The causes of pain in the right hypochondrium are not always obvious. Most often, a survey is required, in which all probable factors will be methodically excluded. This is explained by the fact that all organs inside are closely interconnected, therefore, the causes of pain in the right hypochondrium may have different factors and etiology.
Sometimes they occur in quite healthy people. Such people usually complain of discomfort in the right hypochondrium when it occurs after a heavy meal or during physical exertion. This soreness is categorized as “healthy” pain that does not require treatment. The liver fills with blood when adrenaline rushes, so it has to react with stabbing pain in the right area. Usually, this condition goes away quickly, as soon as breathing is restored or the stomach is slightly empty.
Pain in the right hypochondrium occurs in women during pregnancy and menstruation. During pregnancy, the belly grows, over time it begins to put pressure on the intestines. The latter reflexively compresses the internal organs in the form of the liver, gallbladder, and pancreas. During menstruation, the hormonal balance changes, the necessary balance is disturbed, which provokes spasms of the biliary tract.
The causes of pain in the right hypochondrium can be felt in the back or in the front. The primary diagnosis of the alleged disease depends on this. Soreness in the hypochondrium is most often characteristic of liver damage. With any liver disease, the causes of pain are that the organ is full-blooded and has its own capsule. This capsule has its own pain receptors. But they react only at the moment when the liver begins to stretch this capsule.
Next to the liver is another organ that tends to be more aggressive. The causes of pain in the right hypochondrium are often attributed to gall bladder... Its functionality depends on the usefulness of the liver, but it is capable of having independent diseases. Chronic inflammation can produce sharp, cutting pains. Pain in the right section may be twitching and accompanied by bitterness in the mouth, especially in the morning.
Hepatitis can cause pain in the right hypochondrium. There may be a feeling of chewing, heaviness, discomfort. Hepatitis is accompanied by yellowness of the skin, weight loss. The degree can be different, its presence is an optional condition. The disease can proceed latently, without expressive symptoms and manifest itself only at the last stage.
Intestine as a provocateur of pain in the right hypochondrium
The colon along its entire length can give acute pains, especially in the presence of such a phenomenon as flatulence. Very often, the reasons are assigned primarily to the intestines. It looks like a wide belt that borders both hypochondria. As long as the focus of inflammation / irritation is in the intestine itself, the pain can be comparable to moderate, tolerable. The process changes and they become as aggressive as possible when the peritoneum is involved.
Most often, the presence of pain in the right hypochondrium indirectly indicates the presence of such diseases:
- colitis of various etiology. They give spasms, pains, imitation of gynecological diseases;
- Crohn's disease. It is accompanied by severe pain, ulcerative lesions of the intestine;
- intestinal obstruction, fecal obstruction. The pains are sharp, spastic;
- acute appendicitis. It starts in the epigastric region, turns into severe pain in the right section.
All of these diseases are pronounced and require the obligatory intervention of specialists.
If the sensations in the “front” part of the department are more and more clear, then when the patient complains about the right side of the back in the hypochondrium, everything can be more complicated. Several organs are capable of creating such signs, it is important to determine the causes of such a pathology in time.
Most often, the right kidney gives such soreness in the right hypochondrium. There are several possible kidney-related diseases that can cause discomfort and soreness:
- urolithiasis disease;
- pyelonephritis in the acute stage;
- necrosis of the nipple of the kidney;
- kidney cancer.
Kidney syndrome almost always has a main symptom: a high fever. Therefore, in the presence of fever, nausea, severe spasm on the right side of the back, it is necessary to call an "emergency".
There is also the adrenal gland above the kidney, whose functions are also important for health. In the presence of large tumors, the adrenal gland can cause pain and provoke dysfunction of the entire hormonal background.
Neuralgia and osteochondrosis
Often soreness in the hypochondria occurs with exacerbation of neuralgia. It is not so easy to diagnose neuralgia, it is skillfully disguised as many diseases. Neuralgia can manifest itself as pain in the hypochondrium, radiating to any part of the spine. Usually it is persistent, lasts for weeks, and it is difficult to completely stop it.
Osteochondrosis, no less often than neuralgia, gives persistent and aggressive pain in the right section. This occurs more often with an exacerbation of thoracic or lumbar osteochondrosis. Soreness can be felt in the back and hypochondrium at the same time. Often exacerbation of osteochondrosis is combined with neuralgia. The syndrome of pains of varying strength, there is a significant restriction in the performance of movements. With osteochondrosis, the character can change from aching to aggressive, shooting and breaking.
Other causes of pain in the right hypochondrium
With bruises, blows in the ribs, persistent pain appears. It should be alerted if it intensifies in the hypochondrium with inhalation or attempts to sneeze. Also, an unnatural crunch when trying to sit down or bend over.
More rare causes are associated with vena cava thrombosis. This happens if a blood clot breaks off and blocks either the hepatic vein or the main vein. There may be pain radiating to the lower back or to the back of the hypochondrium. In another case, the pains appear more extensive and respond in the scapular region.
The appearance of dull pain often indicates an exacerbation of the chronic form of a disease. Usually chronic forms are sluggish, sometimes almost latent. But if the liver is involved in the process, do not expect pungency. By default, the liver cannot hurt at all. This organ may not fully manifest itself in any other way than with minor signs.
If the pain is persistent, it is worth suspecting the presence of tumors or serious pathologies. Under stress, it can pass if there is a partial blockage of the bile ducts. Soreness in the right hypochondrium will become acute:
- with peritonitis;
- renal colic;
- intestinal obstruction;
- intestinal vascular thrombosis.
Contacting a specialist should not be postponed when acute pain occurs, especially in combination with fever. It so happens that the delay in calling a team of doctors is fatal. The reasons may be different for the birth of pain, but recovery and return to a full-blooded life will depend only on the timeliness of assistance.
Other causes of pain in the right hypochondrium
If you are worried about intense pain in the right hypochondrium, you should immediately consult a doctor or call ambulance... In no case should you use warm compresses. You can attach ice wrapped in a cloth. It is forbidden to use pain medications, as they can make it difficult to diagnose the disease. If the discomfort has subsided, it is recommended to visit a gastroenterologist in the near future and undergo an examination of the gastrointestinal tract. Medkrugozor.ru
Painful sensations are a signal for the body about the occurrence of a pathological condition, illness or injury. For a person, pain has a protective function, since it indicates the need for treatment in time.
Causes of pain in the right hypochondrium
Anatomically, the upper right quadrant of the abdomen includes: the liver, gallbladder, part of the diaphragm and small intestine, duodenum, right kidney, pancreas.
Diseases and injuries of these organs can intensify the onset of pain in the right side under the ribs:
Violation of the patency of the biliary tract (cholecystitis). A sharp, sharp pain that suddenly began, especially at night, is formed when the patency of the biliary tract is impaired and in acute. In the case of an increase in the tone of the gallbladder, its tendency to contract increases, and the frequency and strength of its contractions also increases. Such processes are accompanied by sharp and short-term pain and are often provoked by nervous overstrain and stress.
Pain syndrome in acute cholecystitis caused by the ingress of stones from the gallbladder into its excretory duct. Gallstone syndrome forms stagnation of bile and inflammation of the bladder. Such biliary colic is characterized by severe pain in the right rib area, which is felt in the same hand, hyperthermia, and nausea.
Ulcerative duodenitis duodenum. Stitching pain primarily indicates ulcerative duodenitis of the duodenum. The main reason for this pathology is the activity of the bacteria Helicobacter Pylori, which destroys the intestinal mucosa. Stitching and even "dagger" pain occurs mainly at night, its intensity decreases after food enters the digestive system. General symptoms are also observed: hyperthermia, bloating, nausea, a feeling of heaviness in the abdomen, general malaise.
Renal colic. Patients complain of stabbing pain in the kidney. In this case, the pain becomes unbearable and does not change with a change in body position. The pain is caused by the presence of stones in the urinary system, which with sharp edges damage the mucous membrane of the urinary system and cause congestion.
Pancreatitis Pulsating pain is indicative of. The exact cause of pancreatic inflammation has not been established. Pathology begins with throbbing, intense, girdle pain. If these symptoms occur, the patient needs immediate hospitalization and emergency surgical treatment... Pronounced pain in the right square of the abdomen is observed during the transition from acute to chronic pancreatitis and is amenable to conservative treatment.
