Pain in the right hypochondrium is a sign of many diseases, so even an experienced and qualified specialist will not be able to make an accurate diagnosis only on the basis of this symptom.
Quite harmless reasons, such as overeating or excessive exercise, can cause pain. But more often discomfort in the area of the right hypochondrium provokes an inflammatory process, acute and chronic diseases of the digestive, genitourinary system, internal organs (liver, kidneys), biliary tract.
Why does the right hypochondrium hurt, in which cases does this symptom pose no danger, and in which cases does it require immediate medical attention? You will find answers to all questions in our article.
Right hypochondrium hurts: possible causes
To determine the area of the right hypochondrium, it is enough to attach the palm of the left hand to the ribs so that the wrist is in the middle of the side, and the little finger is adjacent to the lower edge of the costal arch. Projections of the following organs fall on this anatomical quadrant of the abdomen:
- gallbladder, liver;
- bending of the colon;
- right kidney and adrenal gland;
- part of the diaphragm that separates the abdominal and thoracic cavities.
In addition, pain in the right hypochondrium may appear as a reflection of problems with the pancreas, inferior vena cava, bile ducts and duodenum.
Physiological causes of pain
Often patients complain that it hurts in the right hypochondrium after eating. Such a symptom in a healthy person may be a reaction to eating fatty, fried, spicy foods or alcohol. Even physically developed people can experience discomfort and stabbing pains in the right hypochondrium if they do hard physical work or start training immediately after a heavy meal.
Another cause of physiological pain is late pregnancy. During this period, the fetus reaches a large size and presses on neighboring organs (liver, gallbladder, diaphragm), causing aching pain in the right hypochondrium. Colic in the right side in women can also provoke premenstrual syndrome, which causes spasm of the biliary tract.
Accompanying illnesses
But more often, pain and heaviness in the right hypochondrium provoke a variety of diseases of the internal organs. Among them:
Pain in the right hypochondrium can have a different character. So, for chronic diseases, pulling, aching pain sensations are characteristic, which are pursued constantly, for a long time.
The acute nature of the pain is a sign of serious problems that require urgent surgical intervention. Under the concept of "acute abdomen" the following conditions are hidden:
- appendicitis, exacerbations of cholecystitis, pancreatitis, cholelithiasis.
- bleeding in the abdomen caused by injury or trauma;
- lacerations and damage to internal organs(kidneys, liver, gallbladder, colon);
- intestinal obstruction, perforation of the stomach, obstruction (blockage) of the bile ducts.
Sharp, intense pain is dangerous with the likelihood of developing a pain shock, which is accompanied by a drop in blood pressure, loss of consciousness, and heart rhythm disturbance. A stabbing pain in the right hypochondrium can be a sign of an exacerbation of ulcerative colitis, an intestinal infection, or blockage of a bile duct stone.
Pain and heaviness in the right hypochondrium is a sure sign of chronic cholecystitis, biliary dyskinesia of the hypomotor type, fatty hepatosis of the liver, hepatitis of various etiologies, and an increase in the size of the liver against the background of heart failure.
Sometimes discomfort and painful colic in the right side of the abdomen are a manifestation of pseudo-abdominal syndrome that accompanies diseases such as pyelonephritis (inflammation of the kidneys), pneumonia (inflammation of the lungs) or myocardial infarction.
Complex of symptoms
Lack of appetite
Pain in the right hypochondrium is usually accompanied by a whole range of symptoms that suggest the presence of a certain pathology and facilitate the provisional diagnosis. Such symptoms may indicate various diseases of the digestive, nervous, endocrine or respiratory systems and suggest the presence of an inflammatory process or acute conditions that require surgical intervention. The most characteristic of this list are the following manifestations:
- nausea, vomiting;
- lack of appetite;
- increased fatigue, weakness, apathy;
- jumps in blood pressure;
- symptoms of intoxication of the body (high temperature, joint and muscle pain, chills);
- dyspeptic symptoms (belching, bloating, diarrhea, flatulence);
- cardiac arrhythmia, loss of consciousness;
- pain in the heart, lower back;
- yellowness of the skin, sclera of the eyes, mucous membranes;
- discoloration of feces and urine, difficulty urinating;
- neurological disorders and other specific symptoms characteristic of a particular disease.
It is the accompanying symptoms that are often the determining factor in the diagnosis of a particular disease. A full examination, including laboratory and hardware research methods, helps to fully see the clinical picture of the disease and make the correct diagnosis. Timely treatment can eliminate pain and relieve other unpleasant symptoms of concomitant disease.
What does pain in the right hypochondrium mean?
