Right Lower Abdominal Pain: Is It Appendicitis? - Gastroenterology and Hepatology

Right abdominal tenderness?

This morning, I suddenly experienced a dull pain in my lower right abdomen.
It hurts when I press on it, but there is no rebound tenderness.
Jumping on one leg only causes slight pain.
The pain was initially vague, but it gradually became more pronounced by the evening.
Could this be appendicitis? I do not have a fever and my appetite is decreased.

A-Jia, 20~29 year old female. Ask Date: 2021/06/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

If you still experience significant discomfort, you should seek medical attention.

Reply Date: 2021/06/24

More Info

Right lower abdominal pain can be concerning, especially when considering the possibility of appendicitis. Appendicitis typically presents with a few hallmark symptoms, including pain that starts around the belly button and then shifts to the right lower quadrant, often accompanied by nausea, vomiting, loss of appetite, and sometimes fever. However, the absence of fever and appetite loss in your case does provide some reassurance, but it does not completely rule out appendicitis.

Given your description of the pain as "dull" and "gradually becoming more noticeable," along with the fact that pressing on the area causes discomfort but does not elicit rebound tenderness, it may suggest that the pain is not solely due to appendicitis. Rebound tenderness is a classic sign of peritoneal irritation, which is often seen in cases of appendicitis. The fact that you can jump on one leg with only mild pain also suggests that the pain may not be severe enough to indicate an acute surgical issue.

There are several potential causes for right lower abdominal pain that are not related to appendicitis. These can include:
1. Muscle Strain: If you have recently engaged in physical activity or changed your routine, a muscle strain could be the culprit. This type of pain typically worsens with movement or certain positions.

2. Gastrointestinal Issues: Conditions such as constipation, gas, or irritable bowel syndrome (IBS) can cause discomfort in the lower abdomen. If you've had any dietary changes or increased intake of certain foods, this could be a factor.

3. Ovarian Issues: In females, ovarian cysts or other gynecological issues can lead to localized pain in the lower abdomen. If you are of reproductive age, this is something to consider.

4. Hernia: An inguinal hernia can present with localized pain, especially if there is a bulge or if the pain increases with certain movements.

5. Urinary Tract Issues: Conditions such as a urinary tract infection (UTI) or kidney stones can also cause pain in the lower abdomen, although these are typically accompanied by other urinary symptoms.

Since your symptoms have been persistent and are gradually worsening, it is advisable to seek medical attention. A healthcare provider may perform a physical examination and possibly order imaging studies, such as an ultrasound or CT scan, to rule out appendicitis and other potential causes of your pain.

In the meantime, keep track of any additional symptoms that may arise, such as changes in bowel habits, urinary symptoms, or any new systemic symptoms like fever or chills. This information will be helpful for your healthcare provider in determining the cause of your pain.

In summary, while appendicitis is a possibility, the characteristics of your pain and the absence of certain classic symptoms suggest that there may be other explanations. Prompt evaluation by a healthcare professional is essential to ensure an accurate diagnosis and appropriate management.

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