Aching pain in the right side indicates liver disease:
Aching pain is triggered by liver disease. The overwhelming majority of people with liver diseases go to doctors with the appearance of severe pain, although it is preceded by a slight intensity of aching pain. Each type of viral, to one degree or another, proceeds with a feeling of aching pain. The long period of development of viral hepatitis is asymptomatic. The severity of symptoms depends on the activity of the pathogen virus. ( General manifestations of the disease: chronic fatigue, decreased performance, systemic disorders with hyperthermia. Local symptoms are a feeling of heaviness and aching pain in the liver, the skin acquires a yellow tint, and a change in the transparency of urine. An accurate diagnosis is established only by laboratory analysis for markers of hepatitis.)
Aching pain can also signal cirrhosis of the liver. Unfortunately, pain in this pathology appears already in the last stages of the disease. In the early stages, there is no pain, although the liver develops inflammatory process... Subsequently, it leads to the death of a significant number of hepatocytes. In the liver, instead of dead cells, connective tissue is formed. The body can no longer fulfill its functions. At this time, aching pain occurs in the right abdomen under the ribs.
Aching pain can also be one of the signs of liver cancer. With a slight pain syndrome in combination with weight loss, chronic fatigue, low-grade fever, an increase in organ size, it is necessary to consult an oncologist surgeon.
Inflammatory processes.
Dull pain is characteristic of frequently occurring inflammatory processes in the right hypochondrium:
Chronic cholecystitis. This is an inflammation of the gallbladder, which proceeds slowly and gradually and passes against the background of gallstone disease. The disease arises from damage to the inner wall of the bladder stones. As a result, the wall thickens and becomes covered with ulcers, which scar over time. Such changes lead to stagnation and deterioration of the outflow of bile. A person with chronic cholecystitis feels mild pain on the right side of the abdomen, vomiting, and bloating. Pain symptoms are especially aggravated after malnutrition, especially fats.
Chronic pancreatitis. Chronic inflammation of the pancreas may result from untreated acute pancreatitis or gallstone disease. With the course of the disease, irreversible changes take place in the organ in the form of replacement of the organ parenchyma with connective tissue. Such processes disrupt the main functions of the gland, including the production of digestive enzymes and the hormone insulin, which lowers blood sugar levels. Patients suffer from dull pain that occurs under the ribs on the right and left sides after eating, a feeling of bloating and heaviness in the abdomen, symptoms, nausea and vomiting.
Chronic pyelonephritis. This is an inflammatory process in the renal calyx-pelvis system. Pain in chronic unilateral pyelonephritis is often felt on the opposite side of the diseased kidney. The pain increases after exercise. In patients with no apparent reason, the body temperature rises, urination becomes more frequent, and rises. Also, patients note chronic fatigue, deterioration in working capacity.
Chronic hepatitis. Half of the cases of acute hepatitis that have not been fully treated become chronic. The symptomatology of this disease is very individual and depends on the state of the functional state of the body and the causes of gastritis. The presence in the patient of aching and pulling pain in the right abdomen under the ribs, attacks of nausea and vomiting, impaired appetite, intolerance to fats and alcohol may indicate chronic hepatitis. Physical examination shows a moderate increase in the size of the liver, palpation of which causes a dull pain.
Chronic duodenitis. Inflammation of the duodenal mucosa provokes dull pain in the right and upper abdomen, nausea and vomiting with bile, decreased appetite, heartburn and frequent diarrhea. Duodenitis is anatomically interconnected with the pancreas and bile glands, so it often proceeds in parallel with the inflammatory processes in these glands.
Gynecological aspects of pain in the right hypochondrium
- diseases internal organs;
- injuries;
- diseases of the musculoskeletal system;
- neurological diseases.
- localized in the right hypochondrium;
- are at first paroxysmal, and then permanent;
- at the peak, inflammation intensifies with any action that increases intra-abdominal pressure - coughing, sneezing, straining, and even breathing.
- upset stool;
- an admixture of mucus and / or blood in feces;
- bloating;
- anorexia;
- progressive drop in body weight;
- nausea and vomiting.
- ovarian apoplexy;
- torsion of the legs of the ovarian tumor;
- salpingo-oophoritis.
- bleeding;
- pelvioperitonitis;
- etc.
- Diet therapy:
- refusal from fatty, fried, spicy - with diseases of the gallbladder;
- exclusion of coarse fiber, spices - for bowel diseases;
- complete hunger for several days - with acute pancreatitis;
- Drug treatment:
- for inflammation in any area - antibiotics;
- for oncological diseases - radiation, chemotherapy and radiotherapy;
- with shingles - antiviral drugs, the only effective in this pathology;
- antispasmodics and analgesics - just as an element of complex treatment;
- Surgical intervention is an extreme and sometimes the only effective measure to combat pathology:
- appendicitis;
- torsion of the legs of the ovarian tumor;
- his apoplexy;
- ectopic pregnancy;
- gallstone disease;
- some forms of Crohn's disease;
- tumors of the Vater nipple.
- liver;
- right lung;
- several sections of the large and small intestine;
- one of the areas of the diaphragm;
- adrenal gland and kidney;
- gallbladder and bile ducts.
- heart and lungs;
- pancreas;
- intercostal muscles;
- nerves extending from the spinal cord.
- acute form or exacerbation of chronic cholecystitis. In this case, the pain syndrome is caused by the formation of calculi in the gallbladder or its ducts, since they injure and expand the affected organ;
- duodenal ulcer or stomach - in such cases, they speak of stabbing pain in the right hypochondrium;
- renal colic- the appearance of pain is caused by the same reasons as cholecystitis;
- pancreatitis - characterized by the expression of throbbing pain in the right ribs;
- acute form of appendicitis;
- chronic course of pyelonephritis, hepatitis and duodenitis;
- liver disease - characterized by the expression of dull aching pain. Among such ailments, hepatitis, cirrhosis, fatty hepatosis and oncology of this organ are most often distinguished;
- fracture of the ribs.
- excessive physical exertion - this often applies to people who are not accustomed to sports, but because of any situation are forced to perform intense physical activity;
- the period of bearing a child - the severity and pain in the right hypochondrium during pregnancy is quite normal for women, especially in the third trimester. This is due to the active intrauterine growth of the baby, which squeezes and leads to the displacement of some internal organs. However, if a similar symptom manifests itself in the first months of waiting for the baby, then it may indicate an ectopic pregnancy;
- a change in hormonal levels in premenstrual syndrome - during this period, the body produces a lot of such a sex hormone as estrogen in the fairer sex. Under its influence, spasm of the bile ducts occurs.
- above - pain syndrome may indicate a lesion of the diaphragm, which is at the level of the fifth rib;
- in the lower part - this is the zone of the edge of the edge of the ribs, which often signals acute appendicitis;
- behind - is a sign of the development or course of a pathological process in the kidneys or pancreas;
- in front - often a sign of one or another disease of the stomach and duodenum, lungs or liver, gallbladder and ducts.
- bursting pain in the right hypochondrium - observed with cholecystitis, cirrhosis and other liver diseases;
- acute pain in the right hypochondrium - characterizes ulcerative lesions of the duodenum or stomach;
- sharp pain under the right ribs - often the appearance of pancreatitis and has a shingles in nature;
- dull and pulling pain in the right hypochondrium - in most cases it indicates an exacerbation of any chronic pathological process, and is also often part of the clinical picture characteristic of benign and malignant neoplasms of the liver;
- pressing pain that intensifies when inhaling, as well as during coughing or sneezing, is very often a manifestation of pneumonia and often spreads to the entire right side.
- attacks of nausea, which quite often end in vomiting. In this case, vomiting does not bring relief to the patient's condition;
- an increase in body temperature indicators;
- yellowness of the skin, as well as the mucous membranes of the oral cavity;
- severe weakness and rapid fatigability;
- an increase in the size of the abdomen;
- frequent urge to urinate;
- stool disorder - alternation of constipation and diarrhea or the predominance of one of these signs;
- severity and discomfort in the projection of the affected organ;
- irradiation of pain in the right hand, shoulder blade or lower back;
- fetid odor from the mouth;
- persistent heartburn;
- cardiopalmus;
- difficulty breathing;
- cough;
- bleeding of mucous membranes;
- belching with an unpleasant sour smell;
- bitterness in the mouth;
- signs of acute intoxication of the body;
- right-sided appearance of herpes;
- burning sensation in the right hypochondrium.
- general clinical and biochemical examination of blood and urine;
- determination of the level of liver function tests;
- coprogram;
- endoscopic procedures and biopsy;
- CT and MRI;
- radiography with or without contrast medium;
- determination of chorionic gonadotropin in case of suspected ectopic pregnancy.
- acute and unbearable pain, the attack of which lasts a very long time;
- loss of consciousness;
- persistent vomiting;
- uterine hemorrhage;
- the presence of blood in urine, vomit and feces;
- high fever;
- a stool disorder that lasts several days in a row.