Discomfort in the right side occurs with a variety of pathological conditions, the most common of which are diseases of the gastrointestinal tract and internal organs, pathologies of the biliary and genitourinary systems, injuries of a different nature. Often, pain in this area occurs with diseases of the spine, heart or respiratory system. The nature and severity of the pain, the place of its localization and the severity of the accompanying symptoms indicate the development of a disease.
Pain in the right hypochondrium in front usually arises from organs that are adjacent to this area and may indicate the following diseases:
Cholecystitis (acute and chronic).
The chronic form of the disease is characterized by pulling, dull pains that occur periodically, usually after a violation of the diet, overeating and eating forbidden foods (fried, spicy, fatty). The exacerbation of the disease is accompanied by an increase in the inflammatory process in the gallbladder, the appearance of nausea, bitterness in the mouth and pain in the right hypochondrium. The inflammatory process provokes stagnation of bile, which is accompanied by indigestion, nausea, vomiting with an admixture of bile, a change in the color of the skin, which acquire a yellow-green hue. carried out in a complex, with the use of antibacterial agents, choleretic drugs, antispasmodics, painkillers. Mandatory is the observance of a special diet, the rejection of bad habits, lifestyle adjustments.
Cirrhosis of the liver
This diagnosis means irreversible destruction of the liver, which is a consequence of chronic hepatitis, hepatosis, circulatory disorders of the liver, its alcohol and drug intoxication. With cirrhosis, there are persistent pains in the right hypochondrium, which are not stopped by painkillers. At the same time, other symptoms develop - the liver and spleen increase in size, skin itching increases, and yellowness of the skin appears. Treatment methods are based on the use of symptomatic supportive therapy, which includes hepatoprotectors, essential phospholipids, vitamins, drugs to strengthen the immune system.
Viral hepatitis
Accompanied by prolonged arching pains in the right hypochondrium and severe symptoms of intoxication of the body (weakness, fatigue, dyspepsia, nausea, vomiting, lemon skin and sclera, skin itching, discoloration of urine and feces). Treatment is selected depending on the form of hepatitis, antiviral drugs are used, maintenance therapy is aimed at regenerating liver cells. The task of complex therapy in this case is to stop the inflammatory process and prevent possible complications. In addition to drug treatment, the patient is recommended a special diet, giving up bad habits, and a healthy lifestyle.
Cholelithiasis
It is characterized by the formation of stones in the gallbladder, which contributes to the occurrence of pain in the right hypochondrium and other unpleasant manifestations. The formation of stones is preceded by obstruction of the outflow of bile, dysfunction of the gallbladder, liver, biliary tract, concomitant diseases (chronic cholecystitis, pancreatitis, endocrine pathologies).
An exacerbation of gallstone disease causes the movement of stones that can clog the bile ducts and cause severe colic in the right hypochondrium, accompanied by nausea, vomiting, fever, weakness, yellowing of the skin and sclera. In this case, urgent surgical intervention is necessary, which is carried out in different ways. Endoscopic methods remove stones from the bile ducts, preserving the gallbladder and its functions. The classic operation involves the removal of the gallbladder along with the calculi contained in it.
Pancreatitis (inflammation of the pancreas)
A typical symptom of the disease is bursting pain in the right hypochondrium, accompanied by bloating, pallor or yellowness of the skin, upset stool, nausea, and vomiting that does not bring relief. Pancreatitis can be acute and chronic, develop as a result of alcohol intoxication, the presence of cystic formations or a purulent process. The treatment regimen is selected by a specialist individually, taking into account the severity of symptoms and the form of the disease, and is based on the use of medications, diet therapy, physiotherapy, alcohol and smoking cessation.
peptic ulcer
Characteristic pains in the right hypochondrium in front are accompanied by peptic ulcer of the stomach and duodenum. The nature of pain and its intensity depends on many factors. Discomfort occurs after eating, on an empty stomach or after physical exertion. The pain syndrome is accompanied by heartburn, sour belching, vomiting, loss of strength, alternating diarrhea and constipation, and palpitations. Often, peptic ulcer occurs in a latent form, in advanced cases there is a threat of internal bleeding and peritonitis, which poses a danger to the life of the patient and requires urgent surgical intervention.
Bowel disease
Strong, unbearable pain on the right causes inflammation of the colon. Pain in this case extends to the entire right side (up to the groin) and the navel. If the peritoneum is involved in the inflammatory process, this can lead to pain shock. In addition, bowel diseases such as colitis, Crohn's disease, ulcerative colitis, tumor processes, and appendicitis contribute to the appearance of spastic pain in the right hypochondrium.
Pain in the right hypochondrium behind causes diseases of the genitourinary system, kidneys and adrenal glands, thrombosis of the vena cava.
Pyelonephritis
Acute inflammation of the kidneys is accompanied by pain on the right side, under the ribs, radiating to the back, difficult and painful urination, edema, high fever, and general intoxication of the body. At the same time, pronounced pulling pains become permanent, there is a decrease in the volume of urine excreted, up to its complete cessation.
