregnancy. The right lower abdomen hurts sharply, sometimes leading to fainting, the pain often radiates to the rectum. Patients try not to move so as not to increase the pain. Signs of intoxication and circulatory disorders may gradually appear: pallor, cold sticky sweat, nausea and vomiting, rapid heartbeat, and sometimes bloody discharge appears from the genital tract2, 14. Of course, if such symptoms appear, you must immediately seek medical help.

Pain in the right lower abdomen may periodically occur due to the connection with the menstrual cycle. Pain during menstruation can manifest itself as cramping or be aching and bursting. They often arise in the lower abdomen and then spread to the back, inner thighs, and rectum19-21.

Diagnostics

A gastroenterologist examines patients with complaints of pain in the right side; if necessary, other specialists are involved - a surgeon, a gynecologist, a nephrologist. During the physical examination, peritoneal symptoms, specific signs of appendicitis are checked, and deep palpation of the abdomen is performed. To establish a diagnosis, laboratory and instrumental methods are recommended:

Sonography.
Ultrasound of the abdominal organs is a screening method. Using ultrasound, inflammatory processes, space-occupying formations, and enlarged mesenteric lymph nodes are detected. Doppler ultrasound visualizes blood flow in the large vessels of the abdominal cavity.
Radiography.
A survey radiograph is not very informative; detailed visualization of the intestine is provided by irrigoscopy with double contrast. The method is suitable for detecting tumors, ulcerative defects, local narrowing or expansion of the intestine. Abdominal CT is widely used.
Colonoscopy.
Using endoscopic instruments, the mucous membrane of the colon is examined, and a biopsy sample is taken for chronic inflammation or suspected cellular atypia. If symptoms indicate damage to the small intestine, a modern method is used - video capsule endoscopy.
Gynecological examination.
Women undergo a standard bimanual examination and vaginal speculum examination. To exclude pathology of the appendages, an ultrasound of the pelvic organs is performed. For a more detailed examination, hysteroscopy, transvaginal sonography, and hysterography are prescribed.
Laboratory methods.
The list of mandatory studies includes clinical blood and urine tests, coprogram, and checking stool for helminth eggs. The expanded diagnostic complex includes biochemical blood tests with assessment of the content of acute-phase proteins, and stool culture.

Acute appendicitis

Perhaps this is the first pathology that a person thinks about when pain appears in the lower abdomen on the right. The pain in this case does not go away, arising near the navel, and eventually moves downwards1, 2, 15. The sensation may begin as dull, gradually becoming tugging, cutting, burning. A person’s health deteriorates and symptoms of digestive disorders occur: vomiting, bloating, constipation, and sometimes diarrhea15.

Acute appendicitis is treated surgically; if similar symptoms appear, you should immediately call an ambulance1.

Why does my lower abdomen hurt?

The content of the article

In most clinical cases, the manifestation of pain in the lower abdomen is a consequence of impaired functioning of the urinary and digestive organs. But there are other serious diseases that manifest themselves with similar symptoms. Regardless of gender, doctors identify the following causes of such pain in women and men:

Appendicitis. Sharp pain appears in the right iliac region. If the internal organs are abnormally located, the syndrome may also appear on the left side. If the cause of discomfort is appendicitis, a person, in addition to abdominal pain, experiences high fever, nausea and vomiting. If a patient is diagnosed with chronic appendicitis, the pain in the lower abdomen will not be sharp, but weak, often aching.
Diverticulitis . When a protrusion perforates on the wall of the sigmoid colon, pain appears similar to the sensations of appendicitis. But with diverticulitis, pain spreads to the entire lower abdomen.
Inflammation of the bladder mucosa . This pathology is characterized by a gradual increase in pain: a person is bothered by a stabbing sensation in the lower abdomen. Against the background of the pathology, high temperature and frequent urination appear.
Acute urinary retention . The pathology is characterized by the appearance of a mechanical obstruction to the outflow of urine: stones in the bladder or neoplasms in the urinary system. Sharp pain is clearly localized 2 fingers below the navel. A person feels a full bladder well, but when going to the toilet, urine does not come out of it. The condition requires immediate medical attention, as there is a possibility of rupture of this organ.
Cystitis. The clinical picture of this disease is characterized by localization of pain over the pubic region, its nature is usually acute, and the syndrome can radiate to other areas of the abdomen.
Chronic urethritis. Discomfort in this case is described as increasing, but not severe.
Inguinal hernia strangulation. The pain syndrome in this case develops quickly, usually after unusual physical activity of a person - lifting an object that is too heavy, performing exercises without prior preparation, etc. The pain syndrome is quite sharp, but at the same time its location is blurred, so the patient cannot always accurately point to the location of the pain. The strangulation is accompanied by diarrhea, which after a few hours turns into vomiting.
Inflammatory kidney damage . Against the background of severe pain in the lower abdomen, a person develops an elevated temperature, chills, and may develop a fever.
Acute intestinal obstruction . The pain appears suddenly, the patient suffers from constipation and increased gas formation, in which the gases do not pass away and cause intestinal colic, and weakness develops.
Irritable bowel syndrome. This is a chronic disease in which a person is often bothered by pain in the lower abdomen, bowel behavior disorders (unreasonable diarrhea or constipation) and flatulence.
Colon pathologies of inflammatory nature: ulcerative colitis, Crohn's disease. The nature of the pain in this case is pronounced, appears against the background of elevated temperature, and is often accompanied by disruption of the gastrointestinal tract.
Adhesive disease . This condition develops after operations in the peritoneum or pelvis. Pain in the lower abdomen becomes chronic and difficult to treat.
Malignant tumors in the urinary system , intestines or abdominal area. Pain is an indicator of the transition of the disease to a severe stage. The syndrome can also spread to those areas where metastases appear - groin, lower back, spine, etc.

The causes of this symptom can be various diseases associated with damage to many organs and systems. In addition to the listed pathologies, metabolic, hormonal, mental and many other disorders in the body can be a provoking factor for pain. Therefore, if such a pain syndrome occurs, it is recommended to consult a specialist and undergo a comprehensive diagnosis.