Right Lower Quadrant Pain - Less common causes

Authored by Dr Jacqueline Payne, 08 Jul 2017

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Reviewed by:
Dr Helen Huins, 08 Jul 2017

What are the other possible causes of right lower quadrant pain?

Inflammatory bowel disease

Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease (IBD). IBD is not to be confused with irritable bowel syndrome (IBS) which is very different. These conditions cause the lining of the gut to become inflamed. Diarrhoea (sometimes with blood mixed in) is usually the main symptom.

  • Crohn's disease:
    • Any part of the gut can be affected and the pain depends on which part is affected.
    • The most common place for it to start is at the end of the small intestine (ileum) causing right lower quadrant (RLQ) pain.
    • This is where the appendix is and the symptoms can be very like appendicitis.

See separate leaflet called Crohn's Disease for more information.

  • Ulcerative colitis
    • Diarrhoea is often mixed with mucus or pus.
    • Blood mixed with the diarrhoea is common.
    • The tummy (abdominal) pain is typically crampy.

See separate leaflet called Ulcerative Colitis for more information.

Colon cancer

  • Colon cancer is one of the most common cancers in the UK (in contrast, cancer of the small intestine is rare).
  • Although it can affect any part of the large bowel (colon), it commonly affects the last part (descending colon) which is on the left-hand side.
  • Pain is more likely to be in the left lower quadrant (LLQ) than the RLQ.
  • There is usually a change in how often you need to open your bowels and you may notice that you have lost weight, without trying.

See separate leaflet called Colon Cancer and Rectal Cancer for more information.

Kidney stones

  • Kidney stones are hard stones that can form in the kidney, in the tube (the ureter) draining urine from the kidney, or in the bladder.
  • A stone that passes into the ureter draining urine from your right kidney may cause pain that starts in your right loin and spreads (radiates) to your groin and RLQ, or into your testicle (testis) if you are a man.
  • You may notice blood in your pee.

See separate leaflet called Kidney Stones for more information.

Shingles

  • In some cases you may have pain from shingles before a blistery rash appears.
  • Pain tends to be sharp or burning.
  • You may not feel quite yourself.
  • The tummy (abdomen) is a common place for shingles rash.

See separate leaflet called Shingles (Herpes Zoster) for more information.

Abdominal aortic aneurysm

  • An abdominal aortic aneurysm is a swelling of the largest blood vessel in the body (the aorta) inside the abdomen.
  • It doesn't usually cause any symptoms but can occasionally cause pain before it bursts. The pain is usually felt in your back or the side of your tummy (abdomen) but it can occasionally be felt in the right lower (or left) quadrant.

See separate leaflet called Abdominal Aortic Aneurysm for more information.

What else could it be?

These lists of possible causes for RLQ are by no means exhaustive and there are many other conditions that can cause pain in the RLQ. Problems in your spine or back could be 'referred'. Referred pain in this situation means that it is coming from your back but you are feeling it around the front. Muscular pulls and sprains can also affect you in the tummy area. If this is the case, moving the particular muscle would make the pain worse, whereas if you were to lie completely still, it wouldn't hurt.

Further reading and references

  • Cartwright SL, Knudson MP; Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008 Apr 177(7):971-8.

  • Kim JS; Acute Abdominal Pain in Children. Pediatr Gastroenterol Hepatol Nutr. 2013 Dec16(4):219-224. Epub 2013 Dec 31.

  • Cartwright SL, Knudson MP; Diagnostic imaging of acute abdominal pain in adults. Am Fam Physician. 2015 Apr 191(7):452-9.

  • Manterola C, Vial M, Moraga J, et al; Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011 Jan 19(1):CD005660. doi: 10.1002/14651858.CD005660.pub3.

hi been having pain on my right had side since I had my water in fecation I worried in case it's my appendix just need a vise plz

teresa32313
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