Lower abdominal pain on the right or left

Lower abdominal pain on the right or left

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Lower abdominal pain is very common and, depending on whether it is acute or chronic, or in a woman or a man, can have a variety of causes. If the abdominal pain appears on the left, it can be, for example, diverticulitis, while complaints on the right side often indicate appendicitis. The typical “women's ailments” in the area of ​​the lower abdomen include, for example, recurrent menstrual pain before or during the menstrual period, which is manifested by a strong pulling or cramps. But men can also experience complaints in this region if, for example inflammation of the prostate, hernia or urinary stones. How strong and in what form these occur is very different, accordingly the pain can e.g. are perceived as dull and diffuse, boring, pulling or stinging. In addition, the pain is often not limited to the lower abdomen, but radiates to other areas of the abdomen, the flanks or the back. To avoid health risks and to rule out serious illnesses, lower abdominal pain should always be clarified by a doctor. This is especially true if they appear suddenly and are accompanied by fever and / or bleeding.

Causes of lower abdominal pain

Abdominal pain in the lower abdomen is often due to disturbances in the intestine, with the parts in the pelvic area being particularly affected (large intestine with appendix, rectum, etc.). But also stomach problems such as Gastritis (inflammation of the stomach) can lead to symptoms that radiate to the lower abdomen. Lower abdominal pain often occurs e.g. in people who suffer from a functional disorder of the intestine or a so-called "irritable bowel syndrome", which affects an estimated one fifth of the population in different forms.

Characteristic here are mainly recurrent, cramp-like pains in the lower abdomen, which are perceived as severe stinging, pressing or pulling. Some of the symptoms are expressed in the form of upper abdominal pain, constipation or diarrhea, which in most cases only occur during the day. In addition to this, unspecific general symptoms such as e.g. Headache, increased menstrual cramps, difficulty sleeping, general fatigue or depression.

Another cause of severe, acute abdominal pain in the lower area can be an inguinal hernia (inguinal hernia) in which the parts of the intestine that have escaped (e.g. the intestine) are pinched (incarceration). Fever, nausea and vomiting often occur here, while in the case of a “normal” fracture there are often no symptoms apart from the characteristic swelling in the groin area and mild aching groin pain. Incarceration is a serious complication of the inguinal hernia, because if the affected section of the intestine is no longer supplied with blood, it can lead to dangerous inflammation and even die in an emergency. Accordingly, there is an absolute emergency here that requires immediate surgery.

Likewise, acute intestinal infections with pathogens such as Yersinia enterocolitica or Escherichia coli can lead to severe pain or cramps in the lower abdomen, which are often accompanied by other symptoms such as Fever or diarrhea are accompanied. Similar symptoms are typical for inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. However, mouth ulcers or skin rashes often occur here, in rarer cases conjunctivitis or eye inflammation and joint pain are also possible.

In addition, ureteral stone disease can cause lower abdominal pain. This mainly affects people between the ages of 30 and 50, and men are represented slightly more often than women. But children can also already form ureter stones, which are crystalline deposits (concretions) in the ureter (ureters), which can consist of calcium oxalate, calcium phosphate or cystine, for example. If they reach a certain size, they can no longer pass through the urinary tract and hit the walls of the ureter, causing typical colic-like flank pain that radiates to the back and lower part of the abdomen or to the genital area ("renal colic") . If the stone causes injuries to the ureter wall, this can also result in bleeding, which can be recognized by the red color of the urine. In some cases, the stone gets stuck in the ureter, which means that the urine can no longer drain freely and leads to kidney congestion.

Naturopathy and home remedies for pelvic pain

Left pelvic pain

Complaints on the left side of the lower abdomen can be an indication of a so-called "diverticulitis", which is an inflammation of protrusions in the intestinal wall (diverticula). This can be limited to the diverticula (peridiverticulitis) or, in rare cases, occur across the intestinal wall and thus lead to complications such as peritonitis, fistulas or an intestinal obstruction. From a medical point of view, diverticulitis is often triggered by a low-fiber diet and a lack of exercise, which causes hard bowel movements and constipation. As a result, the mucous membrane bulges outwards due to the increased pressure. If faecal residues remain in the diverticula, they can attack the mucous membrane and lead to inflammation, with the last part of the large intestine (colon sigmoideum) being affected in most cases.

