Pain in your right lower abdomen has a wide range of causes, from trapped gas that resolves on its own to appendicitis that needs emergency surgery. The location matters because several important organs sit in that area: your appendix, the end of your small intestine, part of your colon, your right ureter, and (if you have ovaries) your right ovary. Figuring out which one is responsible depends on how the pain started, how it feels, and what other symptoms came with it.
Appendicitis: The Most Urgent Possibility
Appendicitis is the first thing most people worry about with right lower abdominal pain, and for good reason. It’s common, it can become dangerous quickly, and it has a distinctive pattern. The pain typically starts around your belly button as a vague, hard-to-pinpoint ache. Over the next several hours, it migrates down and to the right, settling in the lower abdomen where it becomes sharp, constant, and noticeably worse than the initial discomfort.
Other warning signs tend to stack up in a predictable order: loss of appetite and low energy come first, followed by nausea, constipation or diarrhea, inability to pass gas, and eventually fever. You may also notice that extending your right leg or bending at the right hip makes the pain worse. If you’re experiencing severe pain that’s been building over hours and settling into the lower right side, that warrants a trip to the emergency room. Most hospitals will use a CT scan with contrast to confirm the diagnosis, though pregnant patients are typically evaluated with ultrasound or MRI instead.
Gas and Digestive Cramping
Not every pain in this area is an emergency. Trapped gas is one of the most common culprits, and it can occasionally produce surprisingly sharp pain. The key differences: gas pain tends to move around, you can often feel it shifting through your intestines, and it usually improves within minutes to hours after you pass gas or have a bowel movement. Passing gas more than 13 to 21 times a day, along with bloating and burping, suggests excess gas rather than something structural.
Appendicitis pain, by contrast, stays fixed in one spot, gets steadily worse over time, and doesn’t improve with gas or a bowel movement. If your pain is coming and going, shifting locations, and relieved when you pass gas, it’s far more likely to be digestive than surgical.
Crohn’s Disease and Ongoing Inflammation
If you’ve been dealing with recurring right lower abdominal pain for weeks or months, Crohn’s disease is one possibility worth considering. This inflammatory bowel condition most commonly affects the very end of the small intestine, which sits in the right lower abdomen. That’s why Crohn’s so often shows up as cramping in this specific spot.
The pattern looks different from appendicitis. Crohn’s pain tends to come and go over long stretches, often alongside diarrhea, fatigue, unintentional weight loss, and poor nutrient absorption. It’s a chronic condition, so the symptoms build gradually rather than escalating over a single day. If your right-sided belly pain keeps returning and you’re also losing weight or having frequent loose stools, bring this up with your doctor.
Ovarian Cysts and Reproductive Causes
For anyone with ovaries, a cyst on the right ovary can produce pain that feels like it’s coming from the lower right abdomen. Most ovarian cysts cause no symptoms at all and disappear on their own. But larger cysts can create a dull ache or sharp pain below the belly button toward one side, along with bloating, fullness, or a feeling of pressure in the abdomen.
Two complications make ovarian cysts more serious. A ruptured cyst can cause sudden, intense pain that may come with light-headedness. Ovarian torsion, where a large cyst causes the ovary to twist on itself and cut off its own blood supply, produces sudden severe pelvic pain along with nausea and vomiting. Torsion is a surgical emergency. If you experience a sharp, out-of-nowhere pelvic pain that makes you nauseous, get evaluated immediately.
Kidney Stones Passing Through the Ureter
A kidney stone that drops from the right kidney into the ureter (the tube connecting the kidney to the bladder) can produce intense pain that radiates into the lower right abdomen and groin. This happens when the stone gets stuck, blocking urine flow and causing the kidney to swell and the ureter to spasm.
Kidney stone pain is distinctive. It tends to come in waves, it’s often described as one of the most severe pains people have experienced, and it typically starts in the back or side below the ribs before spreading toward the lower stomach and groin. You may also notice blood in your urine, pain during urination, or an urgent need to urinate frequently.
Inguinal Hernia
An inguinal hernia occurs when tissue pushes through a weak spot in the abdominal wall near the groin. It’s more common on the right side and more common in men, though anyone can develop one. The hallmark sign is a visible or palpable bulge in the groin area, sometimes extending into the scrotum. Along with the bulge, you may feel discomfort, heaviness, or a burning sensation in the groin.
Hernia pain has a clear relationship with physical activity. It gets worse when you strain, lift something heavy, cough, or stand for long periods. It often improves when you lie down. If the bulge can no longer be pushed back in, becomes very painful, or you develop nausea and vomiting, the hernia may be trapped (incarcerated), which requires urgent medical attention.
How to Tell What’s Serious
A few features separate pain you can monitor at home from pain that needs immediate evaluation:
- Escalating pain over hours: Pain that started mild and has been getting steadily worse, especially if it’s now fixed in the lower right abdomen, raises concern for appendicitis.
- Fever or chills: These suggest infection or significant inflammation.
- Vomiting blood or shortness of breath: Either of these alongside abdominal pain warrants emergency care.
- Sudden, severe onset: Pain that hits all at once and is immediately intense can signal a ruptured cyst, ovarian torsion, or a kidney stone.
- Pain that resolves with passing gas: This is reassuring. It points toward a digestive cause rather than something structural.
Mild, intermittent discomfort that comes and goes over days without worsening is less likely to be an emergency, but persistent or recurring pain deserves a medical evaluation to rule out conditions like Crohn’s disease, hernias, or ovarian cysts. Severe right lower abdominal pain that’s been building for hours, especially with fever, nausea, or vomiting, should be evaluated the same day.