A “stitch” is commonly known as exercise-related transient abdominal pain (ETAP), described as a sharp, cramping, or pulling sensation usually felt just under the ribs. When this sudden, localized pain occurs while a person is at rest or performing minimal activity, it signals a different set of potential causes. This non-exertional right-sided pain is less about physical strain and more often related to the organs and structures housed within the right side of the torso. This kind of abdominal discomfort requires consideration of digestive, structural, and sometimes more serious internal issues.
Common Digestive Explanations
The most frequent causes of right-sided pain when not exercising involve the gastrointestinal tract, creating discomfort that mimics a sharp stitch. This sharp pain is often attributed to trapped gas attempting to pass through the large intestine. This is particularly true in the upper right side of the abdomen where the colon makes a sharp bend called the hepatic flexure, located near the liver.
Gas or air trapped at this turn can lead to hepatic flexure syndrome. This discomfort is typically crampy and twisting, often easing when gas is passed or a person changes position. Constipation, where stool movement is slowed, can also lead to gas buildup and distention, causing similar right-sided abdominal pressure and pain.
Other common digestive conditions, such as Irritable Bowel Syndrome (IBS), can produce cramping that feels like a stitch. IBS involves abnormal gut motility, leading to pain often accompanied by bloating, gas, diarrhea, or constipation. The pain from these intestinal issues results from the stretching or spasming of the organ walls, which is perceived as a sharp, sudden sensation.
Issues with the Gallbladder and Liver
Pain that persists or is more intense in the upper right quadrant (RUQ) may point to issues with the gallbladder or liver. Problems often arise when hardened deposits known as gallstones form, blocking the bile duct. The resulting pain, known as biliary colic, can be severe and is frequently mistaken for a muscle cramp or gas.
Gallstone pain is often described as steady, sharp, or cramp-like, building in intensity and sometimes lasting from thirty minutes up to several hours. This discomfort can be triggered by a heavy or fatty meal and may radiate to the back or the right shoulder blade. Unlike transient gas pain, gallstone pain is rarely relieved by passing gas, changing position, or taking over-the-counter indigestion medication.
Less commonly, inflammation of the liver, known as hepatitis, can cause a duller ache in the upper right abdomen. Separately, kidney stones can cause severe pain that begins in the back or flank and radiates forward to the abdomen and groin. This pain changes location as the stone moves through the urinary tract and can sometimes be perceived as a right-sided stitch.
Muscular and Structural Factors
Physical causes not related to the internal organs can also manifest as sharp, stitch-like pain on the right side. The diaphragm, the muscle beneath the lungs responsible for breathing, can undergo spasms that mimic a side stitch. These spasms are often triggered by rapid, shallow breathing, coughing fits, or sudden movements that stress the muscle.
Poor posture, especially prolonged slouching while sitting, can compress the diaphragm and abdominal structures, contributing to these spasms. Extended periods of sitting can also cause tension in the abdominal wall muscles and connecting ligaments, resulting in discomfort. Additionally, intercostal muscle strain, affecting the muscles between the ribs, produces a sharp, localized pain that worsens with deep breathing, coughing, or twisting.
An abdominal muscle strain, or a “pulled muscle,” can occur without intense exercise, sometimes resulting from a sudden twist, chronic coughing, or improper lifting. This pain is localized and intensifies when the affected muscle is used, distinguishing it from an organ-related issue. Dehydration and electrolyte imbalances, such as low potassium or sodium, can also cause muscle cramps and spasms in the midsection that feel like a stitch.
Recognizing Urgent Symptoms
While most non-exertional right-sided pain is temporary, certain accompanying symptoms require immediate medical evaluation to rule out serious conditions. Pain that is sudden, severe, and worsening over a short period should be considered an emergency. Appendicitis, which is an inflammation of the appendix, typically causes pain that starts near the belly button and later settles into the lower right abdomen, becoming more intense.
Several “red flag” signs indicate the need for prompt medical attention. These include a persistent fever, unrelenting vomiting, or pain so severe it causes a person to double over. Immediate medical care is necessary if the pain is accompanied by blood in the stool, a fast heartbeat, confusion, or low blood pressure.
Pain that radiates to the back or shoulder, especially when combined with yellowing of the skin or eyes (jaundice), suggests complications related to the gallbladder or liver. Pain that wakes a person from sleep, or abdominal rigidity upon light touch, are also signs that the issue is not a simple muscle cramp or trapped gas. Conditions like a ruptured organ, severe infection, or a blocked bile duct can quickly become life-threatening without prompt diagnosis and treatment. Self-diagnosis is insufficient when severe or persistent pain is present.