Typically, this leads to sudden, dull pain in the left lower abdomen, which is similar in character to the (right-sided) complaints of appendicitis, which is why the disease is often referred to as "left appendicitis". The pain can radiate up to the back, in addition there are in many cases fever, nausea and vomiting, discomfort when urinating as well as abnormalities in bowel movements such as diarrhea, constipation or pus in the stool.

Lower abdominal pain on the right

Appendicitis (appendicitis) is typical of pain in the right lower abdomen, although contrary to the name, the appendix itself is not affected at all. Instead, it is a bacterial inflammation of the so-called worm process (appendix), an appendage of the appendix up to 10 cm long, which is usually found in the lower abdomen on the right side. Appendicitis is very common (approx. 100 cases per 100,000 inhabitants annually) and particularly often affects younger people between the ages of 10 and 20 years.

The inflammation is mainly characterized by severe pain, which usually begins in the area of ​​the navel and then changes over the next few hours to the right side of the abdomen, but it is also possible to radiate into the left area. The pain is initially described by many of those affected as persistently dull and / or oppressive and usually intensifies with shocks such as Cough, sneeze, or bounce. Other symptoms such as a slight increase in temperature, nausea, vomiting and constipation often occur, loss of appetite, an accelerated pulse or excessive sweating at night are also possible. Appendicitis, on the other hand, is less “typical” in pregnant women, as the position of the appendix changes during this time and the pain accordingly tends to occur in the upper or middle area of ​​the abdomen on the right side. Appendicitis usually also changes in children, in that the symptoms are more pronounced overall than in adults. Accordingly, in many cases, small patients suffer from pain in the entire abdominal area and increased nausea.

Appendicitis has various causes, but in most cases there is constipation in the intestine, e.g. can arise from fecal stones or scar strands. A kinking of the worm process can also result in secretion build-up and inflammation. In rare cases, fruit kernels, worms or other foreign bodies can also be used as triggers for closure. In addition, intestinal infections can spread to the appendix, and appendicitis can also occur as a symptom of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.

Lower abdominal pain of the woman

Pain in the abdomen of a woman can have various causes. Typical here are e.g. recurrent, cramp-like pain during menstruation (dysmenorrhea) that almost every woman experiences at least once in the course of her life. If the menstrual pain is very pronounced, this can also indicate “endometriosis”, which mainly affects women of childbearing age. This is a widespread, benign disease in which “scattered” uterine lining (endometrium) also settles outside the uterus. However, since the displaced tissue participates in the menstrual cycle like the "normal" mucous membrane, the disease often leads to severe cramps and increased, painful bleeding, especially during the period.

Other possible symptoms are, for example, cycle disorders, infertility or intermenstrual bleeding, and depending on the spread of the tissue, e.g. Urination problems, pain during intercourse or back pain occur. Since the symptoms of endometriosis are cycle-dependent, they usually disappear with the onset of menopause or during pregnancy. In endometriosis, the specific symptoms that occur depend primarily on where the tissue foci are. Accordingly, these can be very different, in some cases there are no typical complaints.

Other genital causes of pain in the lower abdomen in women can be, for example, an ectopic pregnancy (tubal pregnancy) or ovarian cyst (ovarian cyst), as well as inflammation of the ovaries and fallopian tubes (adnexitis), malformations of the genital organs, narrowing of the vagina or a so-called “fibroid” “Considered in the uterus. This is a tumor or growth that can occur at various points in the muscle layer of the uterus. Fibroids are the most common benign tumors of the female genital tract and can develop in principle in every woman, but mostly between the 35th year of life. About a quarter of those affected have no complaints from the uterine tumor, so that in these cases no treatment is usually necessary.

