Any long-term pain, regardless of localization, should alert, as it signals a pathological process in the body. Uncomfortable sensations may indicate inflammation and the need for urgent medical intervention. So, for example, you should definitely visit a doctor if it hurts in the right side of the lower abdomen. Often, this symptom indicates problems with the pelvic organs or peritoneum. It can occur at any age in both sexes.
So, why does the right side of the lower abdomen hurt? There can be many reasons, but, regardless of the etiology, the patient should not be given pain medication until the doctor makes a diagnosis. Anesthetics can distort the clinical picture, and an incorrect diagnosis indirectly poses a threat to the health and sometimes life of the patient. In some cases, when the right side is sore and gives back to the lower abdomen, urgent surgery may be required.
Interestingly, the causes of pain in the same part of the body in men and women may differ. For example, in women, the right side of the lower abdomen hurts with diseases of the appendages, ovaries, uterus, or ectopic pregnancy. In men, most often this symptom provokes an attack of acute appendicitis or renal colic. Some diseases appear equally in both sexes - they just start to hurt in the lower right side. These include pathologies of the large and small intestines, cancerous tumors and much more.
Acute appendicitis
Finding an answer to the question of why the right side hurts below, the first thing that should come to mind is acute appendicitis. This problem is diagnosed in almost 70% of visits to specialists with pain in this department. Mostly acute appendicitis occurs in young people, although the development of pathology in newborn infants and in the elderly is not excluded.
As you know, there is only one way to treat acute appendicitis - removing the inflamed appendix. According to statistics, for this reason women are 2-3 times more likely to be on the operating table than men.
The pain in acute appendicitis has a clear localization. Symptom often occurs unexpectedly, without any previous factors. Basically, the disease manifests itself in the evening or night time, which is associated with the activity of the vagus nerve - it is this element that innervates the appendix. In almost half the cases, the pain occurs first in the epigastrium, but after some time it moves to the lower right side.
How to distinguish appendicitis pain
It is important to know that with acute inflammation of the appendix, it is always strong, but it is of a different nature. In some patients, the pain is pulling, aching, in others - stitching, cramping. A pulsating and bursting type of pain can indicate a rupture of the inflamed process. Uncomfortable sensations often radiate to other places or spread throughout the abdominal cavity.
The intensity and severity of pain in young patients surges - acute appendicitis develops rapidly and rapidly, but in the elderly, on the contrary, all symptoms are blurred, less pronounced.
If a person has inflammation of appendicitis, then the resulting pain will not disappear until the disease is cured. All patients are advised to take a supine position - so the pain subsides a bit. It is important to try not to cough, not sneeze, not laugh - any active actions lead to increased discomfort. Patients with acute appendicitis have difficulty moving around. In this case, other symptoms may accompany painful sensations:
- nausea;
- vomiting
- bowel disorders;
- low-grade fever.
It is worth noting that in children with this disease, persistent fever can be observed. High body temperature in adults (above 38.5 ° C) occurs with peritonitis, sepsis, and the formation of abscesses in the peritoneum.
In general, the prognosis for appendix inflammation is favorable. Only a late request for medical help can lead to death.
Renal colic
Against the background of urinary tract diseases, renal colic may occur. The appearance of a pain attack is associated with a violation of the outflow of urine from the renal pelvis and ureter, as well as the progression of urolithiasis.
With renal colic, the right side hurts below and gives to the lower back, then discomfort moves into the iliac region. Often, the pain syndrome goes unnoticed. An exacerbation of renal colic without instrumental diagnostic methods is quite difficult to distinguish from signs of acute appendicitis, as sudden and localized symptoms are characteristic of both ailments. But still there is a difference in symptoms. With renal colic, the pain syndrome gives into the bladder and genitals, accompanied by frequent urination. However, with abnormal placement of the appendix, the patient may experience a similar clinical picture. Differentiate renal colic with appendicitis by the following criteria:
- With uncomplicated colic, the patient's body temperature always remains within the normal range. Acute appendicitis in most cases is accompanied by subfebrile condition or fever.
- A sign of acute appendicitis is pain, aggravated by the slightest movement, so patients try to take an easier position in bed, lying on their right side. Attacks of pain in renal colic are in no way associated with body position. There are no positions that at least helped to dull the pain. Patients with renal colic rush around in bed all the time or walk around the room.
- With renal colic, the right side of the lower abdomen and lower back hurts, and with appendicitis the pain in the back does not give off.
Treatment for renal colic is to restore the outflow of urine and eliminate spasm with medication. With frequent recurrence of pathological episodes, it is necessary to consult with a urologist.
Diverticulum inflammation
Sometimes the cause of pain is diverticulitis. This disease is characterized by periodically repeated stitching pain on the right side and can occur in both men and women. With diverticulitis, diverticulums form - peculiar bags formed due to protrusion of the intestinal walls. The intestinal contents accumulate and stagnate in them, which subsequently leads to an inflammatory process.
