Penn Medicine Princeton Health: A Guide to Abdominal Pain


Whether from eating a big meal or catching a stomach bug, almost everyone experiences some sort of abdominal pain every now and then. But how do you know if abdominal pain is indigestion from last night’s dinner or something more serious? Its location often offers one of the first clues to its cause:

Lower Right Quadrant
Sudden pain that occurs in the lower right side of your abdomen and gets progressively worse over a period of 12 to 48 hours is highly suspicious of appendicitis. It is characterized by inflammation of the appendix caused by a blockage inside the organ. Though it tends to affect males in their teens and twenties, it can happen to anyone (Editor’s note: such as Bon Jovi drummer Tico Torres when he was 59).

If left untreated, appendicitis can cause the appendix to burst and spread at fatal infection into the abdomen, which is why appendicitis is a medical emergency.
Treatment almost always requires surgical removal.

Upper Right Quadrant
Pain in the upper right abdominal side that often occurs at night and worsens after eating could be a sign that gallstones are blocking your gall bladder’s bile ducts.

Gallstones are, pebble-like pieces, usually made of cholesterol or bilirubin, that form in your gall bladder. About a quarter of the nearly 1 million people diagnosed with gallstones each year will need to be treated, usually with surgery.

Women, especially women in their 30s and 40s, are more likely to develop gallstones than men. Gallstones also tend to run in families.

Lower Left Quadrant
Pain in the lower left quadrant of your abdomen, particularly if you’re an older adult, may be associated with diverticulitis, the inflammation of small pouches that often develop in the colon. These pouches are common in older people and typically don’t cause any symptoms.

Mild diverticulitis will resolve on its own, but if it is more severe, antibiotics may be necessary. Patients who suffer recurrent bouts of diverticulitis may require surgery to remove the troublesome pouches.

Uppper Left Quadrant
While an occasional episode of pain in the left upper abdomen or below the breastbone is usually heartburn (acid reflux), it could signal gastroesophageal reflux disorder (GERD) if such episodes occur regularly.

GERD affects about 20 percent of the U.S. population, according to the NIH, and can lead to more serious health problems over time. While anyone can develop GERD, you are more likely to have it if you are overweight, obese, pregnant, taking certain medications, or a smoker.

By Dr. Tomer Davidov, F.A.C.S. You can learn more about abdominal health at the Princeton Fitness & Wellness Center, 1225 State Road, Princeton on Friday, July 19 from 1-2PM. Visit or call 888.897.8979. Admission is free.

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