The others, on the other hand, typically experience cycle disorders in the form of heavy, long-lasting bleeding and / or bleeding between periods as well as pain in the lower abdomen. The long, heavy bleeding also increases the risk of iron deficiency anemia, which in turn can lead to cardiovascular problems, paleness of the face, dizziness and headache. Depending on the size, location and growth of the growth, neighboring organs may also be affected, causing further symptoms such as increased bladder pressure, frequent urge to urinate, constipation, back pain, discomfort during sexual intercourse or a bladder infection are possible.

A number of non-genital causes can also be considered for pelvic pain in women. These include inflammation of the appendix or kidney, urinary tract infections, kidney stones or irritable bowel syndrome, as well as various tumors (e.g. ovarian or cervical cancer), an inguinal hernia, inflammatory bowel diseases such as e.g. Crohn's disease, an intestinal obstruction (ileus) or scars or adhesions following surgery.

Lower abdominal pain during pregnancy

In addition, women frequently experience complaints in the lower abdomen during pregnancy, which in any case must be clarified promptly by a doctor in order to avoid health risks for mother and child. Often there are relatively “harmless” reasons, because especially in the first and second trimester of pregnancy, the growing child and the associated stretching of the uterus often cause navel pain. Even at the end of pregnancy, most women experience natural pain in the lower abdomen when the labor pains begin.

In addition to that, serious causes can also be responsible for lower abdominal problems during pregnancy. It is possible here e.g. a malformation of the placenta or a tear in the uterus, premature or miscarriage is also possible. Accordingly, it is essential to take the pain seriously and have it examined by a doctor, especially during pregnancy.

Fallopian tube inflammation

Inflammation of the fallopian tube and ovary ("adnexitis") can also cause severe pain in the lower abdomen. In most cases, this occurs on both sides and primarily affects young women between the ages of 15 and 25. The disease is usually caused by bacteria such as gonococcus or chlamydia, which can reach the fallopian tubes and ovaries (adnexa) via various infection routes. If it is an ascending (ascending) infection, the pathogens get from the vagina through the uterus to the fallopian tubes and from there to the ovaries. However, the prerequisite here is that there is a bacterial infection of the vagina, such as vaginal inflammation, which often arises from unprotected sexual intercourse. In addition, certain conditions (e.g. period, births or miscarriages, insertion of the spiral) must be met so that the bacteria can get into the uterus at all and are not "warded off" by natural protective barriers such as the cervix.

On the other hand, a “descending” (descending) infection is spoken of if the bacteria can get from a neighboring organ to the fallopian tubes and ovaries, such as in the case of appendicitis or colon inflammation (proctitis). Due to the close proximity, the pathogens can either “jump” directly from one organ to the other, but it is possible to spread to the adnexa via the lymphatic pathway. In addition, an infection via the blood path (hematogenous infection) can also occur, e.g. through the tuberculosis pathogen Mycobacterium tuberculosis, in the context of a virus flu or in mumps.

Depending on how the inflammation develops and the treatment proceeds, a medical distinction is made between an acute and chronic form of adnexitis. Typical for the first case are sudden abdominal pain, often accompanied by fever, purulent vaginal discharge and a strong feeling of illness. In addition, other symptoms can occur, such as a pressure-sensitive, bloated stomach, nausea and vomiting, diarrhea, constipation, vaginal bleeding or pain when urinating. If the acute complaints are not treated appropriately, there is a risk that they will persist in the long term or return again and again (chronic adnexitis), which can also occur due to scarred changes as a result of a previous, healed inflammation.

If there is such scarring or even adhesions with neighboring organs, this can lead to lower back pain after intercourse in some women, and there is also frequent menstrual pain, flatulence and constipation. Typically, chronic adnexitis is a very long-term illness that can significantly reduce the well-being and quality of life of the woman concerned. In addition, the infection can lead to complications and long-term consequences such as inflammation of the peritoneum, sepsis or even infertility, which is why the inflammation should always be taken seriously and treated medically at an early stage.