Why does the right side of the lower abdomen hurt with diverticulitis? Because inflammation develops in the sacs of the terminal ileum. On this site Meckel's diverticulum is formed. A fragment of the large intestine at the level of the cecum and ascending intestine is no less often protruded. In these sections, diverticulums are, as a rule, sporadic, therefore pains are inconsistent, and arise from time to time.
Against the background of diverticulitis, patients often have constipation, diarrhea. Without proper treatment and diet, the chronic course of the disease sometimes leads to perforation of the intestinal wall with the subsequent development of peritonitis. The most popular and effective way to treat diverticulums is to remove them surgically.
Crohn's disease
If the patient has a pain in the right side below and gives to the epigastric region, Crohn's disease can be suspected. This intestinal pathology in manifestations resembles acute appendicitis. An erroneous perception of the disease in vain can lead the patient to the operating table.
Despite the intense pain that is characteristic of Crohn's disease, treatment of this atypical inflammatory disease is carried out mainly in a conservative way. Surgery is indicated only for complications characterized by the formation of ulcers, deep fissures and fistulas, as well as the formation of adhesions and strictures in the abdominal cavity.
Most often, in acute Crohn's disease, the terminal ileum is affected - this is the extreme part of the small intestine, so the right side below hurts in patients. You can distinguish this disease from inflammation of the appendix by bloody diarrhea and persistent fever.
Intestinal mesenteric mesadenitis
Does a man have a sore right side of the lower abdomen? Perhaps the reason lies in the inflammation of the lymph nodes of the mesentery. This fragment of the intestine is a section by which the entire intestine is fixed to the posterior wall of the abdominal cavity. In the mesentery there are blood vessels, nerve receptors and lymph nodes, with inflammation of which the pain syndrome occurs on the right side in the lower abdomen. Uncomfortable sensations have an unstable periodic nature: either they will appear with sharp stitching or cramping pain, then they become pulling, aching, background.
Despite the fact that this disease is diagnosed in men much less often than acute appendicitis or renal colic, it cannot be completely ruled out. Mesadenitis often develops due to damage to the lymph nodes with tubercle bacillus. However, with an infectious etiology of the disease, in addition to painful sensations, other signs will be observed:
- increase in body temperature;
- increased sweating;
- weight loss;
- weakness and malaise.
At risk for the development of mesadenitis are persons with weakened immunity, as well as children and the elderly. Inflammation of the lymph nodes has a chance of developing other infectious diseases. Therapy consists in the use of anti-inflammatory, antibacterial and immunomodulating drugs. The main emphasis is on the treatment of the underlying disease and the rehabilitation of infectious foci in the body.
Malignant tumors
The cause of the condition in which the right side of the lower back hurts and radiates to the abdomen may be a neoplasm of the kidneys or intestines. Most often we are talking about cancer of the ileum, since anatomically it is a fragment of it located in the lower parts of the large intestine on the right side. If for a long time the man has a sore right side below, and the pain itself is paroxysmal, it needs urgent examination and a colonoscopy. Cancer of the ileum is a relatively rare disease, which is especially susceptible to the stronger sex at a young age.
In addition to pain, tumor growth is accompanied by frequent diarrhea, in which the body quickly loses water. At the early stages, it is almost impossible to recognize the disease, although in some cases, patients with a tumor of the ileocecal angle (the joining point of the small intestine and colon) may have a sphincter function that regulates the flow of processed mass from the small intestine to the large one. As a result, there is a reverse casting of intestinal contents - therefore, the patient hurts below, in the right side. This symptom is an almost integral part of the clinical picture of bowel cancer. Pain can also intensify with a complication of the carcinogenic process by infection of the affected area.
At the last stages of cancer, pain becomes more intense, which is explained by the germination of the tumor through the walls of the intestine or compression of the nerve endings. With bowel cancer in terminal patients, palliative treatment is performed. In addition, in the late stages of oncology, the pain syndrome is exacerbated by the development of severe anemia and pronounced signs of intoxication of the body - severe weight loss, aversion to food, weakness, headache, nervousness.
Ectopic pregnancy
Why does it hurt at the bottom of the right side of women? Any gynecologist will say that first of all, it is necessary to exclude an ectopic pregnancy. Especially if, in addition to pain on the right side, a woman has an irregular menstrual cycle. By the way, right-sided tube pregnancy is diagnosed several times more often than left-sided pregnancy .
The reason for the development of ectopic fertilization is the pathology of the fallopian tubes, in which the zygote is not able to reach the uterine cavity. Sometimes a fertilized egg is prevented from passing to the womb by an anatomical or congenital defect in the reproductive system (narrowing, adhesions), as well as the inflammatory process suffered by a woman, which led to mechanical obstruction of the fallopian tubes. With functional inferiority of muscle fibers, the progress of a fertilized egg is inhibited, and it, attaching itself to the fallopian tube, begins to destroy the membrane of its wall as it grows.