Ectopic pregnancy. Normally, a fertilized egg moves into the uterine cavity for attachment and development. If this process is violated and the egg is fixed in another place, an ectopic pregnancy occurs. Gynecological symptoms: absence of menstruation in combination with bloody discharge. This pathology is accompanied by a pain syndrome in the form of pulling pains in the right or left abdomen, depending on the place of attachment of the egg. Pain arises from overstretching, and sometimes rupture of the fallopian tube. You should immediately go to the hospital for hospitalization and termination of pregnancy.
On the second day, red edematous spots appear, in the place of which bubbles with a transparent liquid form on the 3-4th day. At this time, regional lymph nodes also increase, and the pain syndrome becomes more intense. As a result of the disease, the bubbles burst, in their place are areas of persistent pigmentation. After recovery, some patients may experience postherpetic neuralgia with pain in the hypochondrium, which is difficult to treat.
Children's helminthiasis, accompanied by pain in the right hypochondrium
This phase is characterized by an appetite disorder, nausea, bloating, diarrhea and constipation. Neurological symptoms include hyperexcitability, intellectual impairment, and the development of asthenic symptoms. In rare cases, there is a possibility of ascaris penetration from the intestine through the bile ducts into the liver and gallbladder. Under such circumstances, the child may experience severe pain, as with an attack of acute cholecystitis, gallstone disease, hepatitis.
In conclusion, I would like to note that when the pain described above appears, it is necessary to urgently consult a doctor. This will allow you to avoid the development of severe pathologies and timely carry out complex treatment of the disease.
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N.I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
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In the right side, pain appears as a symptom of a problem in the body. Depending on the affected organ, the patient may feel pain in the right hypochondrium or pain in the right side of the lower abdomen, in the very side, in the lateral part of the back. Pain syndrome can spread far beyond the site of maximum pain and give in one direction or another. In any case, the location and nature of the pain gives a lot of information about the pathology that provoked it.
Table of contents: We recommend reading:Pain in the right hypochondrium
In this place, pain can occur due to:
Diseases of the internal organs as a possible cause of pain in the right side
Among diseases of internal organs, the most severe pain sensations are caused by the pathology of the gallbladder. Acute and chronic, and its complication - , , tumors of the nipple of Vater and acute pancreatitis - with all these diseases, pain is localized in the right hypochondrium.
In acute cholecystitis, along with this symptom, an increase in temperature is noted, bitter, nausea with bouts of vomiting appears, which does not improve the patient's well-being. Contrary to popular belief, jaundice is not typical for this disease.
Chronic cholecystitis does not manifest itself in any way without exacerbation. Having become aggravated, in terms of symptoms in general and in the nature of pain in particular, it is very reminiscent of acute inflammation:
Pain in the right hypochondrium with gallstone disease does not occur so often. Stones in the gallbladder may not manifest themselves for years. Very often they are discovered by accident during a routine ultrasound examination or examination of a patient for other diseases.
But everything changes if the stone blocks the exit from the gallbladder.
At this moment, there are intense paroxysmal pains under the right costal arch of a cutting, stabbing, tearing character. Often they are given to the lower back, under the right shoulder blade, to the arm, and sometimes to the region of the heart. A person at the peak of an attack of biliary colic agrees to do anything to get rid of the pains, they are so strong.
Simultaneously with painful sensations, nausea with repeated vomiting occurs, the patient rushes about in bed, since the pain does not subside in any position.
Tumors of the Vater's nipple, the places where the bile ducts exit into the duodenum, appear in a similar way. By itself, the neoplasm does not cause pain. However, if it is present, cholangitis inevitably occurs - an inflammation of the biliary tract, in which pain is localized in the left hypochondrium. Along with them, the patient has a fever, chills, severe jaundice.
With dyskinesia of the biliary tract, the nature of the pain in the right side is quite varied and depends on the type of its course.
With hyperkinetic type of dyskinesia, pain in the liver region is acute, sharp, paroxysmal. In the hypokinetic type, on the contrary - constant, dull, aching, sometimes completely absent. Dyskinesia of the type of biliary colic is also possible, in which the pain is high-intensity, unbearable, arises suddenly and is accompanied by interruptions in the heart, a feeling of fear. In the latter case, sometimes doctors can make a mistake in the diagnosis and make an incorrect preliminary diagnosis of myocardial infarction. However, the data of laboratory tests and the decoding of the ECG can exclude cardiac pathology.
Pain in acute pancreatitis is more often localized in the upper abdomen and is of a girdle nature, covering both sides and even the back.
This surgical pathology occurs most often against the background of the abuse of strong alcohol, which is accompanied by an abundant intake of fatty, spicy, fried foods. If left untreated, the disease can be quickly fatal.
Pain in the right side as a result of trauma
A bruised or broken rib can also cause pain in the upper abdomen or pain in the right side under the ribs. Their strengthening is noted during breathing, body movements, coughing, sneezing. In the first hours after the injury, the pain is diffuse in the area of impact, but after a few hours it is precisely localized at the site of injury. The use of X-ray allows detecting a fracture of the ribs, and ultrasound of the internal organs makes it possible to separate the injury from the pathology of the liver or gallbladder.
Shingles as a Possible Cause of Right Side Pain
Caused by the herpes virus, this pathology is very similar to acute pancreatitis in its symptoms. At the onset of the disease, severe pains are noted in the left and less often in the right half of the abdomen, acute, sharp, permanent. The appearance of nausea and even vomiting characteristic of pancreatitis is possible. This symptom complex can mislead even experienced doctors who begin to treat inflammation of the pancreas. Fortunately, after a few days, characteristic vesicular rashes in the form of a ribbon appear on the abdomen (this is why the disease is called "shingles"). From this moment, the diagnosis becomes obvious and the patient is prescribed the correct treatment, if this has not been done earlier.
Pain in the right side of the abdomen
There are loops in the middle floor of the right half of the abdomen small intestine and the ascending colon.
In the right side of the abdomen, pain can only be caused by damage to these organs. They are usually permanent, strong enough, not associated with food intake and are accompanied by other symptoms:
Pain in the lower abdomen on the right
In this area of the abdomen, pain can be triggered by a variety of diseases. Their clinical picture is sometimes very similar to one another and depends on the affected organ.
Diseases causing pain in the lower abdomen on the right
The most common surgical pathology.
The pain usually occurs in the upper abdomen or near the navel, moving after a few hours to the right iliac region (above the groin crease). At the same time, other phenomena of dyspepsia are possible in the form of a single diarrhea, nausea, and occasionally vomiting, loss of appetite and a slight rise in temperature.
Acute appendicitis has a number of characteristic symptoms, which are determined by the surgeon during palpation of the abdomen.
In addition to appendicitis, Crohn's disease can provoke pain in the right side of the lower abdomen.
With terminal ileitis - a variant of the development of Crohn's disease - the pains are localized in the right iliac region and very much resemble appendicitis. Other symptoms also often resemble a picture of appendicitis, therefore, diagnostic errors are not uncommon, when already at the operation a "healthy" appendix is found, but inflammation in the end section of the small intestine is detected.
Gynecological diseases as causes of pain in the right side of the lower abdomen in women
In the suprapubic region or the right and left groin, pain can appear due to pathologies of the uterine appendages:
With these diseases, pain is often permanent, accompanied by a variety of secretions from the genital tract - from bloody to purulent, sometimes fever occurs simultaneously with them, often very high.
Any of the listed diseases is very dangerous, since in the absence of treatment it leads to the development of severe complications:
Important:if pain occurs in the right side of the lower abdomen in pregnant women, a woman should immediately contact a gynecologist.
Treatment of pain in the right side
Since pain is a symptom, then it is not it that needs to be treated, but the disease that provoked it. How often do we take analgesics or antispasmodics in any situation! And how often then surgeons or gynecologists scold patients for not immediately seeking help. But any disease is easier to treat at the very beginning, and not at the stage of development of serious complications.
In the treatment of the described diseases, all methods available to medicine are used:
Whatever the pain in the right side - constant or paroxysmal, stabbing, aching or pressing - it is a symptom of trouble in any organ. Ignoring her, taking analgesics and antispasmodics on her own is the right way to the hospital bed, or even to the table to the surgeon. Sometimes a person gets to the doctors too late and then all their efforts are in vain. Therefore, for any painful attack, even if it has passed, do not be lazy - contact at least a local therapist. Better to let him grumble that you came to him in vain, rather than have a surgeon operate on you or open you up by a pathologist.