Urolithiasis disease
When the right kidney is damaged, pains of an intense nature occur, localized on the right, but radiating to the back and lower back. The migration of stones from the kidney through the ureter provokes renal colic and paroxysmal severe pain radiating to the thigh and groin area.
Other reasons
In addition to the above diseases, the following conditions can cause the development of pain in the right hypochondrium:
- Pneumonia, bronchitis - an inflammatory process in the lungs causes excruciating coughing attacks, which give pain in the right hypochondrium and are accompanied by a feeling of lack of air.
- Gynecological problems (for example, inflammation of the appendages) in women also cause characteristic spastic pains in the right side, which radiate to the groin and back.
- Heart failure, myocardial infarction. Insufficiency of blood circulation leads to the appearance of edema, accumulation of fluid in the abdominal cavity, an increase in the size of the liver and the appearance of dull, aching pain. With the development of myocardial infarction, sharp dagger pains suddenly appear in the epistragia and right hypochondrium, extending beyond the sternum and under the shoulder blade.
- Herpes zoster is a viral infection that is accompanied by blisters along the intercostal nerve trunks, severe pain, fever, and other unpleasant symptoms.
- Intercostal neuralgia is a disease of the nervous system, accompanied by stabbing, sharp pain, which increases with bending, turning, and breathing.
- Osteochondrosis of the lumbar spine - causes pain of varying intensity, from aching to sharp, shooting, and is accompanied by limited mobility.
In addition, injuries (fractures and bruises of the ribs), malignant tumors of internal organs, thrombosis of the vena cava, or intestinal obstruction can become the cause of characteristic pain.
First aid for pain syndrome
Pain in the right hypochondrium does not require a visit to a doctor if they are caused by physiological causes (overeating, excessive exercise). In all other cases, this symptom indicates the development of the disease or the exacerbation of an existing pathology. To alleviate the condition at home, you can take an antispasmodic tablet (No-shpy, Drotaverine, Papaverine, Sparex). Do not drown out the pain with strong painkillers, this can blur the picture of the disease and make it difficult to make a correct diagnosis.
Important! With the appearance of pain in the right hypochondrium of any intensity, it is forbidden to apply a hot heating pad to the sore spot! Warming up will provoke an increase in the inflammatory process and lead to unpredictable consequences.
Do not delay seeking medical help, as delay can significantly worsen the condition and cause dangerous life-threatening complications. Pain may indicate an exacerbation of severe pathological processes that have previously been asymptomatic, so it is necessary to undergo an examination as soon as possible and receive adequate treatment.
Which doctor should I contact?
If you experience pain in the right hypochondrium, you must first make an appointment with a therapist. The specialist will collect the necessary history, examine the patient and, in order to clarify the diagnosis, write out a referral for a number of laboratory and hardware studies. Based on the results of the diagnostic examination, the patient will be diagnosed and referred for further treatment to narrow specialists. Depending on the nature of the pathology, the patient will be treated by a gastroenterologist, hepatologist, endocrinologist, infectious disease specialist, traumatologist, gynecologist and a number of other specialists.
When is urgent medical attention needed?
Acute pain in the right hypochondrium may indicate dangerous complications that require emergency medical attention. Doctors call this condition "acute abdomen". This definition includes internal bleeding, rupture and damage to internal organs, appendicitis, peritonitis, perforated ulcers and other processes that threaten the life of the patient. It is urgent to call an ambulance team if the following symptoms appear:
- the appearance of acute, unbearable pain, the intensity of which is growing;
- incessant, painful vomiting with an admixture of bile or blood, which does not bring relief;
- a sharp drop in blood pressure, pallor of the skin, loss of consciousness;
- delay or lack of urination;
- loose stools, blood in stools;
- heat;
- prolonged constipation, bloating, which may be signs of intestinal obstruction.
Attacks of acute pain in pregnant women may be a sign of an ectopic pregnancy or miscarriage, which requires urgent hospitalization and surgical intervention.
Before the arrival of the doctors, the patient should be laid on his side, unfasten his clothes to facilitate breathing, apply a cold compress to his forehead. It is impossible to allow the patient to move, eat, drink liquid, it is forbidden to give any medications.
Prevention measures
Preventive measures to prevent pain in the right hypochondrium are reduced to the following recommendations:
- healthy and active lifestyle;
- rejection of bad habits;
- proper and nutritious nutrition;
- taking medicines only as prescribed by a doctor;
- avoidance of stressful situations;
- compliance with the rules of personal hygiene;
- the use of barrier contraceptives during sexual intercourse, the rejection of casual relationships.
Regular medical examinations (once a year) will allow you to prevent or timely detect any deviations in health and receive the necessary treatment.
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