Pain on the right side of the body, particularly in the abdomen, is a frequent concern because this region houses a complex collection of organs. The right side contains the liver, gallbladder, appendix, parts of the intestines, and the right kidney, so the location of the discomfort offers initial clues about its source. A wide range of conditions, from mild digestive upset to serious medical emergencies, can cause this symptom. This article provides general information about potential causes based on the pain’s location, but it is not a substitute for a professional medical diagnosis.
Causes of Pain in the Upper Right Abdomen
The upper right quadrant (URQ) of the abdomen, situated beneath the rib cage, is home to the liver and the gallbladder, making them frequent sources of pain. Inflammation of the gallbladder, known as cholecystitis, often results from gallstones blocking the cystic duct, causing bile to back up and irritate the organ lining. This pain is sharp or cramping and may spread to the right shoulder blade or the back. Acute discomfort often flares up after consuming a meal high in fat, as the gallbladder contracts to release bile.
Liver issues, such as hepatitis, manifest as a dull ache or fullness in the URQ. Hepatitis, which is inflammation of the liver tissue, can be caused by viral infections, excessive alcohol consumption, or certain medications. Liver inflammation may be accompanied by fatigue, a general feeling of unwellness, or jaundice (yellowing of the skin and eyes). A peptic ulcer, an open sore in the lining of the stomach or duodenum, can also cause a burning sensation that radiates to this upper right area.
The pain associated with a duodenal ulcer feels like a gnawing or burning discomfort that improves temporarily after eating or taking antacids. Inflammation of the pancreas (pancreatitis) can also cause severe upper abdominal pain that may extend to the back. Given the concentration of digestive organs in this area, a medical evaluation is recommended to pinpoint the source of discomfort.
Causes of Pain in the Lower Right Abdomen
The lower right quadrant (LRQ) is the classic location for an inflamed appendix. Appendicitis begins when the appendix becomes obstructed, leading to inflammation and swelling, causing a dull pain around the navel or upper abdomen first. Within a few hours, as inflammation progresses and irritates the abdominal wall lining, the pain shifts and localizes to a sharp point in the LRQ. This migratory pattern is a hallmark sign of appendicitis, and the pain intensifies with movement, coughing, or jumping.
Other digestive tract issues can cause discomfort in the LRQ, including flares of inflammatory bowel disease (IBD), such as Crohn’s disease, which commonly affects the end of the small intestine. Right-sided diverticulitis, inflammation of small pouches in the colon, can also mimic appendicitis symptoms. For women, the LRQ is also the location of the right ovary and fallopian tube, introducing specific potential causes.
Gynecological conditions causing LRQ pain include ruptured ovarian cysts, which cause sudden, sharp pain, or pelvic inflammatory disease (PID), often accompanied by fever and unusual discharge. An ectopic pregnancy, where a fertilized egg implants outside the uterus, is a serious cause of lower abdominal pain in women of childbearing age and requires immediate medical attention. A thorough medical workup is necessary to distinguish the source of the pain in females.
Pain Originating in the Flank and Back
Pain in the flank refers to discomfort felt on the side of the body, specifically the area between the lower ribs and the hip bone, often extending into the back. The most common source of pain in the right flank is the right kidney and its associated structures. Kidney stones cause a distinct, intense pain, described as colicky, meaning it comes in waves as the body attempts to pass the stone through the ureter. This pain radiates downward from the flank toward the groin and is often accompanied by blood in the urine, nausea, and vomiting.
A kidney infection (pyelonephritis) causes a constant, dull ache in the flank and is accompanied by systemic symptoms. These symptoms include a high fever, chills, and painful or frequent urination, indicating a bacterial infection has traveled up the urinary tract. Unlike pain from a muscle strain, kidney pain does not change significantly with body position or movement. Musculoskeletal issues, such as a strained back muscle or a pinched nerve in the spine, can also cause right flank pain.
Muscular pain in the flank is exacerbated by specific movements, such as bending or twisting, and may feel like a persistent soreness. Another cause is shingles, the reactivation of the varicella-zoster virus, which causes a painful, burning rash that often affects the flank area. Distinguishing between a muscular issue and a deeper organ problem is guided by the presence of other symptoms like fever or changes in urination.
Warning Signs Requiring Immediate Care
While many causes of right-sided pain are not medical emergencies, certain accompanying symptoms indicate a need for immediate care. Any pain that is sudden, severe, and unrelenting, especially if it prevents a person from sitting still or finding a comfortable position, requires emergency evaluation. This intensity of pain can signal a ruptured organ, a perforated ulcer, or a severe vascular event.
Pain accompanied by a high fever (above 100.4°F or 38°C) and chills suggests a serious infection, such as a kidney infection or an abscess that needs urgent treatment. Persistent vomiting, particularly if bloody or resembling coffee grounds, is a sign of internal bleeding or obstruction in the upper digestive tract. The inability to pass gas or have a bowel movement, combined with abdominal swelling, can indicate a dangerous intestinal blockage.
Other red flag symptoms include blood in the stool or urine, which points to bleeding within the gastrointestinal or urinary systems. Signs of shock, such as a rapid heart rate, confusion, clammy skin, or lightheadedness, indicate a life-threatening situation. Tenderness that is significantly worse when pressure is quickly released from the abdomen (rebound tenderness) is a specific sign of peritonitis and warrants an immediate trip to the emergency room.