Pain in the right hypochondrium is an alarming manifestation that may indicate that there is a malfunctioning of the internal organs located in this projection. However, in some cases, such a symptom does not pose a threat to human health.
The expression of such a symptom is not limited by age or gender, which is why it often occurs even in children. In addition, there are several factors in the appearance of soreness under the right ribs, which may indicate this or that pathology. These factors include the nature, location and intensity of pain. Also, there are frequent cases when pain is felt in the right hypochondrium from the side, but a completely different organ is affected.
If pain occurs once and with low intensity, then this is not a reason for panic. The source of suspicion of a pathological process in the body should be constant or recurring pain in the right hypochondrium. In such situations, you need to seek help from clinicians as soon as possible, who will conduct a number of diagnostic activities and draw up a scheme for the most effective treatment.
Patients should know which organs are located in the projection of the right side:
The spread of pain in this zone can occur if a person has diseases of such internal organs as:
Etiology
Often, constant and severe pain in the area of the right ribs indicates such diseases:
All of the above factors most often lead to the formation of pain in the right hypochondrium. However, there are a number of reasons that are not so common, but still cause the appearance of pain in this localization. Rare sources include:
Periodic aching pain in the right hypochondrium occurs at least once in every person's life, even in the absence of diseases.
The so-called "healthy pain" can be due to the following reasons:
Since the causes of pain under the right ribs will be individual for each patient, the treatment tactics will be prescribed personally to each patient.
Classification
There are several types of pain in the right hypochondrium. The first of the classifications implies the division of such a symptom according to its localization:
The second classification of pain implies its division depending on the type of pain sensation. Thus, such a symptom is divided into:
Symptoms
Since in the overwhelming majority of cases pain in the hypochondrium on the right is a sign of a particular disease, it will not be the only external manifestation. Additional symptoms include:
Diagnostics
In cases of such a symptom, even if it is periodic pain during pregnancy, it is necessary to seek medical help as soon as possible. Diagnostics is carried out by a gastroenterologist, but if necessary, additional consultations of an infectious disease specialist and a gynecologist may be required. After carrying out the initial set of diagnostic measures, which include interviewing the patient, studying the medical history and life history, performing a thorough physical examination, diagnosing the condition that caused pain in the right hypochondrium, will include:
Only after studying the results of similar, and, if necessary, other diagnostic examinations, the doctor will be able to prescribe the most effective treatment tactics.
Treatment
Elimination of this or that disease is individual in nature, but with an exacerbation of chronic diseases, it will be enough to take antispasmodics and follow the rules of sparing nutrition provided by the attending physician. In addition, you can use recipes traditional medicine, but such therapy should by no means be the only approach to neutralize such a symptom.
However, there are situations in which soreness in the hypochondrium on the right requires immediate medical attention. The main indications are:
It is strictly forbidden to take any medications when the above signs appear. An urgent need to call an ambulance team medical care to relieve acute symptoms and transport the patient to the hospital for further treatment and examination.
Any pain that occurs in the hypochondrium on the right side is a reason to pay close attention to this and observe the frequency of its occurrence and intensity. Ignoring abdominal pain under the right rib and stopping it for a short time with the help of analgesics leads to the further development of possible serious pathological conditions and a loss of time to start therapy.
First place out possible reasons pain in the right side under the ribs in front occupy cholelithiasis and problems of the biliary tract, the second - pathological processes in the liver and edema with a lack of blood supply to this organ.
In medicine, these include trauma, rupture of the kidney, gallbladder, liver, colon. The pains are often unbearable.
Additional symptoms in these cases:
an initial increase in heart rate and further bradycardia; profuse sweat; cold skin of the limbs; a sharp drop in blood pressure up to the onset of painful shock; violation of the functioning of organs.
If a person lies down, then with cirrhosis or damage to liver tissue, the pain becomes stronger.
Acute purulent inflammation of the gallbladder, appendicitis, acute pancreatitis, intestinal penetration often give rise to intense, intolerable pain that radiates to the epigastric zone or to the area of the right scapula.
At the same time, there is:
profuse sweating; reflex tension of the muscles of the peritoneum in the form of a protective reaction; chills with high fever; frequent vomiting without relieving the patient's condition; shock from severe pain irritation.
The pains are spasmodic and intense.
Additional symptoms:
long-term fainting; shortness of breath, a sharp drop in blood pressure, dizziness, pallor of the skin and mucous membranes, weakness, rapid pulse; accumulation of exudate in the abdominal cavity, the acquisition of a yellow tint to the skin, sclera and mucous membranes.
Vascular thrombosis of the liver is characterized by intolerable pain with a return to the area of the scapula.
With this form of infarction, there are burning, compressing pains in the epigastric zone and the right side under the ribs, radiating to the scapula or to the retrosternal region. They are often confused with stomach pain. They are wavy with a decrease and a sharp increase.
severe pallor; arrhythmia, tachycardia, or bradycardia; drop in pressure to loss of consciousness; possible shock; enlargement of the liver, edema in the abdomen, on the ankles, the presence of exudate in the peritoneal cavity.
The nature of the pain: sharp unbearable, aggravated by stretching the intestine. Lead to painful shock if irritation of the peritoneum begins. Spread over the entire right side up to the umbilical region and groin.
Pain in the first stage is concentrated under the right rib in front, gradually descending to the iliac region.
Additional symptoms:
temperature rise; possible nausea and vomiting.
If the inflammation is acute, intense stitching, cutting pains under the ribs on the right side in front are most likely. They can be caused by a moving stone that has difficulty passing through the lumen of the duct, or by pathogenic bacteria.
Features: painful sensations are cramping in nature with irradiation to the muscles of the right shoulder. Accompanied by vomiting with bile, bitterness in the mouth, airy belching. The temperature may rise to subfebrile.
In the case of calculous (stone) cholecystitis, jaundice often occurs, giving a yellowish-green color to the skin.
Chronic cholecystitis of any genesis is characterized by dull, aching pains. They can radiate to the shoulder blade.
Additional symptoms: unpleasant bitterness in the mouth in the morning, mild nausea and bloating in the stomach and intestines. In this case, the skin and whites of the eyes usually have a slight yellowish tint, and the patient does not perceive fatty or fried foods. Stitching pains occur after eating.
The nature of the pain: lingering bursting or dull, accompanied by heaviness due to edema and blood filling the liver.
Features of the clinical picture: pain is accompanied by intoxication of the body and dyspeptic manifestations in the form of vomiting. The skin, mucous membranes and eye sclera become yellowish with a lemon tinge. The urine darkens, the stool is discolored and looks like yellow or light clay. After eating, aching pains occur from the liver.
Features: with cirrhosis, abdominal pain in the right hypochondrium is persistent. There is a clear swelling of the liver, spleen, intense itching of cholezous genesis occurs, icteric skin color, palms turn red.
It is an overgrowth of cysts that causes the echinococcus worm. Suppuration of the cyst threatens the development of a destructive liver abscess. In this case, there is an increase in pain, severe chills, a significant increase in heart rate, a strong increase in the liver.
Intense, sharp pain, leading to shock. Pallor, sweating, frequent urination.
There is a sudden cutting pain, which the person tries to relieve by pulling his legs to the stomach.
Additional symptoms for peptic ulcer disease:
nausea, vomiting; burning in the epigastrium, belching with acidic contents.
Pain is often spasmodic, accompanied by constipation, diarrhea, bloating, flatulence. After eating - cramping. With Crohn's disease, ulcerative colitis, pain torments the patient not only in the right side, but also in the lower abdomen, accompanied by bloating.
Tumors of the adrenal glands give rise to constant exhausting pain.
Such pains can accompany an inflammatory process in the lungs.
With an infectious lesion of the right lung due to pneumonia and pleurisy, a stabbing pain on the right may appear. When inhaling, laughing, or coughing, it gets stronger.
This is usually accompanied by:
temperature increase; severe general weakness; dry or wet cough (even rare); reduction of discomfort when lying on the right side.
If the patient suffers from gastric ulcer on the right side, as a rule, the pain is concentrated on the right, covering the back and lumbar region. When you press on the painful area, the pain is slightly reduced, therefore, squatting or lying on the stomach, the person feels better.
With cholecystitis, hepatitis, when the liver is enlarged, when you press on it, the pain under the ribs on the right side in front will intensify, becoming more intense and acute.
Pain in the right side from above can be a sign of not only pathological conditions, but also appear for natural reasons.
Many complain that stitching pains occur in the right hypochondrium when running or walking fast. If such symptoms appear infrequently, then it is similar to the physiological tension of the ligaments of the liver during stress and shaking. With frequent repetitions of such pains, it is necessary to undergo an examination for the possible development of gallstone disease.