Abdominal pain man

If men experience pain in the lower abdomen, various causes can also be considered. Often there is irritation or inflammation of the appendix (appendicitis), which is accompanied by other symptoms such as Fever, chills, nausea and vomiting is accompanied. In older men in particular, complaints in the lower abdomen can also indicate a disease of the prostate (“prostate gland”). This is a small gland below the bladder that forms an important part of the male reproductive system by producing a secretion that serves to protect, move and nourish the sperm cells. Although the prostate is only about the size of a walnut, it can cause major problems for many men. Inflammation (prostatitis), for example, is possible here, which, in addition to complaints in the lower abdomen, often leads to a feeling of pressure in the perineal area and anus pain as well as in some cases difficulty in erection, pain during and after ejaculation and fever. Problems with urination often occur, as the patient feels a strong urge to urinate, but can only drain a few drops of urine on the toilet.

The majority of men in middle to older age are also affected by a benign enlargement of the prostate (benign prostatic hyperplasia, in short: BPH). This arises as a result of an excessive proliferation of cells, which in itself is relatively harmless, since it is neither aggressive nor uncontrolled as in the case of malignant growth (cancer). Accordingly, a disease value only exists if other symptoms such as e.g. frequent urination at night, urinary retention or difficulty in urinating despite greatly increased voiding pressure. As a result, those affected experience a constant feeling of fullness in the bladder and a permanent urge to urinate, and in addition, pathogens in the residual urine can quickly lead to increased urinary tract infections or bladder stones. If the disease is discovered early, it can usually be treated well using current methods. However, if this does not happen, the ever-increasing prostate exerts ever greater pressure on the urethra, which can lead to urinary retention and very painful bladder stretching in an emergency. If the urine stagnates in the bladder and extends to both kidneys, there is also the risk that it will be permanently damaged or even cause kidney failure. Accordingly, the first signs of BPH such as If urine is interrupted or urine drips, a urologist is consulted to clarify the symptoms and to be able to initiate any necessary treatment steps.

In addition to benign enlargement, a malignant tumor (prostate carcinoma) of the prostate gland can cause lower abdominal pain. With more than 60,000 new cases every year, this is the most common form of cancer in men in Germany, which mainly affects men aged 60 and over. In the beginning, prostate cancer usually does not cause any symptoms, so it can only be recognized as part of an early diagnosis examination, which is recommended once a year by specialists for all men aged 40 and over. Only in the further course do complaints arise, which are often relatively unspecific and can therefore also indicate other diseases of the prostate. For example, an increased (nocturnal) urge to urinate, problems with urination, blood in urine and sperm, pain in the lower abdomen or prostate or erectile dysfunction are possible.

If the cancer has already formed daughter tumors (metastases) in the bones in advanced cases, there are often other symptoms such as severe complaints in the lower back, hip or leg pain. Exactly what exactly causes prostate cancer has not yet been clearly clarified, but certain risk factors are known that can promote the occurrence. These include, above all, age and a family disposition, in addition, connections with diet and general lifestyle (exercise, smoking, etc.) are suspected. If the cancer is detected early, the chances of a cure are usually good, which is why it is all the more important that men at the latest from the age of 45 take the cancer screening tests offered by the statutory health insurance companies.

In addition to prostate diseases, there are a number of other causes for pelvic pain in men. These include urinary tract infections, inflammation of the kidneys, an inguinal hernia or kidney stones, gastrointestinal disorders or inflammatory bowel diseases (e.g. ulcerative colitis). An intestinal obstruction (ileus) or inflammation of bulges of the intestinal wall (diverticulitis) as well as other tumors (e.g. colon cancer) or intestinal polyps are also conceivable. In addition, the complaints in the lower abdomen in men e.g. caused by an abnormal sagging of the abdominal artery (aneurysm).


