Symptoms · Lower abdomen
Pain in the lower right abdomen
The short answer
Pain that starts around the belly button or the upper belly and moves to the lower right side over a few hours, with loss of appetite, nausea or a mild fever, is typical of appendicitis. It usually gets worse with walking, coughing or pressing on the area. Do not wait it out: see a doctor the same day. If you think it could be appendicitis, do not eat or drink, because you may need an operation.
How patients describe it
- Pain that moves from the belly button to the lower right
- Sharp pain when I cough or walk
- No appetite and nausea
- Pain low down on the right side
- Fever and feeling unwell
Go to the emergency room now if you have
- Pain that keeps getting worse, or stops you walking normally
- Fever above 38°C, or chills
- Repeated vomiting
- A hard belly, or sharp pain when you press and let go
- Pain that suddenly eases and then becomes much worse, which can mean the appendix has burst
- A missed period or possible pregnancy with this pain
- Sudden severe pain in the scrotum (men)
Lower right belly pain that is new and getting worse should be seen the same day.
What can cause it
Appendicitis
Pain that starts near the belly button and moves to the lower right, with loss of appetite, nausea and a mild fever.
Next step: Examination, blood tests, and an ultrasound or CT scan.
Stomach infection (gastroenteritis)
Cramping with diarrhoea and vomiting, often after a suspect meal, easing in a few days.
Next step: Fluids and rest; see a doctor if you cannot drink or it lasts.
Constipation or trapped gas
Cramping that comes and goes and eases after passing stool or wind.
Next step: Fibre, fluids and activity; see a doctor if it continues.
Kidney or ureter stone
Severe cramping pain from the side or back towards the groin, sometimes with blood in the urine.
Next step: Urine test and a scan.
Ovarian cyst, period pain or ectopic pregnancy (women)
Low pain on one side, sometimes with a late period or spotting.
Next step: A pregnancy test and a gynaecology check; urgent if pregnancy is possible.
What you can do now
- Do not eat or drink if the pain is getting worse, and go to the emergency room
- Avoid strong painkillers and laxatives before you have been examined, because they can hide the signs
- Do not put heat on the belly
- Note when the pain started, where it began, and where it is now, and tell the doctor
Tests your doctor may order
- A careful examination of the belly
- Blood tests for infection, and a urine test (and a pregnancy test for women)
- Ultrasound or a CT scan of the abdomen
When is surgery needed?
- Appendicitis is usually treated by removing the appendix, by keyhole or open surgery. Most people go home after 1–2 days.
- For some adults with mild, uncomplicated appendicitis, antibiotics alone may be an option; about 4 in 10 of these patients later need surgery. Your surgeon will advise what is safest for you.
- Other causes are treated according to what they are.
Related operation guides
Questions people ask
Can appendicitis go away on its own?
Mild cases can settle with antibiotics, but only a doctor can tell whether that is safe. Waiting at home can let the appendix burst, so get new, worsening lower right pain checked the same day.
Can I take a painkiller while I wait?
Ask the doctor first. Strong painkillers can hide the signs, so avoid them until you have been examined.
How long is recovery after the operation?
Most people walk the same or the next day and go home within 1–2 days. Sick leave is about 1–2 weeks, and heavy lifting or sport waits 4–6 weeks.
Is the operation safe in pregnancy?
Yes. Appendectomy is safe in all trimesters, but the symptoms can look different in pregnancy, so see a doctor early.
This page gives general information and does not replace the advice of your treating team. In an emergency, go to the nearest emergency room.