During pregnancy, healthy young women may also experience painful sensations on the right side of the liver. This is due to the rapidly growing uterus, which puts pressure on all the surrounding organs, constricting the gallbladder.
If at the same time there is no nausea, bitterness in the mouth, bloating, heaviness, then this phenomenon is mechanical and not dangerous. But the constant appearance of such symptoms can signal a dysfunction of bile secretion.
First of all, when acute pain occurs, it is necessary:
immediately call an ambulance team; not trying to cope with pain by taking antispasmodics or analgesics that smooth clinical picture conditions requiring immediate surgical care or intensive care in a hospital; under no circumstances use warming compresses and heating pads, which can lead to internal bleeding or rupture of a suppurative abscess (for example, with appendicitis),
If there are no indications for immediate hospitalization of the patient, the ambulance doctor will simply transfer the patient under the supervision of a polyclinic therapist to diagnose and select a treatment regimen.
To understand why pain occurs in the right hypochondrium, one should observe their nature, dynamics and place of concentration. The main thing is to help yourself in a timely manner by seeking advice from a therapist and to carry out all the necessary examinations.
What can hurt in the right hypochondrium, learn from the video:
Acute or recurrent pain in the right hypochondrium suffers in one form or another about thirty percent of the adult population of the planet. Pathological changes in internal organs cause almost ninety percent of these pains.
Doctors have calculated that most often this type of pain is caused by:
1st place: diseases of the gallbladder and biliary tract 2nd in frequency: hepatic pathologies and liver edema with circulatory failure.
Where is the right hypochondrium located?
In topographic anatomy, the right hypochondrium is understood as a section of the anterior abdominal wall, limited by: 
from above - by the projection of the diaphragm (5 edge) from below - by the lower edge of the costal arch from the inside - by a line passing vertically through the lowest point of the ribs from the outside - by a line running vertically from the upper protruding pelvic bone (iliac crest) if the lower border of the region is extended to the back, then it will pass through the 12th rib and the third lumbar vertebra.
To find the right hypochondrium in practice, put the palm of your right hand horizontally on the ribs so that the wrist is located in the middle of the side, and the edge of the little finger coincides with the lower edge of the ribs. If, without changing the position of the wrist, clasp your back with your palm, you get a posterior projection of the right hypochondrium.
Shadows from such internal organs as: 
liver, gallbladder, bend of the colon (part of the large intestine), the upper part of the right kidney, the adrenal gland and the peritoneal part of the right half of the diaphragm separating the chest and abdominal cavity, sometimes pains from the pancreas, duodenum, bile ducts, and the inferior vena cava are also reflected here.
Pain under the right hypochondrium in healthy people
In a number of physiological conditions, even a healthy person may experience discomfort or pain in the right side.
Pain on exertion
An untrained person taking on hard work or sports activities may experience stabbing pains in the right hypochondrium. The fact is that, on the one hand, the release of adrenaline reduces the tone of the bile ducts and promotes their stretching with stagnant bile. At the same time, the filling of the liver with blood increases, its capsule stretches and begins to prick in the hypochondrium.
If you start exercising after a hearty lunch, then sooner or later pain in the hypochondrium will almost certainly arise. Long-distance running and push-ups are especially not recommended after meals. Untrained breathing can also lead to a spasm of the diaphragm (the muscle that separates the chest and abdominal cavity), which can also cause short-term pain until breathing evens out after exertion.
But the story about the expansion of the inferior vena cava under the influence of adrenaline, which begins to put pressure on the liver during exercise, is somewhat fantastic. Although this theory is published by some medical websites, it is sad to state that adrenaline narrows the vessels (both arteries and veins), and the liver does not have pain receptors and only responds with pain to the stretching of the capsule from the inside.
Pregnancy
In pregnant women in the third trimester, the uterus is colossally stretched and presses on all organs with which it comes into contact, displacing the intestines, pressing the stump and gallbladder. Therefore, for healthy pregnant women, stitching or pressing pains in the right hypochondrium are quite common. In addition, progesterone, which preserves late pregnancy, expands the biliary tract and stimulates bile stagnation. And if you give physical activity with such a belly, then some discomfort can be felt with a high probability.
Pain in women
At the end of the menstrual cycle, some women experience a sharp imbalance between low progesterone and high estrogen, which leads to spasm of the biliary tract and can also cause colic in the right hypochondrium.
Taking hormonal contraceptives can worsen the course of premenstrual syndrome and increase the frequency of stabbing pains due to a violation of the passage of bile (see the pros and cons of oral contraceptives).
Causes of pain in the right hypochondrium
If pain in the right upper quadrant in front
Pain in the area of the right hypochondrium is given by those organs that are most closely adjacent to this area.
Liver disease
They give prolonged dull or bursting pains, a feeling of heaviness due to the plethora and edema of the organ stretching its capsule, in which there are pain receptors. And the right hypochondrium is projected by the large right lobe of the organ.
Hepatitis
Viral, alcoholic or toxic hepatitis gives a picture of intoxication (weakness, lethargy, disability) and dyspepsia (nausea, loss of appetite, vomiting). At the height of the disease, jaundice with a lemon tint of the skin and whites of the eyes joins. During the same period, urine acquires the color of beer, and feces - the color of clay due to disturbances in the exchange of bile pigments.
Cirrhosis of the liver
This is the death of its cells and restructuring with the formation of nodes that compress the bile ducts and blood vessels. This disease can be the outcome of chronic hepatitis; cardiac cirrhosis is also known against the background of disorders of the blood supply to the liver. With cirrhosis, pain in the right hypochondrium occurs almost at the very beginning of the disease, and is persistent. They are combined with enlargement of the liver and spleen, jaundice, itchy skin, insomnia, redness of the palms. Overflow of blood to the portal vein system leads to varicose veins of the esophagus, the risk of bleeding from it, the accumulation of fluid in abdominal cavity... In the later stages, the liver decreases in size, its performance decreases, the patient may die against the background of a hepatic coma.
Echinococcosis
These are cysts with a liquid content, which are caused by the worm echinococcus. Cysts are most often located in the right lobe of the liver and, as they grow, squeeze the capillaries and intrahepatic bile ducts, causing severe severity in the hypochondrium and uneven enlargement of the liver. If the cyst festers, then a cavity filled with pus develops - a liver abscess. In this case, the pain intensifies, the body temperature rises and inflammation of the peritoneum or even blood poisoning may develop.
Hepatocellular carcinoma is masked for a long time as cirrhosis and is clarified only by examination of liver tissue.
Congestive heart failure
It leads to a deterioration in blood circulation in a large circle, which leads to an increase in the liver, edema in the legs and the anterior abdominal wall, accumulation of fluid in the abdominal cavity. At the same time, heaviness is felt in the right hypochondrium. If heart failure goes into an irreversible phase, the liver may change, as in cirrhosis.
The abdominal variant of myocardial infarction is characterized by very severe burning or pressing pains in the epigastrium, in the right hypochondrium. Sometimes the pain begins like a knife blow: it is sharp and intense, it can radiate to the right shoulder blade or to the sternum. This variant of pain is characteristic of heart attacks of the posterior wall of the heart muscle. Also, these pains can be wavy in nature (decrease and increase after 30-60 minutes), may be accompanied by rhythm disturbances, a drop in pressure, pallor and shock.
Colon
It gives pain the more, the more it stretches. So, any bowel disease, accompanied by flatulence, will give a sharp, almost unbearable pain. In this case, the pain from inflammation of the intestine or its destruction will be less pronounced until the peritoneum is included in the process, the irritation of which can lead to painful shock (injury to the intestine). Since the bend of the colon, which is located in the right hypochondrium, is only a part of the intestine, the pain will spread to the umbilical region and to the entire right side to the groin.
Colitis gives severe spastic pain and stool disturbances (constipation with a spastic variant or diarrhea with an infectious one), flatulence and malabsorption. Ulcerative colitis (in 20% of cases) and Crohn's disease can cause inflammation of the entire intestine, severe bleeding, stools with pus and mucus and be complicated by intestinal obstruction, suppuration or intestinal necrosis. Pain in this case is characteristic not only of the hypochondrium, but also of all the lower abdomen, has the character of spasms and is combined with bloating. Tumors most often give a clinic of intestinal obstruction and a picture of an acute abdomen, diffuse pain, symptoms of irritation of the peritoneum, pallor, cold sweat, and a drop in pressure. With appendicitis, pains, starting in the epigastrium, gradually descend through the area of the right hypochondrium into the right iliac region.