Depending on the cause of the lower abdominal pain, a variety of different medications, procedures and measures can be considered for treatment. Accordingly, it is essential to take the symptoms seriously and have them clarified promptly by a doctor. This is especially true if the pain is acute and severe and is accompanied by fever and / or bleeding. In this case, the doctor or a gynecologist or urologist should be consulted immediately. In many cases, specialists for gastrointestinal disorders (gastroenterologist), neurologists or orthopedists are also a good address.

If the complaints go e.g. inflammation of the fallopian tubes and ovaries, it is particularly important to treat them as early and as possible in order to avoid complications such as Avoid adhesions and far-reaching consequences such as infertility. Accordingly, bed rest should be strictly observed in the acute stage of the disease, which is why e.g. Pregnant women (especially if there is a parallel fever, unclear diagnosis or a spreading abscess) are often recommended to be hospitalized. The therapy is primarily conservative with medication, whereby antibiotics and other anti-inflammatory painkillers (non-steroidal anti-inflammatory drugs, NSAIDs for short) such as diclofenac or ibuprofen are normally used. In addition to this, hormone preparations can be prescribed to avoid irregularities in the menstrual period.

If complications such as peritonitis or an intestinal obstruction (ileus) occur that cannot be treated with conservative measures, surgical therapy for adnexitis is necessary. In the case of recurring complaints from the organs affected, this can also be indicated in the chronic stage, for example by the uterus or ovaries are removed. Since complete healing of adnexitis can take up to three weeks, the treatment should not be stopped even after the acute symptoms have subsided, in order not to risk health risks or re-infection. In this context, sexual intercourse should also be avoided during acute inflammation, and in many cases it is also advisable to treat the patient's sexual partner in order to avoid repeated infection by the patient.

If, on the other hand, there is a benign enlargement of the prostate (benign prostatic hyperplasia), treatment is not always necessary, instead the respective symptoms determine the need for therapeutic measures. For example, various medications can be used to relieve severe prostate problems, but the cause cannot be remedied in this way. For example, Alpha receptor blockers (alfuzosin, tamsulosin etc.) or so-called “5-alpha reductase inhibitors” such as finasteride, the latter not only alleviating the symptoms, but also reducing prostate tissue.

If drug therapy is insufficient or complications such as increased susceptibility to infection, blood in the urine or bladder stones, the doctor usually recommends surgical therapy. Here, too, there are various processes, each with its own advantages and disadvantages. Therefore, those affected should always carefully inform themselves in advance and consult with the doctor treating them in order to select the individually "most suitable" method.

The standard procedure is the "transurethral resection of the prostate" (TURP), in which the prostate tissue affected is removed by means of an electrical loop and removed via the urethra. In addition to this, the “transurethral incision of the prostate” (TUIP) can be considered as a further development of conventional TURP and the “transurethral microwave therapy” (TUMT), which is also carried out via the urethra.

Alternatively, laser methods can be used to treat benign prostatic hyperplasia, in which the prostate tissue is destroyed or cut out and removed using laser beams. Here, the so-called "holmium laser enucleation" (in short: HoLEP) is considered to be an effective and sustainably successful process. With the help of laser beams, the excess prostate tissue is first completely removed step by step. It can then be crushed in the urinary bladder using a special instrument and finally aspirated through the urethra (morcellation). The procedure is endoscopic, i.e. without cutting through mirror instruments, moreover the energy of the laser closes the blood vessels so effectively that bleeding rarely occurs. Other options are interstitial and transurethral laser coagulation and vaporization, whereby the former, unlike the others, can be done on an outpatient basis under local anesthesia.

Naturopathy for pelvic pain

In addition to the possibilities of conventional medicine, depending on the cause, naturopathy also offers numerous applications for complaints in the lower abdomen. With the right homeopathic remedies, for example, mood swings and period pains can be significantly alleviated or even completely cured before or during the monthly period. The question here is e.g. Lachesis, especially if headache or migraine and associated dizziness and / or nosebleed occur before the bleeding begins. This remedy is also useful for low back pain, abdominal cramps, irritable mood as well as a feeling of being overwhelmed and restless.

