Right abdominal pain and side pain (tagiliran): causes and when to go to the ER

The tagiliran is your side, from the lowest ribs to the hip. Doctors call pain here flank pain. Where it hurts gives a first clue:

• Under the right ribs: the gallbladder (apdo) or the liver.
• Lower right belly: the appendix, or in women the right ovary or tube.
• Low on the back or side, just under the ribs, on either side: a kidney (bato). This pain can spread to the groin.
• Lower left belly: often the bowel, such as constipation, gas or diverticulitis.
• Along the ribs, with a stripe of rash: shingles (kulebra).
• Sharp pain in the side of the chest when you breathe in: the lining of the lungs (pleurisy), sometimes from pneumonia.
• Worse when you twist, bend or lift: often a strained muscle.

Gas and constipation can cause cramps on either side (see our kabag guide), and a urine infection (UTI) can spread to a kidney.

Only a health worker who examines you can find the cause. For belly pain in general, see our stomach pain guide.

The appendix is a small pouch of the bowel in the lower right belly. When it gets blocked, often by hard poo or a bit of undigested food, it can swell and become infected.

The pain usually starts around the belly button, then over a few hours moves to the lower right and gets worse. It hurts more when you move, cough or press there. You may lose your appetite, feel sick, vomit or have a fever. If the pain moves to the lower right or keeps getting worse, get checked at a hospital the same day: there is no home test for appendicitis.

Children, older people and pregnant women may have milder pain, or pain elsewhere. A sudden drop in pain is not good news. If the appendix bursts, the pain may ease for a while, then severe pain spreads over the whole belly. This is an emergency. Treatment is usually an operation to remove the appendix.

Gallstones are common and often cause no trouble. Pain starts when a stone blocks the tube out of the gallbladder. It is usually severe and constant, in the upper middle belly or under the right ribs, lasts more than 30 minutes, and may come with vomiting.

If the gallbladder becomes inflamed (cholecystitis), the pain is sharp, spreads toward the right shoulder, gets worse when you breathe in deeply, and does not settle within a few hours. You may have a fever. This needs hospital care.

Watch for yellow skin or yellow whites of the eyes, dark pee and pale poo. Yellowing is harder to see on brown skin, so check the eyes.

Gallstones are more likely in women, people over 40, people with obesity or diabetes, people who eat a lot of fatty food and little fiber, and after fast weight loss. Painful gallstones are usually treated by removing the gallbladder.

Kidney stone (bato sa bato) pain starts in the side or lower back and may spread to the groin, the testicles or the vaginal area. It often comes in waves: very bad, then easier, then bad again. You may feel sick, pee often, or see pink, red or brown pee.

Small stones often pass in the pee within a few weeks, with medicine from a doctor for the pain. Larger stones may need shock waves to break them up, or a thin tube to remove them.

Kidney infection usually brings pain in the back or side with a high fever, chills or shivering, often with burning when you pee and cloudy or dark pee. It needs antibiotics from a doctor. Without treatment it can lead to sepsis, a life-threatening reaction to infection. A stone with fever is especially urgent, because a blocked, infected kidney needs care fast.

You have a kidney on each side, so stones and kidney infections can cause pain on the left too. Other causes:

• Constipation and gas, with cramps that ease after you poo or pass gas.
• Diverticulitis, an inflamed pouch in the bowel wall, with severe, constant pain that may come with fever. In Western countries it is usually on the left, but Asian studies find it mostly on the right, close to the appendix.
• Pancreatitis, a swollen pancreas, with sudden severe upper belly pain spreading to the back. Gallstones and heavy drinking are the most common causes. It needs a hospital.
• Shingles, pleurisy and muscle strain, on either side.

There is no home treatment for severe pain. If the pain is strong, keeps getting worse, or comes with a danger sign, go to the emergency room. Painkillers may ease the pain but do not treat the cause, so never let them delay a check-up.

For mild pain without danger signs, such as a sore muscle after lifting:

• Keep moving gently, and use a warm compress wrapped in a towel.
• Ask a pharmacist which painkiller suits you, and follow the label.
• Drink enough water, and don't hold your pee in.

