The bottom right side of my stomach hurts

By Joseph Bennington-CastroMedically Reviewed by Jane Yoon Scott, MD

Reviewed: October 22, 2022

Appendicitis develops when your appendix — a small pouch attached to your large intestine — becomes inflamed.

Sharp pain in your abdomen is the foremost sign of appendicitis, but a pain in your belly doesn’t necessarily mean you have the condition.

Almost everyone will experience abdominal pain at one time or another, because there’s a long list of things that can cause this problem.

Possible Causes of Abdominal Pain, Including Appendicitis

Aside from appendicitis, some of the most common causes of abdominal pain include:

• Gallstones
• Ovarian cysts
• Irritable bowel syndrome (IBS)
• Urinary tract infection (UTI)
• Crohn’s disease
• Indigestion
• Gas
• Gastroenteritis
• Peptic ulcers
• Kidney infection
• Lactose intolerance and food allergies
• Constipation
• Hernia
• Ectopic pregnancy

The severity of the pain doesn’t always correspond to the seriousness of the condition that’s causing the pain. Life threatening conditions such as colon cancer may cause only mild pain, while a minor bout of gas may cause painful cramping. (1) Looking at the specific type of pain you’re experiencing can help you zero in on the condition you may have.

More on Causes of Abdominal Pain

Foods That Frequently Cause Gas

For example, cramping abdominal pain is commonly due to gas and bloating. It’s generally not caused by something serious (such as appendicitis), and may be followed by diarrhea. (1)

“Colicky pain,” or abdominal pain that’s severe and comes and goes in waves, is typically the result of kidney stones or gallstones. (1)

If your pain isn’t localized to a specific area, and instead you feel it in more than half of your belly, you may have a stomach virus, indigestion, or gas. Sometimes stress or anxiety causes vague, nonlocalized abdominal pain as well. (1)

If that pain becomes more severe over time, or your abdomen becomes swollen, it could be the result of something obstructing or blocking your large intestine.

On the other hand, if your pain is only found in one area of your belly, it’s possibly due to an issue with one of your organs, such as the gallbladder, pancreas, appendix, or stomach.

The way the pain evolves over time can also be useful in determining what’s causing it. Certain conditions tend to cause acute pain over the course of hours or days, while other conditions cause pain that comes and goes but doesn’t necessarily worsen over time. (2)

Is It Appendicitis Pain or Something Else?

Most often, the pain you feel when you have appendicitis begins as a dull ache around your belly button that shifts to your lower right abdomen, where your appendix is located.

Additionally, appendicitis pain:

• Begins suddenly — it often wakes people up at night.
• Becomes significantly sharper in a matter of a few hours.
• Starts before other co-occurring symptoms, such as fever, nausea, and vomiting
• Is associated with loss of interest in eating.
• Worsens when you move around, breathe deeply, cough, or sneeze.
• Spikes when you drive over a speed bump or experience other jarring motions. (3)

To diagnose appendicitis, your doctor will perform a physical exam, which will investigate your abdominal symptoms more specifically.

If you have appendicitis, you will likely: (4)

• Hurt when someone applies and then quickly releases pressure in your lower right abdomen, a symptom called “rebound tenderness.”
• Experience rebound tenderness in your lower right abdomen when someone applies and quickly releases pressure on the lower left side of your abdomen.
• Unconsciously guard your lower right abdomen when someone tries to touch it.
• Feel pain when someone applies resistance to your right knee as you try to lift that leg up while lying down on your back.
• Ache in your abdomen when you move your bent right knee to the left and right while lying down on your back.

Other Sources of Lower Abdominal Pain

A study that looked at appendectomies over the course of 10 years suggested that almost 12 percent of those performed were conducted on patients who didn’t actually have appendicitis. (5)

This is because several health issues can also cause pain that’s localized to your lower right abdominal area, making an accurate diagnosis of appendicitis difficult without using imaging tests, such as computed tomography (CT), ultrasound, and MRIs.

For instance, ovulation pain occurs on either the right or left side of the lower abdomen and can be quite sharp, like appendicitis pain. But that pain doesn’t start near the belly button, nor does it get worse with movement.

Constipation can cause pain localized in the lower right abdomen, as well as rebound tenderness. But the constipation starts before the abdominal pain, unlike when you have appendicitis — though constipation can be a symptom of appendicitis.

A kidney infection can be another cause of lower right abdominal pain — if the right kidney is infected — but this also causes groin pain, back pain, and painful urination. (6)

Pain from kidney stones can spread to the lower right abdomen, though it doesn’t start at the belly button; it usually starts below the ribs on one of your sides and back. It also usually comes in waves. (7)

Ovarian cysts don’t usually cause noticeable symptoms. But they can sometimes result in lower abdominal pain, which is generally dull, aching, and intermittent, rather than sharp and constant, like appendicitis pain.

Ectopic Pregnancy and Abdominal Pain

Ectopic pregnancy, in which a fertilized egg gets implanted outside the uterus, can result in right-sided abdominal pain.

Unlike appendicitis, ectopic pregnancy is often marked by cramp-like pain, and sometimes even shoulder and neck pain.

Vaginal bleeding is also a common symptom of an ectopic pregnancy. (8)

Additional reporting by Deborah Shapiro.

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Editorial Sources and Fact-Checking

1. Abdominal Pain. MedlinePlus. February 7, 2022.
2. Abdominal Pain: Causes. Mayo Clinic. July 3, 2021.
3. Appendicitis: Overview. Mayo Clinic. August 7, 2021.
4. Symptoms and Causes of Appendicitis. National Institute of Diabetes and Digestive and Kidney Diseases. July 2021.
5. Seetahal S, Bolorunduro O, Sookdeo T, et al. Negative Appendectomy: A 10-Year Review of a Nationally Representative Sample. The American Journal of Surgery. April 1, 2011.
6. Symptoms and Causes of Kidney Infection (Pyelonephritis). National Institute of Diabetes and Digestive and Kidney Diseases. April 2017.
7. Symptoms and Causes of Kidney Stones. National Institute of Diabetes and Digestive and Kidney Diseases. May 2017.
8. Ectopic Pregnancy. MedlinePlus. January 10, 2022.

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