Gallbladder disease
They give the highest percentage of intense and sharp (cutting or stabbing pains), which are characteristic of acute inflammation. In this case, a displaced stone that closes the lumen of the neck of the bladder or bile duct or bacterial flora may be to blame for the inflammation. Pain in acute inflammation occurs at the point between the rectus abdominis muscle on the right and the costal arch. They are cramping, strong, radiating to the right shoulder or left hypochondrium. There may be bitterness in the mouth, belching of air, nausea and vomiting of bile. Sometimes the body temperature rises. For calculous cholecystitis, the development of obstructive jaundice with a yellow-green tint of the skin and mucous membranes is typical.
For chronic cholecystitis, aching dull pains, sometimes radiating to the shoulder blade, morning bitterness in the mouth, moderate nausea, appetite disorders, bloating, intolerance to fatty and fried, a slight yellowish tint of the whites of the eyes and skin are more common.
Pain in the right hypochondrium behind
In this area, injuries of the lower ribs, intercostal nerves, right kidney, adrenal gland, and inferior vena cava most often hurt.
Urolithiasis disease
Diseases of the right kidney and, first of all, urolithiasis can cause intense pain. The stone or sand, which began the journey from the renal pelvis, scratches it, and then the ureter, so pain in renal colic will be not only in the projection of the lower ribs, but also in the lower back and in the lateral abdomen. The pain is paroxysmal and severe. She gives to the thigh, genitals. When tapping the edge of the palm along the lower back, the pain intensifies and can radiate to the groin. In this case, traces of blood may appear in the urine. In some patients, renal colic is accompanied by vomiting.
Pyelonephritis
Acute infectious inflammation of the kidney - pyelonephritis - a process in which there is pain in the kidney area, fever, intoxication.
There may be pain at the end of urination, frequent urination (including at night) and false urge. In some cases, edema appears on the face.
Apostematous pyelonephritis is a formation of purulent inflammation in the kidney, which can be limited (abscess or carbuncle) or diffuse.
In this case, the pains acquire a constant pulling character, the temperature rises and there may be a decrease in daily urine output (up to a complete cessation of urination).
Renal papillary necrosis
It can be a consequence of oxygen starvation of the renal tissue when the vessels that feed it are blocked (by infectious agents or in diabetes mellitus). In this case, the pain is constant, combined with blood in the urine. The patient may die from septic shock.
Acute upper paranephritis
This is an inflammation of the fatty tissue in the upper part of the kidney against the background of infection from the tonsils, carious teeth or other foci of inflammation. First, there is a temperature up to 38, moderate lower back pain on the affected side. After 2-3 days, the pain moves to the right hypochondrium, intensifies with a deep breath. Lower back pain worsens with a sharp straightening of the body and when walking.
Kidney cancer
If a tumor develops in the kidney, then for a long time it does not manifest itself. In the later stages, bleeding and constant non-intense pain in the projection of the kidneys appear. If the tumor interferes with the outflow of urine, then acute pain and episodes of acute urinary retention may occur.
Right adrenal gland
most often gives pain in large tumors. Pheochromocytoma is accompanied by a persistent increase in blood pressure, myocardial dystrophies, disorders heart rate... Aldosteromas change the body's water balance, corticosteromas disrupt metabolism, corticoestromes contribute to the feminization of men, corticoandosteromas form secondary male characteristics in women.
Rib bruises
Contusions of the posterior segments of the 10th, 11th and 12th ribs give pronounced constant aching-gnawing pains, accompanied by a characteristic crunch in fractures. The pain is aggravated by deep breaths, coughing, or bending in a healthy direction.
Intercostal neuralgia
In the right hypochondrium behind, intercostal neuralgia (severe stabbing pain that restricts mobility and intensifies when turning, bending, deep inhalation) or muscle inflammation (myositis) may appear.
Osteochondrosis of the lumbar spine
It gives pains of varying intensity, which are accompanied by limited mobility, muscle tightness and tension symptoms. Pain in this case can be from aching to shooting of varying degrees of intensity.
Shingles
Herpetic eruptions along the nerve, in which there is a row of vesicles with cloudy contents against the background of a reddened strip of skin, reminiscent of a belt strike. At the site of the lesion there is a strong burning sensation, itching of the skin and pain.
Vena cava thrombosis
A rare variant of thrombosis of the inferior vena cava (when a thrombus comes from the iliac veins and clogs the main vein trunk) gives pain in the lower back (right hypochondrium from the back) and a clinic similar to the late stage of kidney tumors. If the hepatic segment is thrombosed, then intense pain will arise in the right hypochondrium in front and will be given under the right scapula. This will cause fluid accumulation in the abdominal cavity and jaundice.
Sharp pain
Acute pain in the right hypochondrium is characteristic of urgent surgical conditions, united by the concept of “acute abdomen”.
Injury to internal organs (injuries to the liver, kidney, colon, ruptures of the liver, gallbladder or kidney, hematomas of the liver and kidney). Acute inflammation of the gallbladder, acute pancreatitis, appendicitis at the beginning of the inflammation. Bowel perforation (duodenal, colon), diverticulum rupture. Intestinal obstruction, blockage of the bile ducts. Thrombosis of arteries and veins feeding internal organs and leading to organ necrosis.
At the same time, the pain is very intense, it can lead to painful shock, a drop in blood pressure, loss of consciousness, disruption of the kidneys and heart. The blockage of the hollow organs often results in cramping pain. Bleeding is accompanied by acute anemia and can lead to hemorrhagic shock. In patients with an acute abdomen, the muscles of the abdominal wall are tense, which are trying to protect the right hypochondrium. The pain can be diffuse or punctate, but in any case it is quite intense and sometimes becomes unbearable.
Acute compressive pain in the form of a prolonged attack is also characteristic of the abdominal form of myocardial infarction. Simulates an acute abdomen and renal colic, sometimes intestinal infections, ulcerative colitis. Sufficiently sharp and severe pain occurs with fractured ribs.
Dull pain in the right hypochondrium
Dull aching pain is a common symptom of chronic inflammation. This is the nature of the pain in the following pathologies.
Heaviness in the right hypochondrium
The feeling of heaviness under the right costal arch accompanies the edematous liver against the background of congestive heart failure, hepatitis, fatty hepatosis, hypomotor dyskinesia of the biliary tract, part of chronic cholecystitis.
Pain after eating
Food intake accelerates the secretion and movement of bile, increases blood circulation in the liver and stimulates intestinal peristalsis. Therefore, food provokes pain in pathologies of the liver, gallbladder, intestines. In this case, the nature of the pain can be different: nausea and dull pain are characteristic of cholecystitis, sharp pain of a spastic nature accompanies colitis and intestinal dysbiosis, stitching pains accompany biliary dyskinesia or cholelithiasis.
Pain after exercise
Stitching or pulling pain occurs after physical exertion with congested liver, with hepatitis or cirrhosis. An attack of calculous cholecystitis can be provoked by both physical activity or exercise, and shaking driving.
But with hypomotor dyskinesia of the biliary tract, the load somewhat improves the passage of bile and the discomfort may even pass.
They provoke stress and deterioration in intercostal neuralgia, myositis, osteochondrosis, rib fractures, vena cava thrombosis.
What to do?
When pain in the right hypochondrium is concerned, you should consult a doctor. Independent attempts to cope with pain with the help of antispasmodics, such as drotaverine or no-shpa, can smooth out the picture of many acute conditions of internal organs, and this can lead to untimely assistance and a poorer prognosis for the patient.
Heating pads or painkillers containing non-steroidal anti-inflammatory drugs are generally contraindicated until the cause of the pain is clarified, as they can be very harmful (for example, provoke internal bleeding).
For any acute abdominal pain, it is advisable to call an ambulance station or contact the surgeon on duty at the nearest hospital on your own. If there are no indications for hospitalization and emergency treatment, doctors will refer the patient to colleagues at the clinic to clarify the diagnosis and select treatment.
Contacting a polyclinic should start with a visit to a therapist, who, if necessary, will appoint a consultation with a surgeon, neuropathologist, cardiologist, endocrinologist.
Remember that abdominal pain is impractical and often life-threatening. The sooner the patient is examined by a specialist, the more chances he has to get out of the situation with pain in the hypochondrium with the least loss.
Pain in the right side under the ribs can be a symptom of a wide range of diseases, since this quadrant of the abdomen contains a large number of vital organs: liver, kidney, gallbladder, duodenum and pancreas.
In some cases, pain from the diaphragm or small intestine can give off to the right side. Due to the fact that the hypochondrium is permeated with many nerve endings and muscle fibers, the pain sensations are intense and harsh. To make an accurate diagnosis, it is necessary to describe the symptoms in as much detail as possible and indicate the exact location of the pain.
