Pain on the right side of your stomach can come from several different organs, and where exactly you feel it, upper versus lower, helps narrow down the cause. The right side of your abdomen houses your liver, gallbladder, bile ducts, right kidney, appendix, and portions of your small and large intestines. Some causes are harmless and resolve on their own, while others need prompt medical attention.
Upper Right Pain: Gallbladder and Liver
The most common reason for pain in the upper right abdomen is a gallbladder problem. Gallstones can block the bile duct and cause intense, cramping pain just below your right ribcage, often after a fatty meal. The pain typically comes in waves, can radiate to your right shoulder blade, and may last anywhere from 20 minutes to several hours. When the gallbladder itself becomes inflamed (a condition called cholecystitis), the pain becomes more constant, and you may also develop a fever or nausea.
One classic physical sign of gallbladder inflammation is sharp pain when you press below the right ribcage while taking a deep breath. Studies estimate this sign catches between 48% and 97% of cases, depending on the clinical setting, so it’s useful but not definitive. Ultrasound is the first imaging test doctors use for upper right pain because it’s widely available, avoids radiation, and detects gallstones with about 81% sensitivity.
Liver problems, including hepatitis or a liver abscess, can also produce a dull ache or fullness in the upper right area. This pain tends to be less sharp than gallbladder pain and may come with fatigue, yellowing skin, or dark urine.
Lower Right Pain: Appendicitis and Beyond
Pain in the lower right abdomen strongly suggests appendicitis, especially if it started as a vague ache around your belly button and then migrated to a specific spot in the lower right. That spot, roughly one-third of the way from your hip bone to your navel, is where the appendix sits. The pain usually worsens over 12 to 24 hours and gets sharper with movement, coughing, or pressing on the area and releasing.
Appendicitis often comes with loss of appetite, nausea, vomiting, and a low-grade fever. Not everyone presents the same way, though. Nearly one in four people with appendicitis have a normal white blood cell count on blood tests, so normal labs don’t rule it out. CT scans are the preferred imaging tool for lower right abdominal pain because they detect appendicitis with about 91% sensitivity and 90% specificity. Routine CT use has dropped the rate of unnecessary appendix surgeries from 24% down to 3%.
Other causes of lower right pain include inflammatory bowel disease (particularly Crohn’s disease, which often affects the end of the small intestine on the right side), irritable bowel syndrome, and diverticulitis of the right colon.
Kidney Stones
A stone in your right kidney produces pain that’s hard to ignore. It typically starts in your back or flank, just below the ribs, and radiates downward toward your groin. The pain comes in intense waves as the stone moves through the urinary tract, and it can shift location as it travels. Unlike most abdominal pain, kidney stone pain makes it nearly impossible to find a comfortable position. You may pace or writhe rather than lie still.
Accompanying symptoms include bloody or cloudy urine, pain during urination, frequent urge to urinate, nausea, and sometimes fever or chills. If you notice these urinary symptoms alongside your right-sided pain, a kidney stone is a strong possibility.
Causes Specific to Women
Women have additional organs on the right side that can cause pain. An ovarian cyst on the right ovary can rupture or twist (called torsion), producing sudden, sharp lower right pain. Torsion in particular causes severe pain that comes on fast and often triggers nausea or vomiting.
Ectopic pregnancy, where a fertilized egg implants in the right fallopian tube instead of the uterus, causes severe abdominal pain along with vaginal bleeding. This is a medical emergency. Pelvic inflammatory disease, an infection of the reproductive organs, can also concentrate pain on the right side and is usually accompanied by fever, unusual discharge, or pain during intercourse.
Muscle Strain and Trapped Gas
Not every right-sided pain signals an organ problem. A pulled abdominal muscle causes pain that worsens specifically when you cough, sneeze, laugh, or get up from a seated position. You might also notice bruising, swelling, or muscle spasms at the site. The key difference is that muscle strain pain is tied to movement and gets better with rest, while organ pain is more constant and doesn’t follow a clear movement pattern.
Trapped gas is another common and harmless culprit. It tends to cause a bloated, crampy feeling that shifts around and eventually passes, literally. Gas pain rarely stays fixed in one spot for long and doesn’t come with fever, vomiting, or changes in your urine or stool. If your pain moves around your abdomen and improves after passing gas or having a bowel movement, this is the most likely explanation.
A hernia is worth considering too. Unlike a muscle strain, a hernia often produces a visible lump or bulge and can cause constipation, nausea, or vomiting. Hernias don’t resolve on their own the way a pulled muscle does.
When Right-Sided Pain Is an Emergency
Certain patterns of right-sided pain warrant immediate medical care. According to the American College of Emergency Physicians, you should seek emergency treatment if your pain is sudden and severe, doesn’t ease within 30 minutes, or is accompanied by continuous vomiting. A rigid abdomen that feels hard to the touch, high fever, bloody stool, or an inability to pass stool are also red flags.
For women of reproductive age, severe right-sided pain with vaginal bleeding could indicate an ectopic pregnancy, which can become life-threatening if the fallopian tube ruptures. Appendicitis that goes untreated can lead to a burst appendix within 48 to 72 hours of symptom onset, so pain that started near your belly button and moved to the lower right deserves same-day evaluation even if it feels manageable.