If the pain starts before the bleeding and worsens again in the meantime, sepia can also be the treatment of choice. Here, too, headaches and uterine cramps often occur, in addition there is increased vaginal discharge and an increased feeling of tension in the chest. Sepia patients are also characterized by an aversion to sexual intercourse and physical proximity, increased sensitivity and irritability. In addition, Pulsatilla can be helpful if you experience headache, chest pain, or a pull in the uterus before or during bleeding. Other proven remedies for menstrual cramps are, for example, Nux vomica, Lycopodium or Magnesium phosphoricum.

Another alternative healing method for pelvic pain related to the period is aromatherapy, which targets the patient's self-healing powers. Proven remedies include chamomile, lavender, lemon balm or juniper, the essential oils of which are e.g. can be used for a gentle massage of the abdomen or as an additive for the bath water. In addition, various medicinal herbs can help to alleviate the symptoms. Here, in particular, the antispasmodic gooseberry herb comes into question, from which a cup of tea made from a teaspoon of dried herb and approx. 200 ml of hot water (drawing part about 5 minutes) is usually drunk several times a day. Other valuable "helpers" from the field of herbal medicine for menstrual cramps are lady's mantle, yarrow and mugwort as well as chaste tree, black cohosh and oregano. Ginger can also be very beneficial, as it gives warmth from the inside and has a relaxing and pain-relieving effect.

Herbal supplements (phytotherapeutic agents) are also being used increasingly in the treatment of prostate enlargement. Examples include extracts from saw palmetto, pumpkin seeds or rye pollen as well as phytosterols from pine and spruce. In many cases, the symptoms have already been improved here, but it should be borne in mind that the plants have no influence on the benign prostatic hyperplasia itself or the size of the prostate gland.

In addition to this, there are a number of other home remedies for stomach pain for complaints in the lower abdomen. In many cases, warmth is perceived as very pleasant, e.g. a hot water bottle or a cherry stone pillow is placed on the affected area. Auch Essigwickel können bei einem unwohlen Gefühl im unteren Bauch gute Dienste leisten. Für diesen wird ein Handtuch in eine Mischung aus (einem Liter) heißem Wasser und (einem Esslöffel) Essig getunkt, ausgewrungen und für etwa zwanzig Minuten auf die betroffene Stelle gelegt. Beim Reizdarm hat sich die Akupunktur bewährt. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese


  • Parswa Ansari: Akuter Bauchschmerz, MSD Manual, (Abruf 13.09.2019), MSD
  • David H. Barad: Pelvine Schmerzen, MSD Manual, (Abruf 13.09.2019), MSD
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  • James H. Liu: Endometriose, MSD Manual, (Abruf 13.09.2019), MSD
  • Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms, Langversion 5.1, 2019, AWMF Registernummer: 043/022OL, (Abruf 13.09.2019), AWMF
  • Johannes-Martin Hahn: Checkliste Innere Medizin, Thieme Verlag, 8. Auflage, 2018
  • P. Layer et al.: S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie, Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS), Deutsche Gesellschaft für Neurogastroenterologie und Motilität (DGNM), (Abruf 13.09.2019), AWMF
  • Gerald L. Andriole: Benigne Prostatahyperplasie (BPH), MSD Manual, (Abruf 13.09.2019), MSD
  • R. Phillip Heine, Geeta K. Swamy: Unterbauchschmerzen in der Frühschwangerschaft, MSD Manual, (Abruf 13.09.2019), MSD

ICD-Codes für diese Krankheit:R10.3ICD-Codes sind international gültige Verschlüsselungen für medizinische Diagnosen. You can find e.g. in doctor's letters or on disability certificates.

Video: Common Causes Of Abdomen Pain On The Left Side (July 2022).


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