Localization and nature of pain
At the initial examination, the therapist determines the possible disease using two-handed palpation of the abdomen. Depending on the location and nature of the pain, the doctor may suggest which internal organ is damaged and requires additional diagnostics. To do this, the patient must indicate the place of the most intense pain sensations: in front, on the side or behind.
Front and side under the ribs
Liver disease
Liver pathologies are most often the cause of pain in the right side, since this organ occupies almost the entire cavity in the right hypochondrium. The liver is a vital organ that acts as a filter to cleanse the body of harmful substances. The most common liver diseases that are characterized by pain in the right side include the following:
Hepatitis
Infectious liver disease caused by hepatitis A, B, C, D viruses. Infection occurs parenterally (through the blood), mainly when using syringes with infected needles. Hepatitis is also transmitted during childbirth from mother to child and through sexual intercourse.
This pathology can occur in both acute and chronic forms. Pain in hepatitis is dull, aching, pressing in nature and is localized in front of the right side under the ribs. They intensify with a sharp breath, bending forward, or pressing on the abdomen.
In addition to pain, hepatitis has a number of characteristic symptoms:
yellowness skin, constant nausea, general weakness and dizziness, lack of appetite.
It is possible to determine the presence of the hepatitis virus in the body using a blood test. Hepatologists (in the chronic form) and infectious disease specialists (in the acute course of the disease) are engaged in the treatment of the liver. Treatment for hepatitis should focus on killing the virus and repairing liver tissue (preventing cirrhosis). Antiviral therapy is carried out using drugs based on nucleosides and interferons. Long-term neglect of symptoms and lack of treatment can lead to advanced cirrhosis, and, as a result, to the need for a liver transplant.
Liver diseases are treated only under the supervision of a specialist.
Cirrhosis
Inflammatory liver disease of a chronic nature, in which there is an irreversible change in the epithelium of the organ, as a result of the replacement of parenchymal tissue with connective fibers (scars). The volume of healthy tissue decreases and the liver stops working normally.
The reasons for the development of cirrhosis include:
viral hepatitis, long-term alcohol use, Budd-Chiari syndrome, severe chemical poisoning, advanced pathologies of the bile ducts.
Pain in cirrhosis is strong and has a pulsating, sharp character. Strengthened with exercise, deep breaths and changes in the position of the trunk. In addition to pain in the side on the right, cirrhosis is characterized by a feeling of bitterness in the mouth, yellowness of the skin, a sharp decrease in weight, and impaired stool (diarrhea and flatulence).
It is possible to diagnose cirrhosis of the liver using a comprehensive examination, which includes:
biochemical blood test, ultrasound, tissue biopsy, coagulogram, CT.
Treatment is prescribed by a physician hepatologist and consists in eliminating the cause of the disease, following a strict diet and avoiding alcohol. The advanced stages of cirrhosis require urgent transplantation of the donor organ, otherwise the liver will completely lose its efficiency and death will occur.
If the treatment of cirrhosis is started on time, then the likelihood of a favorable outcome increases several times.
Gallbladder disease
The gallbladder is a small organ in the digestive system located under the liver. The main function of this organ is to accumulate and excrete bile (a liquid that promotes the absorption of fats and the movement of food through the digestive tract). Diseases of the gallbladder, which are characterized by pain in the hypochondrium on the right, include:
Dyskinesia of the gallbladder
Disease of the gallbladder, in which the contractility of the walls of the organ decreases and the processes of excretion of bile are disrupted. As a result, there is an accumulation of bile in the body.
The causes of dyskinesia include:
improper diet (predominance of fatty / fried foods, egg yolks), chronic diseases Gastrointestinal tract, stress, menopause in women, hormonal imbalance.
There are two forms of this disease:
hyperkinetic (an increase in the frequency of organ contractions); hypokinetic (a decrease in the frequency of organ contractions).
Pain with dyskinesia of the gallbladder is of a short-term and pulsating character. Increased after eating fatty or spicy foods. Besides severe pain in the right hypochondrium, dyskinesia is characterized by the appearance of a bitter taste in the mouth, nausea, loss of strength, diarrhea and flatulence.
You can diagnose gallbladder dyskinesia using:
biochemical blood test, ultrasound, duodenal intubation.
Treatment is prescribed by a gastroenterologist and consists in adherence to a diet, the use of choleretic drugs, antispasmodics and physiotherapy procedures. If the disease is not treated, complications may arise, incl. leading to the removal of the organ.
Cholelithiasis
A disease in which stones form in the gallbladder and bile ducts. The main causes of gallstone disease include prolonged accumulation of bile in the cavity of the organ and an increase in the concentration of mineral salts in the composition of bile due to metabolic disturbances in the body. Stones form from large particles of bile that cannot leave the gallbladder on their own.
Pain in gallstone disease is characterized by periodic bouts of colic, which are accompanied by a sharp throbbing pain in the right abdomen. They intensify after eating fatty or spicy foods, pressing, bending forward and to the sides. In addition to severe pain in the front in the right hypochondrium, gallstone disease is manifested by nausea, diarrhea, indigestion, flatulence.
biochemical blood test, ultrasound, cholecystocholangiography.
Treatment is prescribed by a gastroenterologist and consists of removing or destroying stones, following a strict diet, and taking anti-inflammatory drugs. Stones can be removed with lithotripsy, acid dissolution of the stones, and surgery. Lack of treatment can lead to increased pain and inflammation of the gallbladder, followed by removal of the organ.
Acute cholecystitis
An acute disease of the gallbladder, in which a rapid inflammation of the walls of the organ develops. The main causes of acute cholecystitis are blockage of the bile ducts with stones and infection that causes inflammation (streptococcal, intestinal, staphylococcal).
Severe pain with cholecystitis occurs in the right hypochondrium and has a constant, pressing character. They intensify with a sharp breath and after eating fried or fatty foods, egg yolks.
Besides characteristic pain cholecystitis is accompanied by:
nausea, stool disorder (diarrhea or constipation), flatulence, belching, bitter taste in the mouth, fever.
This disease can be diagnosed using a biochemical blood test, ultrasound of the gallbladder and ducts. Treatment is prescribed by a gastroenterologist and consists in relieving inflammation, cleansing the stomach and intestines, taking antispasmodics, and following a strict diet. In some cases, a cholecystectomy is performed (a needle is inserted into the gallbladder through which stagnant bile is removed).
Launched cholecystitis can lead to increased pain and subsequent removal of the organ.
Diaphragm diseases
The diaphragm is a muscular septum that separates the abdominal organs from the chest. The diaphragm is located under the ribs (below the lungs) and participates in the breathing process, expanding with inhalation. Pain on the right in the hypochondrium can cause the following pathologies of the diaphragm:
Hernia of the diaphragm
A disease in which internal organs penetrate from the chest into the abdominal cavity and vice versa. The causes of a hernia include a congenital or acquired defect of internal organs: a short esophagus, weakness of the diaphragm muscles. When the hernia reaches a large size (up to 5 cm), pain occurs in the area of the solar plexus, which is given to the area of the right hypochondrium. The pain has a periodic, pressing character. It intensifies with a sharp breath, bending forward and pressing on the area under the ribs.
In addition to pain, in the right hypochondrium may occur:
shortness of breath, heaviness after eating, bloating, lack of oxygen.
It is possible to diagnose a hernia of the diaphragm using ultrasound and MRI. The surgeon is involved in the treatment of this disease. The defect can be eliminated only by surgery.
If the disease is not treated, then the hernia will reach enormous sizes and interfere with the functioning of neighboring organs.
Diaphragmatitis
A disease in which the outer membrane of the diaphragm, the pleura, becomes inflamed. The source of inflammation is an abdominal abscess, peritonitis, or other inflammatory diseases Gastrointestinal tract. Pain with diaphragmatitis occurs when breathing (inhale / exhale) and has an aching character. It intensifies with a change in the position of the body (turns to the sides).
In addition to pain, the following symptoms may be present:
fever, pulmonary edema, bloating, difficulty breathing (it is impossible to breathe in deeply).
Treatment is prescribed by the surgeon and consists of anti-inflammatory therapy and removal of edema. Lack of treatment can lead to suffocation.
Diseases of the duodenum
The duodenum is located between the stomach and small intestine. In the cavity of this intestine, food is broken down into proteins, fats and carbohydrates with the help of enzymes secreted by the pancreas. Pain in the area of the right hypochondrium in front can be caused by the following pathologies of the duodenum:
Ulcer
A disease in which wounds or ulcers form in the walls of the intestine. The culprit for the weakening of the protective functions of the duodenum are the microbes Helicobacter pylori, which destroy the mucous membrane, forming ulcers. This microbe can be found in every second inhabitant of the planet, but peptic ulcer disease affects not everyone.
