Can gastric sleeve surgery cause chronic intermittent right lower quadrant (RLQ) pain?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 18, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Gastric sleeve surgery can potentially cause chronic intermittent right lower quadrant (RLQ) pain, though it's not among the most common complications. This pain could result from several post-surgical issues including adhesions (scar tissue that forms between abdominal tissues and organs), altered gut motility, gallstone formation (due to rapid weight loss), or referred pain from the surgical site 1. Some patients may experience intermittent RLQ pain due to changes in how food moves through the digestive tract after the stomach's size is reduced.

Possible Causes of RLQ Pain

  • Adhesions: Scar tissue that forms between abdominal tissues and organs
  • Altered gut motility: Changes in how food moves through the digestive tract
  • Gallstone formation: Due to rapid weight loss
  • Referred pain: Pain from the surgical site that is felt in the RLQ area

If you're experiencing persistent RLQ pain after gastric sleeve surgery, it's essential to consult with your bariatric surgeon or gastroenterologist promptly, as it could indicate complications requiring medical attention 1. Diagnostic tests such as ultrasound, CT scan, or endoscopy may be needed to determine the exact cause. Treatment depends on the underlying cause and might include pain management, dietary modifications, medications for specific conditions like gallstones, or in some cases, additional surgical intervention. The connection between the surgery and RLQ pain exists because gastric sleeve fundamentally alters digestive anatomy and function, which can create new pain patterns that weren't present before surgery.

From the Research

Gastric Sleeve Surgery and Chronic Intermittent Right Lower Quadrant (RLQ) Pain

  • There is no direct evidence in the provided studies to suggest that gastric sleeve surgery can cause chronic intermittent right lower quadrant (RLQ) pain 2, 3, 4, 5, 6.
  • The studies primarily focus on the diagnosis and management of RLQ pain, discussing various causes such as appendicitis, inflammatory and infectious conditions, diverticulitis, malignancies, and conditions affecting the epiploic appendages, omentum, and mesentery 2, 4, 6.
  • Some studies explore the use of laparoscopy and imaging modalities like CT and MRI in evaluating patients with RLQ pain, highlighting the importance of these tools in determining the underlying cause of the pain 2, 3, 5, 6.
  • While the provided studies do not directly address the relationship between gastric sleeve surgery and chronic intermittent RLQ pain, they do emphasize the complexity and variability of causes for RLQ pain, suggesting that a thorough diagnostic approach is necessary to identify the underlying cause of such pain 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Chronic right lower quadrant abdominal pain: laparoscopic approach.

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005

Research

Beyond appendicitis: common and uncommon gastrointestinal causes of right lower quadrant abdominal pain at multidetector CT.

Radiographics : a review publication of the Radiological Society of North America, Inc, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.