Avoid:

• Ibuprofen, mefenamic acid and similar painkillers if you have a fever, a possible kidney infection or kidney disease, unless a doctor says so. They are also unsafe if the fever could be dengue.
• Leftover antibiotics, or antibiotics without a prescription.
• Giving painkillers to children, or taking them while pregnant, before asking a doctor.

Not sure how urgent it is? Ask Joy, our free AI symptom guide, or ask a nurse.

"Bawal ang buto ng bayabas." Doctors don't ask people to avoid guava or its seeds to prevent appendicitis. The appendix is most often blocked by hard poo, and fruit and vegetables with fiber help keep poo soft.

"Lamig o pasma lang 'yan." A sore muscle can ease with warmth, but fever, burning pee, vomiting or pain in waves need a check-up.

"Delikado kapag nagdugtong ang kulebra." Shingles comes from the chickenpox virus, and its rash stays on one side of the body. Still, see a doctor early: antiviral medicine works best within 3 days of the rash appearing.

"Ipahilot na lang." Gentle massage may ease a stiff muscle, but it can't remove a stone or cure an infection. A side that hurts more when pressed needs a doctor first.

Buko juice counts as fluid, but it should never delay a check-up for severe pain, fever or blood in your pee.

• Drink plenty of water. The NHS advises adults to drink about 2.5 to 3 litres a day, unless a doctor has told you to limit fluids. Outdoor workers and drivers in the Philippine heat may need more. Dark pee means drink more.
• Add fresh lemon juice to water, as the NHS suggests. Calamansi juice in water is a harmless local option.
• Cut down on salt: tuyo, daing, bagoong, instant noodles and salty snacks.
• Limit soft drinks, coffee and alcohol.
• Get enough calcium from food, and don't make big diet changes without your doctor.

If you are pregnant or could be pregnant, side pain needs a doctor quickly. A pregnancy outside the womb (ectopic pregnancy) usually shows in weeks 4 to 12, with pain low on one side, vaginal bleeding, or pain in the tip of the shoulder. Get checked even if your test was negative. A possible kidney infection in pregnancy also needs same-day care. See early signs of pregnancy. Women can also get one-sided pain from a burst ovarian cyst or a pelvic infection.

Children can get appendicitis and kidney infections, sometimes with only a fever. Take any child with severe or worsening pain to a hospital.

Boys and men: sudden, severe testicle pain, or testicle pain with belly pain or vomiting, can mean a twisted testicle. Go to the emergency room straight away.

The doctor will examine your belly and back. You may need a urine test, blood tests, a pregnancy test, an ultrasound or a CT scan.

Where to go: for mild pain that is not getting worse, start at your health center, RHU or YAKAP clinic. For severe pain or a danger sign, go to the nearest hospital emergency room. Find care near you.

YAKAP: PhilHealth's July 2025 FAQ says check-ups and the listed lab tests your doctor orders are free at your registered YAKAP clinic (a private YAKAP clinic may charge up to ₱900 a year). Prescribed medicines on the GAMOT list are free at accredited pharmacies, up to ₱20,000 a year. Read our PhilHealth YAKAP guide.

Emergency room: PhilHealth's Outpatient Emergency Care Benefit pays for ER care at an accredited hospital when you are treated and sent home within 24 hours, for belly pain and other emergencies. It should be taken off your bill at the ER. If you are not registered with PhilHealth yet, the hospital can register you. If you are admitted or need an operation, the hospital case rate applies instead. By law, a hospital must not ask for a deposit before giving emergency care.

Hospital care: as of November 2026, the newest PhilHealth case rates we found (Circular 2024-0037) are:

• appendix removal: ₱46,800
• gallbladder removal, keyhole or open: ₱60,450
• shock-wave treatment for a kidney stone: ₱35,100

In a basic or ward bed, PhilHealth's no co-payment policy says you should not have to pay extra for covered care. Ask the hospital's PhilHealth desk what is left to pay; in a public hospital, a Malasakit Center can help. More in what PhilHealth covers and our stomach and digestion guides.