The reasons for the activation of the microbe include:
unhealthy diet, stress, alcohol abuse, fatty / fried foods, hereditary predisposition.
Severe pain in peptic ulcer disease is localized in the hypochondrium and has a constant and aching character. It increases with pressure and after drinking alcohol.
In addition to severe pain in the right hypochondrium, the ulcer causes:
nausea, loss of appetite, weight loss, stool problems.
Ulcer treatment is prescribed by a gastroenterologist and consists in restoring the intestinal walls, killing bacteria and following a diet. If the ulcer is left untreated, there is a risk of perforation and peritonitis.
Chronic duodenitis
A disease in which inflammation of the duodenum occurs. Duodenitis can occur in both acute and chronic form. The causes of this disease include unhealthy diet (excess of fried and fatty foods) and alcohol abuse. Pain with duodenitis is localized in the area of the right hypochondrium in front and has a bursting, paroxysmal character. Strengthens when turning and tilting the body to the sides.
In addition to the characteristic pain in the hypochondrium, duodenitis causes:
constant nausea, indigestion, stool disturbance (diarrhea and flatulence).
Treatment of duodenitis is prescribed by a gastroenterologist and consists in following a strict diet, restoring intestinal microflora and normalizing digestion processes. If duodenitis is left untreated, an ulcer may occur.
Diseases of the pancreas
The pancreas is an organ in the digestive tract that is involved in the production of digestive enzymes that help the body absorb food. In addition to actively participating in digestion processes, this organ produces the hormone insulin, on which the blood sugar level depends.
Pancreatitis
A disease in which the pancreas becomes inflamed. The disease can occur in both acute and chronic forms.
The causes of pancreatitis include:
diseases of the duodenum, abdominal trauma, helminthic invasions, hepatitis, mumps, hereditary predisposition.
Pain in pancreatitis is localized in the left hypochondrium, with the exception of inflammation of the pancreatic head, since in this situation the pain radiates to the right.
The pain is shingles and sharp. Also, pancreatitis is accompanied by:
nausea, diarrhea, vomiting, general weakness, dizziness.
Diagnostics is carried out using ultrasound, two-handed palpation, blood and feces analysis. Treatment of pancreatitis is prescribed by a gastroenterologist and consists in eliminating the primary disease, following a diet, restoring intestinal microflora and normalizing digestion.
If pancreatitis is left untreated, cholecystitis, ulcers, or peritonitis will occur.
Pain due to helminths
Ascariasis
A disease in which the intestines are affected by the largest helminths ascaris. The maximum length of these worms can reach 15 cm. They live in the small intestine, do not cause symptoms in the anus. Infection occurs when the larvae or eggs of ascaris enter the body.
The main causes of ascariasis include the consumption of unwashed vegetables and fruits that have come into contact with animal feces.
Pain in this disease is localized in the right hypochondrium in front, and has a constant, aching character.
In addition to pain, ascariasis is characterized by:
increased appetite, weight loss, nausea, diarrhea.
Diagnosed by stool analysis and biochemical blood tests. Treatment is carried out medications... If ascariasis is not treated, the helminths will penetrate into the organs and disrupt their work.
Giardiasis
Pain with giardiasis is localized in the upper abdomen, radiating to the right hypochondrium. The pain syndrome increases with inflammation and acute giardiasis.
Also, this disease is accompanied by:
vomiting, nausea, skin rash, drastic weight loss.
Giardiasis is diagnosed with a stool test. Treatment consists in adherence to a diet, the use of medications, and restoration of the intestinal microflora. Why lamblia settled in the small intestine, only the doctor can answer after the examination.
Below the edges
Diseases of the small intestine
In the small intestine, there is a process of splitting complex substances into simpler ones and their subsequent absorption into the blood. The walls of the small intestine absorb useful minerals, vitamins and salts from food, which are the main building blocks for the human body.
Chronic enteritis
Inflammatory disease of the small intestine, in which there is a dysfunction of the digestive system. The main cause of inflammation is pathogens infectious diseases intestines (rotaviruses, dysentery, yersinia, salmonella).
The chronic process develops after an acute infection, when the pathogen is defeated. Pain in chronic enteritis occurs in the area of the right side below the ribs and has a pulsating, pressing character. Aggravated by inhalation and after eating fatty / fried foods.
In addition to the characteristic pain, enteritis is accompanied by:
bloating, problems with stool (diarrhea, constipation, flatulence), sharp weight loss, deterioration of potency in men.
You can diagnose chronic enteritis using:
coprograms, absorption tests, bacteriological analysis of feces, biochemical blood analysis, endoscopic examination.
Treatment is prescribed by a gastroenterologist and consists in eliminating the infection, restoring intestinal functions (treating dysbiosis), following a diet.
If enteritis is left untreated, intestinal obstruction and peritonitis will occur.
Gluten Enteropathy (Celiac Disease)
Congenital disease in which there is an insufficient production of the enzyme peptidase, which is involved in the breakdown of gluten. As a result of this disease, a toxic effect is exerted on the walls of the small intestine from uncleaved enzymes, the intestinal lining becomes thinner and damaged, disrupting the digestion processes.
Pain in celiac disease occurs in the right side below the ribs and is aching, constant. They intensify with a sharp breath, leaning forward and after eating foods containing gluten (pasta, bakery and other products containing cereals). In addition to the characteristic pain, enteropathy is accompanied by constant nausea and severe diarrhea.
You can diagnose this disease using:
Ultrasound, biochemical blood test, absorption tests.
Treatment is prescribed by a gastroenterologist and consists in restoring bowel function and following a strict gluten-free diet. If the disease is left untreated, peritonitis will develop.
Appendicitis
Chronic appendicitis
A disease in which the appendix periodically becomes inflamed under the influence of external or internal factors.
The causes of chronic appendicitis include:
sluggish infection, adhesions and scars on the walls of the organ, unhealthy diet, alcohol and smoking abuse.
The pain is aching, pressing in nature and is localized in the area of the right side below the ribs, radiating to the hypochondrium. Pain sensations intensify after physical exercise, tilts left / right.
Diagnostics is carried out using X-ray, ultrasound, blood tests. The treatment is carried out by a gastroenterologist and a surgeon. As a rule, with a long chronic process, the appendix is removed.
Acute appendicitis
A disease in which acute inflammation of the appendix occurs. The pain has a cutting, paroxysmal character and is localized in the lower abdomen on the right, giving to the hypochondrium. In addition to pain in the hypochondrium, acute appendicitis is accompanied by:
increased body temperature, nausea, vomiting, diarrhea, loss of consciousness.
Diagnostics is carried out using two-handed palpation, blood tests and ultrasound. Acute appendicitis can only be treated by removing the inflamed appendix. Why the appendix is inflamed, only a doctor can tell after an examination.
Lack of timely medical attention can lead to peritonitis, internal bleeding and death.
Female and male diseases
Pain in the right hypochondrium can occur due to gynecological problems in women and urological problems in men. Diseases of the female genital area that cause this symptom include ovarian cysts, ectopic pregnancy, and tumors of the appendages. Diseases of the male genital area include adenoma prostate, prostatitis, inflammation or rupture of the testicle. As a rule, pain in these diseases is localized in the lower abdomen, but can spread throughout the abdomen, radiating to the area of the right hypochondrium.
If there is a suspicion of diseases of the genital area, women need to contact a gynecologist, and men - to a urologist.
Behind
Pain in the right side of the back appears also is a fairly frequent guest and can be caused by diseases of the lungs, musculoskeletal system, kidneys and urinary system. Pain in the right hypochondrium in case of lung pathology (tuberculosis, bronchitis, inflammation) is distinguished by a return to the chest area. An increase in pain can be seen with coughing fits and deep breathing. Pain syndrome with osteochondrosis occurs when the body bends and turns. Increased pain can be seen when a vertebra or nerve endings are pinched in the right rib area. In case of kidney pathology (pyelonephritis), the pain is of a girdle nature and radiates to the coccyx area.
This article discusses only a small part of the diseases in which pain appears in the right side under the rib, but even this small list shows that it is not worth joking with these signals from the body. For any similar symptoms, it is necessary to urgently consult a doctor, since delay can lead to irreversible consequences, for example, the need to remove the organ, and, as a result, a sharp deterioration in the quality of life, disability, and the obligation to use drugs for the rest of your life.
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