Pain in the lower right side of your stomach has several possible causes, ranging from a pulled muscle to appendicitis. The most important thing to rule out first is appendicitis, because it requires emergency treatment. But many other conditions, some mild and some serious, can produce pain in this same spot.
Your lower right abdomen contains the end of your small intestine, the beginning of your large intestine, your appendix, and (in women) the right ovary and fallopian tube. Pain in this area usually traces back to one of these structures.
Appendicitis: The Most Urgent Cause
Appendicitis is the first thing doctors consider when someone reports lower right abdominal pain, and for good reason. A burst appendix can become life-threatening within hours. The classic pattern starts with vague pain around your belly button that hovers or comes and goes. Over several hours, the pain shifts downward and to the right, becoming sharper and more focused. Nausea and vomiting often develop early on and then fade as the pain migrates.
A few physical signs can help you gauge whether your appendix might be involved. Coughing, hopping, or going over a speed bump makes the pain noticeably worse. Pressing on your lower left side triggers pain on the right side. You might instinctively flex your right hip because straightening your leg increases the discomfort. None of these signs alone confirms appendicitis, but together they paint a recognizable picture.
If you have severe, worsening pain in your lower right abdomen, especially with fever or vomiting, go to the emergency room. CT scans detect appendicitis with roughly 97% accuracy, making it one of the most reliably diagnosed abdominal emergencies.
Gas, Constipation, and Other Common Culprits
Not all lower right pain is an emergency. Trapped gas and constipation are among the most frequent causes, especially if the pain comes in waves, improves after passing gas or having a bowel movement, and isn’t getting progressively worse. The junction where your small and large intestines meet sits in the lower right abdomen, so stool buildup or gas pockets in that area can produce surprisingly sharp pain.
A stomach bug or mild food poisoning can also concentrate pain in this region, typically alongside diarrhea, cramping, and sometimes a low-grade fever. This type of pain tends to be diffuse rather than pinpointed to one spot, and it usually resolves within a day or two.
Kidney Stones
A stone moving through your right kidney or ureter can send pain radiating from your back and flank down into your lower right abdomen and groin. This pain is distinctive: it comes in intense waves, often described as the worst pain people have ever felt, and it shifts location as the stone travels. You may also notice blood-tinged urine, frequent urination, or nausea. If the pain is severe and wave-like, it’s worth getting checked for a stone even if it doesn’t feel like a “stomach” problem.
Causes Specific to Women
Women have additional anatomy in the lower right abdomen that can produce pain. Ovulation pain (sometimes called mittelschmerz) happens roughly two weeks before your period when the right ovary releases an egg. It’s typically a dull ache or brief sharp twinge that resolves within a day. Ovarian cysts, which are fluid-filled sacs on the ovary, can cause a similar but more persistent pain if they grow large or rupture.
Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can cause chronic lower abdominal pain that worsens around your period. Pelvic inflammatory disease, usually caused by an untreated sexually transmitted infection, produces pain along with unusual discharge, fever, and pain during sex.
Ectopic Pregnancy
If there’s any chance you could be pregnant, take ectopic pregnancy seriously. This occurs when a fertilized egg implants in the fallopian tube instead of the uterus. Early symptoms mimic a normal pregnancy: missed period, breast tenderness, nausea. The first warning signs are often light vaginal bleeding and pelvic pain on one side. If the tube ruptures, you may feel sudden severe pain, shoulder pain, extreme lightheadedness, or faintness. This is a medical emergency.
Inguinal Hernia
An inguinal hernia happens when tissue, usually part of the intestine, pushes through a weak spot in the abdominal wall near the groin. You might notice a visible bulge in your lower abdomen or groin area that becomes more prominent when you stand up, cough, or strain. The pain tends to be a dull ache that worsens with physical activity and improves when you lie down. Hernias are more common in men but can occur in anyone. If the bulge becomes painful and can’t be pushed back in, or if you develop nausea and vomiting, the hernia may be trapped, which requires emergency care.
Crohn’s Disease and Chronic Causes
When lower right pain keeps coming back over weeks or months, Crohn’s disease is one possibility worth investigating. Crohn’s most commonly affects the end of the small intestine and the beginning of the large intestine, which sit in the lower right abdomen. The immune system attacks the digestive tract lining, causing inflammation that spreads into deeper layers of the bowel wall. Along with cramping abdominal pain, Crohn’s typically causes diarrhea, weight loss, fatigue, and sometimes symptoms outside the gut like joint pain, skin changes, or eye inflammation.
Irritable bowel syndrome (IBS) can also cause recurring pain in this area, though it tends to be more diffuse and closely tied to bowel habits. The key difference is that IBS doesn’t cause visible inflammation or damage to the intestine.
How to Tell What’s Serious
The character of the pain matters more than how much it hurts. A sudden, sharp gas pain can feel terrible but resolves quickly. Appendicitis pain steadily worsens over 12 to 24 hours and doesn’t let up. Here are patterns that warrant urgent evaluation:
- Pain that started near your belly button and moved to the lower right: classic appendicitis pattern
- Pain that gets worse with movement, coughing, or walking: suggests inflammation of the abdominal lining
- Fever above 101°F with worsening pain: points toward infection or inflammation
- Rigid abdomen that’s painful to touch: a sign of serious abdominal irritation
- Lightheadedness, fainting, or rapid heartbeat with abdominal pain: may indicate internal bleeding
- Vaginal bleeding with pelvic pain in early pregnancy: possible ectopic pregnancy
Mild, intermittent pain that improves on its own is less concerning but still worth mentioning to your doctor if it recurs. Pain that wakes you from sleep, causes you to double over, or comes with vomiting and fever deserves same-day medical attention.
What to Expect at the Doctor
Your doctor will press on specific areas of your abdomen to identify where the tenderness is most concentrated. They’ll likely ask when the pain started, whether it’s moved, what makes it better or worse, and about your bowel habits, menstrual cycle, and sexual history. Blood tests checking for signs of infection or inflammation are standard.
If appendicitis or another surgical emergency is suspected, imaging comes next. A CT scan is the gold standard for adults, catching appendicitis about 97% of the time. Ultrasound is often used first for women of childbearing age (to evaluate ovarian and pregnancy-related causes) and for children, though its accuracy for appendicitis is lower, around 82%. For kidney stones, a CT scan without contrast is typically the fastest route to a diagnosis.