Any pregnancy developing outside the uterus is doomed to termination. In this case, natural abortion can be of two types:
- rupture of the fallopian tube;
- discharge of the fetal egg into the abdominal cavity through the ampoule.
In the first case, the woman has a sore right side in the lower abdomen. After a direct rupture of the fallopian tube, the pain syndrome appears suddenly, accompanied by nausea, upset stools, single vomiting, frequent urges to empty the intestines. It seems to the patient that unpleasant cutting sensations are observed throughout the body - pain during rupture of the fallopian tube gives to the perineum, rectum, under the ribs, in the subscapular area, in the collarbone. In the case of a natural interruption of a tubal pregnancy, a woman begins to bleed heavily, which subsequently leads to acute loss of blood and the corresponding symptoms (pallor of the skin and mucous membranes, increased heart rate, decreased blood pressure, dizziness, weakness, fainting).
Tubal abortion, unlike a rupture of the fallopian tube, does not develop so rapidly. Symptoms of abortion increase gradually - the process can last several weeks, but still end in the death of the fetal egg. More often than not, the first sign of a tubal abortion is cramping. The pain in this case is sharp, stitching. After each attack, spotting from the vagina appears. Usually the pains alternate with periods of imaginary relief, while at any time the process of terminating the pregnancy can be complicated by severe internal bleeding or instantaneous rupture of the tube, which is characterized by the above manifestations.
If you suspect a tube pregnancy, a woman must be hospitalized and carefully examined. The treatment of this condition is carried out surgically and medically.
Ovarian disease
If a woman has pain in the lower right side as badly as with acute appendicitis, it is possible we are talking about ovarian apoplexy. This pathology develops mainly in the second period of the menstrual cycle and represents a hemorrhage in the organ. According to statistics, apoplexy of the right ovary is far from the last place among common gynecological diseases.
At risk are young women under 35 years old. Ovarian hemorrhage occurs against the background of impaired circulation of the corpus luteum. Favorable conditions for the occurrence of apoplexy are considered tumors and adhesions in the small pelvis, which compress blood vessels and prevent full blood supply. The likelihood of hemorrhage is much higher in those women who have an anatomically incorrectly located uterus or congenital anomalies in the structure of blood vessels.
Anything can be the immediate push mechanism for apoplexy: from minor physical overstrain to chronic constipation, enema and sexual intercourse. First, during a hemorrhage, the ovarian tissues are saturated with blood, which makes the woman sore from the right side below, and after that the organ ruptures and bleeds inside.
Harbingers of ovarian apoplexy are short-term bouts of pain and spotting spotting. Many girls do not pay much attention to symptoms that soon disappear. After some time, hemorrhage suddenly occurs, which feels like acute abdominal syndrome, associated with vomiting, nausea and increased tone of the anterior wall of the peritoneum. Following these symptoms, there are signs of hidden bleeding - pale skin and mucous membranes, palpitations, and a drop in blood pressure. Surgery for ovarian apoplexy is the only possible treatment that involves partial or complete removal of the organ.
The right side at the bottom can hurt with another ovarian pathology - a twisted right-sided cyst. This complication in most cases occurs in girls and young nulliparous women due to severe physical exhaustion, increased stress, extreme weight loss. Torsion of the legs of the ovarian cyst can also occur in pregnant and newly born women.
- , . , , , , , . . , , .
This category of female diseases includes acute adnexitis and acute salpingo-oophoritis. The reason for almost every second visit to the gynecologist is inflammation of the uterine appendages, in which women of reproductive age are very sore right side down. Pain syndrome, in fact, is the main symptom of this disease, localized by the affected organ. The sensations that occur with adnexitis or salpingo-oophoritis can be completely different, but most often these are aching, pulling, unremitting pains.
Pyosalpinx manifests itself in a slightly different way, developing as a result of an untreated inflammation of the appendages. Due to the appearance of pus in the fallopian tube, the pain can become cramping, and in the case of an abscess, pulsating. At the time of a breakthrough, when pus enters the pelvic cavity, women often feel the so-called dagger pain. In addition, patients often have high fever, nausea, headache, and vomiting. Against the background of inflammatory diseases of the appendages, the volume of vaginal discharge increases, which also change their color and texture.
Treatment of these diseases of the genitourinary system in most cases involves the use of antibiotics taking into account the infectious agent. In severe cases, with the development of complications, surgical intervention is indicated.
If your right side of the lower abdomen is very sore, and other symptoms indicate one of the described pathological conditions, urgently call an ambulance! Do not waste time, as in some cases every minute is worth its weight in gold.