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In young children it is often quite difficult for them to show exactly where the pain is. If this is the case, the list of possible causes widens to almost any cause of tummy (abdominal) ache.

At a glance

  • Right lower quadrant pain is pain in the lower right side of the tummy.

  • Appendicitis is a serious possible cause of sudden right lower quadrant pain.

  • Other causes of sudden pain include gastroenteritis and urinary tract infection.

  • Gradual or recurring pain can be caused by constipation or irritable bowel syndrome.

  • In children, common causes are constipation, gastroenteritis, and mesenteric adenitis.

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המשך לקרוא למטה

What is right lower quadrant pain?

Pain in the tummy (abdomen) is a common problem in children. The right side of the lower part of the tummy (below the tummy button) is called the right lower quadrant of the abdomen. The main issue when pain is in this area is whether or not the diagnosis is acute appendicitis, but there are many other possible causes.

When pain comes on suddenly it is called 'acute'. Acute right lower quadrant pain may be caused by (see links for further details):

When pain comes on more gradually and is more persistent (chronic) or comes and goes (recurrent), the possible causes of right lower quadrant pain include:

In children common causes of right lower quadrant (RLQ) pain include:

עצירות

  • Very common in children.

  • Means passing hard stools (faeces), with difficulty, less often than normal.

  • May cause RLQ pain but more commonly causes pain on the left, over the last part of the colon (descending colon).

See separate leaflet called Constipation in Children for more information.

גסטרואנטריטיס והרעלת מזון

  • Cause diarrhoea.

  • May also cause the child to be sick (vomit) and have crampy tummy (abdominal) pains.

  • Pain may be anywhere in the tummy.

  • Pain may ease for a while each time some diarrhoea is passed.

See separate leaflets called Gastroenteritis in Children ו Food Poisoning in Children for more information.

אי סבילות ללקטוז

  • Leads to bloating, tummy pain, wind and watery stools after drinking milk.

  • Lactose intolerance can sometimes occur for a while after gastroenteritis. The condition gets better when the infection is over and the gut lining heals.

  • Some people are born with a tendency to develop it.

See separate leaflet called Lactose Intolerance for more information.

דלקת בלוטות הלימפה המזנטריות

  • In children with infections such as colds, glands within the tummy commonly become inflamed giving them tummy ache.

  • לילד עשויים להיות תסמינים נוספים של הצטננות, כמו נזלת או כאב גרון.

See separate leaflet called Mesenteric Adenitis for more information.

Appendicitis

  • In older children, symptoms will be similar to those in adults (see separate leaflet on right lower quadrant pain).

  • Babies may get watery diarrhoea and vomiting.

  • Preschool children may just have vague tummy pains and go off their food.

See separate leaflet called Appendicitis for more information.

תסביב האשך

  • Occurs when a testicle (testis) twists around in the scrotum.

  • זה מתרחש אצל בנים וגברים צעירים, בדרך כלל נערים מתבגרים.

  • זה לא רגיל מעל גיל 25 שנים.

  • Severe pain that develops quickly.

  • זה יכול להשפיע על כל צד.

See separate leaflet called Torsion of the Testis for more information.

מחלת צליאק

  • Coeliac disease is caused by a reaction of the gut to gluten. Gluten is found in many foods.

  • It can cause poor growth

  • הצואה עשויה להיות בהירה, מסריחה וקשה להורדה באסלה.

  • כאב לא תמיד מופיע אבל יכול להיות בכל מקום בבטן. הוא נוטה לבוא וללכת.

See separate leaflet called Coeliac Disease for more information.

שאלות נפוצות

Can common childhood illnesses cause right lower quadrant pain?

Yes, infections like colds can lead to glands in the tummy becoming inflamed, causing stomach ache, a condition known as mesenteric adenitis. The child might also have other cold symptoms like a runny nose or a sore throat.

If my child has right lower quadrant pain, does that mean they definitely have appendicitis?

While acute appendicitis is a significant concern when there is pain in the right lower quadrant, it is not the only cause. Many other common conditions can cause similar pain, such as gastroenteritis, urinary tract infection, or even constipation.

My child often gets an upset stomach after drinking milk. Could this be related to right lower quadrant pain?

Yes, if your child experiences bloating, tummy pain, wind, and watery stools after drinking milk, they might have lactose intolerance. This can sometimes happen temporarily after gastroenteritis or some children are born with a tendency to develop it.

What kind of pain might indicate a more serious condition like a twisted testicle in boys?

A twisted testicle (torsion of the testicle) causes severe pain that develops quickly. It typically affects boys and young men, especially teenagers, and can occur on either side.

Can constipation cause pain in the right lower quadrant?

Constipation, which means passing hard stools with difficulty and less often than normal, can indeed cause pain in the right lower quadrant. However, it more commonly causes pain on the left side, over the last part of the colon.

קריאה נוספת והפניות

  • Reust CE, Williams A; Acute Abdominal Pain in Children. Am Fam Physician. 2016 May 15;93(10):830-6.
  • Appendicitis; NICE CKS, May 2021 (UK access only)
  • Desoky SM, George M, Epelman M, et al; Imaging of Right Lower Quadrant Pain in Children and Adolescents: AJR Expert Panel Narrative Review. AJR Am J Roentgenol. 2023 Jun;220(6):767-779. doi: 10.2214/AJR.22.28358. Epub 2022 Nov 23.

המשך לקרוא למטה

About the authorView full bio

Author image

Dr Colin Tidy, MRCGP

General Practitioner, Medical Author

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.

About the reviewerView full bio

Author image

Dr Hayley Willacy, FRCGP

General Practitioner, Medical Author

MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)

Dr Hayley Willacy was an NHS GP working in northwest England, who retired from clinical practice in 2022 after 30 years. 

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