Aching in the Right Side of the Stomach: Why and What to do?

Pain in the Right Lower Quadrant - Causes

Your RLQ, tucked under an invisible line from your belly button to your right hip, is where parts of your colon, your lower kidney, and in women, the right ovary and fallopian tube sit. Pain here can be as mild as a nuisance or as severe as a red flag, making it a tricky puzzle to solve.

In women

• Ovarian cysts: Ovarian cysts are small fluid-filled sacs that can form on or inside the ovaries. While they often go unnoticed, they may occasionally twist or rupture, causing sudden and intense pain in the right lower quadrant (RLQ). This may also be accompanied by nausea and dizziness. Hormonal imbalances may trigger cysts, but many resolve on their own. If complications such as ovarian torsion occur, ultrasound imaging may be used to confirm the diagnosis. Treatment ranges from pain relief to surgical removal depending on severity.
• Endometriosis: Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, commonly affecting the ovaries, fallopian tubes, and pelvic lining. When the right ovary or surrounding pelvic structures are involved, pain may occur in the RLQ. The condition can lead to chronic pelvic pain, particularly during menstruation. Treatment may involve hormonal therapy, pain management strategies, or surgery.
• Pelvic Inflammatory Disease (PID): PID is commonly caused by sexually transmitted infections such as chlamydia or gonorrhoea. If untreated, it can lead to infertility or long-term pelvic pain. Women with PID may experience abdominal pain, fever, unusual vaginal discharge, and discomfort during intercourse. Antibiotic treatment is necessary to control the infection, and sexual partners may also require treatment to prevent reinfection.
• Ectopic pregnancy: An ectopic pregnancy occurs when a fertilised egg implants outside the uterus, usually in a fallopian tube. If the right fallopian tube is affected, severe RLQ pain may occur and may be accompanied by vaginal bleeding and dizziness. This is a medical emergency that requires immediate medical attention.
• Ovulation pain (Mittelschmerz): Mittelschmerz is a German term meaning “middle pain” and refers to mild cramping or discomfort that some women experience during ovulation. The pain may occur on either side of the lower abdomen depending on which ovary releases the egg. It is generally harmless and temporary, usually lasting a few hours to a couple of days.

In Men

• Inguinal hernia: An inguinal hernia occurs when part of the intestine or abdominal tissue pushes through a weak area in the abdominal wall, creating a visible bulge. It may cause a dull ache or sharp pain, especially during lifting or bending. The bulge is often more noticeable when standing. Surgical repair is usually required.
• Epididymitis: Epididymitis is inflammation of the epididymis, the coiled tube behind the testicle that stores and carries sperm. Pain often begins in the scrotum and may radiate to the RLQ. It is usually caused by bacterial infections or sexually transmitted infections and may be accompanied by fever and painful urination. Treatment typically involves antibiotics, rest, ice packs, and anti-inflammatory medication.
• Appendicitis: Appendicitis often begins with a dull pain around the belly button that gradually moves to the RLQ and becomes more severe. Other symptoms may include nausea, vomiting, and fever. Prompt surgical treatment is required to prevent the appendix from rupturing.
• Testicular torsion: Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testicle. This causes sudden and severe scrotal pain that may radiate to the RLQ and may be accompanied by swelling, nausea, and vomiting. Immediate surgery is required to prevent permanent damage.
• Muscle strain: Strain in the abdominal or groin muscles can occur due to heavy lifting, sports activities, or sudden movements. This may cause mild to moderate RLQ pain that worsens with movement or stretching. Rest and over-the-counter pain relief are usually sufficient for recovery.

When should you worry

It's tempting to brush off stomach pain as a minor hiccup, but there are times when it requires prompt attention:

• A sudden, sharp pain that feels more localised and knife-like
• Pain associated with fever, nausea, vomiting, or a change in bowel habits
• The yellow flag of jaundice
• Pain that persists for 24–48 hours or becomes worse

Note: If you experience sudden, severe abdominal pain, persistent vomiting, fainting, or a high fever, call 000 or go to the nearest Emergency Department immediately. These symptoms may indicate a surgical emergency.

Home Remedies to try

If your pain is more uncomfortable than alarming, here are a few remedies you may try at home:

• Warm compress: A heating pad or warm compress may help relax tense muscles and improve blood circulation. Applying it for 15–20 minutes at a time may relieve cramps, digestive discomfort, or muscle strain.
• Hydration: Staying hydrated is important, especially if nausea, diarrhoea, or vomiting is present. Drinking water, herbal teas, or electrolyte-rich fluids may help replace lost fluids and support digestion.
• Over-the-counter medications: Over-the-counter pain relief may help manage mild to moderate discomfort by reducing inflammation. Antispasmodics may help relieve cramps, while medications used for indigestion may ease digestive symptoms.
• Dietary adjustments: Eating small, frequent meals with easy-to-digest foods such as bananas, rice, and toast may help calm the stomach. Avoid fatty, spicy, or acidic foods, and consider ginger or peppermint tea for nausea and bloating.
• Gentle exercise: Light activities such as walking or gentle stretching may support digestion and reduce stress, which can help with RLQ discomfort. Yoga or stretching may also help ease menstrual cramps and improve circulation.

Note: This information is for educational purposes only. Consult a GP before trying home remedies to ensure they are appropriate for your specific condition.

When to consult a doctor?

If your RLQ pain continues for several hours, worsens, or becomes severe, it is advisable to consult a telehealth GP. Seek urgent medical care if you experience any serious symptoms mentioned above.

Can telehealth help?

A telehealth consultation can help you discuss your symptoms and receive initial medical guidance. However, because many causes of RLQ pain require a physical examination or diagnostic imaging such as ultrasound or CT scans, a GP may recommend an in-person assessment or refer you to the Emergency Department if necessary.

Note: The content of this blog is for informational purposes only and does not replace professional medical diagnosis, advice, or treatment.