Upper Right Abdomen Pain
Upper right abdominal pain with additional symptoms should prompt a closer examination for the cause of that pain. Any pain that is intractable, severe, or otherwise accompanied by symptoms that suggest infection, such as fever or chills, should be promptly addressed by your physician.
Upper right abdomen pain, also called right upper quadrant pain refers to pain in the upper right side of the abdomen. The abdomen is what doctors refer to when they mean the area below the ribcage, extending to the pelvis.
Most people refer to abdominal pain as a "stomach ache." There are a lot of different organs in the area of the abdomen, and the stomach is certainly one of them. However, the stomach empties into the small intestine, which empties into the large intestine. Other digestive organs that lead into this circuit include organs that help you digest and metabolize your foods and medications. They are the gallbladder, the liver, and the pancreas. You have quite a few substantial and important blood vessel systems that supply these organs, and they all begin at the aorta or in the complex venous system that takes de-oxygenated blood and metabolites from the organs to the kidney or liver for processing and elimination.
The spleen is located on the left side of the abdomen, in what is known as the left upper quadrant, so if your pain is in the right side, you don't need to worry about your spleen. The kidneys are located in a space behind all of these other organs, and they can cause a great deal of pain in your flank (the side of the abdomen, towards the back) or in your back. A bladder infection will cause pain in the low part of the abdomen, which is technically known as the pelvis. If you feel the bones on the lower sides of your abdomen, you can locate your pelvic region just below. Women have other organs in the pelvis, including the uterus and ovaries, and these organs can "refer" pain that is actually experienced sometimes in the right upper quadrant.
Causes of Upper Right Abdominal Pain
Right upper quadrant pain can have a variety of causes. These causes are usually related to the underlying organ, tissue, muscle, or, rarely, bone. Pain can be referred to the right upper quadrant from several different places outside of the abdomen.
Liver Disorders. Possible causes of upper right abdominal pain can include liver disease. Hepatitis A is one of those causes of right upper quadrant pain that comes from consumption of food contaminated by feces, usually by an infected food preparer who has not washed their hands after using the bathroom. Hepatitis B, C, and the other types of blood-borne hepatitis can cause jaundice, right-upper quadrant pain, nausea, vomiting, and loss of appetite.
Gallbladder Disorders. Gallbladder disorders include gallbladder stones or spasm, pancreatitis (inflammation of the pancreas), and kidney disorders.
Gastric Diseases. There are some people who experience chronic abdominal pain, and some causes include Crohn's disease or ulcerative colitis.
Cardiovascular Disorders. Sometimes, cardiovascular disorders can cause abdominal pain. For example, some people experiencing a heart attack may actually experience pain in their abdomen, although they are more likely to experience discomfort in the chest and upper arms, sometimes radiating to the jaw or the neck.
Respiratory Diseases. You may also have a respiratory disease such as pneumonia, that may be located in one of the lower lobes of your lungs, and this may seem to be causing abdominal pain. You will have other respiratory symptoms, however, that will allow your doctor to rule out abdominal causes of respiratory problems.
Pelvic Inflammatory Disease. Pelvic inflammatory disease is a severe infection of the uterus, which is caused by bacteria, usually sexually transmitted, which will ascent up the vaginal tract through the cervix (the opening to the uterus) into the uterus. Pain can be "referred" from this infection to the right upper quadrant. Pelvic inflammatory disease is usually accompanied by vaginal discharge.
Infections. These include infections anywhere in the digestive tract or the pelvis. Sudden onset of abdominal pain, with nausea, vomiting, or diarrhea, may be due to food poisoning, which can occur from a variety of different harmful bacteria or viruses which are usually transmitted by eating food that has been sitting for a while, or by food contaminated with feces.
Pregnancy. Pregnancy can cause right upper quadrant abdominal pain by pushing up your abdominal contents higher in the abdomen. Pregnant women may have problems with digestion as a result of hormonal imbalances or simply as a result of the mechanical displacement of their digestive organs, by their growing uterus. In the latter stages of pregnancy, some women experience pre-eclampsia, and this condition is very serious when it causes right upper quadrant pain. It is initially characterized by high blood pressure and swelling in the feet and lower legs.
Your physician should address any abdominal pain in pregnancy, as it may indicate a serious problem.
Complications of Upper Right Abdominal Pain
The most severe complications of right upper abdominal pain include abscess. An abscess is a collection of pus as a result of an abdominal infection, and may be in the liver or gallbladder. Any abscess must be surgically drained, because they are "walled off" and won't usually respond to antibiotic treatment.
A particularly troubling complication of right upper abdominal pain that is the result of Hepatits B or C, or other blood borne hepatitis ( known as non-B, non-C) can include "fatty liver" which, if untreated, will progress to fibrosis or hardening of the liver, eventually progressing to the severe and terminal disease of cirrhosis.
Gallbladder disease can progress to an infected gall bladder, known as cholangitis. You will experience chills, rigors, right upper quadrant pain, and nausea or vomiting.
If you have gastritis that is severe, it can progress to peptic ulcer disease. A peptic ulcer, or ulcer in the far end of the stomach or close (proximal) end of the small intestine, can perforate, leading to severe pain, bleeding, shock, and peritonitis, or an infection of the entire abdomen. This is a surgical emergency.
Pain in the abdomen can be accompanied by other symptoms, such as nausea or vomiting. You can also have pain with urination, in the case of a bladder infection, or, if you have gastritis or an ulcer, you may have dark stools, which can indicate the presence of "hidden" blood in your bowel movement.
You may also have bloating and excessive gas, diarrhea, or, in the case of respiratory problems, you may have shortness of breath.
Treatments for Upper Right Abdominal Pain
Treatment of right upper quadrant pain can vary from waiting it out, which is appropriate if it is short-lived and not too severe.
If your pain appear is accompanied by symptoms that are familiar to you, such as constipation or the feeling that you are unable to pass gas, you should increase your intake of water, and try an over the counter remedy such as Metamucil or another dietary fiber, or Gas-X, respectively.
Whatever you believe the cause of your abdominal pain to be, it is important to be aware of possible causes of abdominal pain that should prompt evaluation by a professional. If you have a history of abdominal pain, and you recognize common symptoms, then you might consider a more conservative approach. It is always important to be aware that right upper quadrant pain may be associated with conditions that range from fairly insignificant to life-threatening, and if your right upper quadrant pain is unusual in nature, or accompanied by other symptoms, don't hesitate to seek advice from a health care professional.
When to See a Doctor
See your physician for abrupt onset of severe pain accompanied by fever, chills, nausea or vomiting. Any other symptoms, including pain with urination, jaundice (yellow skin or yellowed whites of the eyes), severe back pain, accompanying chest pain, sweating, or profuse diarrhea for longer than a day, should prompt a visit to your physician or the local emergency department immediately. An acute abdomen, or abdominal pain indicating a need for surgical intervention, is characterized by severe pain when you release pressure on your abdomen.