Pain in the right upper quadrant: causes and diagnosis
Pain in the right hypochondrium develops either in diseases of localized organs there, or in diseases of those organs whose nerve endings either go to the right subcostal themselves, or intersect with the nerves located there.
The most common is the cause of pain in the right hypochondrium - liver and gallbladder disease, but there are other conditions accompanied by this symptom
It is only the doctor who can precisely determine the origin of the pain. Treatment is appointed depending on the detected pathology.
In right hypochondrium localized:
1) Hepatitis. They can be caused by:
3) Heart failure, in which there is a stagnation of blood in the liver with its increase. Usually before that person already knows about his heart disease( angina, cardiomyopathy, hypertension), he also has heart problems.
1) Cholecystitis is an inflammation of the inner membrane of the gallbladder. The pain on the right under the rib can be sharp, develops after eating fatty foods. It is accompanied by weakness, nausea, fever, bitterness in the mouth.
2) Gallstone disease manifests itself in the form of heartburn, alternating constipation and diarrhea. If the stone starts to move along the ducts, the pain becomes very strong, it gives back to the shoulder, shoulder blade, back, neck to the right, it can give to the heart area. Blockage of the bile ducts with a stone is accompanied by icteric staining of the skin and sclera, lethargy, nausea.
3) Pancreatitis. In this case the pain is localized not only under the rib on the right, but extends to the hypochondrium of the left, gives in the back. In this case, the general condition worsens, nausea and vomiting develop, often - diarrhea.
Various inflammatory bowel diseases( including infectious diseases) can be accompanied by intestinal colic, which can be manifested by pain in any part of the intestine, including in the right upper quadrant.
It is characterized by:
Right under the rib can be sick both with acute and with chronic pyelonephritis. But such a pain will be more localized in the back, accompanied by a violation of urination.
Acute pyelonephritis also manifests itself as symptoms of intoxication( nausea, lethargy, decreased appetite) and increased temperature to high digits. The chronic process is aggravated by hypothermia, accompanied by a subfebrile condition up to 37.1-37.4 ° C;at the same time it is painful.
Inflammation of an atypically located vermiform appendage( it may be under the liver) can cause pain on the right under the rib. It is intense, accompanied by nausea, 1-2 multiple vomiting, fever, symptoms of intoxication( see the first signs of appendicitis).
Inflammation, developed in the right lung tissue, can manifest atypically - pain in the right hypochondrium. In addition, there is an increase in temperature, often - cough with sputum, severe weakness, lack of appetite. There may also be a feeling of lack of air( see the symptoms of pneumonia).
Very rarely, adnexitis can manifest not a typical pain over the pubis, but pain in the rib. In addition, the temperature rises, there are abundant discharge from the vagina, appetite decreases, lethargy appears( see symptoms of inflammation of the appendages).
In this case there is no lethargy, weakness, fever, discharge or stool. Pain can be localized in the hypochondrium, but you can find a point on the spine that will be painful when you press it with your finger( see symptoms of osteochondrosis).
Before the appearance of a rash in the intercostal space, the disease becomes painful. In this case, the pain is associated with breathing, the temperature can rise, the reddening area between the ribs can be seen( see symptoms of herpes zoster).
Pain in the right upper quadrant may also be accompanied by:
In order to determine the cause of pain in the right upper quadrant, you need to contact a gastroenterologist or infectious disease specialist. These doctors can prescribe such studies:
Because the pain in the right upper quadrant is a symptom of the disease, then you need to treat the disease, and not a separate symptom.
Given the variety of reasons, therapy in each case will be significantly different: from manual therapy and taking several medications with osteochondrosis before an emergency surgery with appendicitis.
The most common is the cause of pain in the right hypochondrium - liver and gallbladder disease, but there are other conditions accompanied by this symptom
It is only the doctor who can precisely determine the origin of the pain. Treatment is appointed depending on the detected pathology.
Right hypochondria
In right hypochondrium localized:
- diaphragm;
- liver;
- biliary tract, through which bile passes into the gallbladder;
- bend of the intestine.
- of the lung;
- intercostal muscles;
- of the kidney;
- of the pancreas;
- of the spine;
- of the heart.
Pain in the right upper quadrant as a consequence of liver diseases
1) Hepatitis. They can be caused by:
- viruses A, B, C and others: in this case there is a short period when a person experiences muscle pain, weakness, a slight increase in temperature. Later a person begins to feel pain in the liver, while the whites of his eyes turn yellow, his urine darkens, and the feces become light;
- alcohol: no prodromal phenomena, as in the previous case, no. A person abuses alcohol, after which the right hypochondrium starts to ache, sclera turns yellow, skin may turn yellow. Along with this, nausea, bloating may be felt;
- toxins( fungi and other poisons): pain accompanied by yellowing, nausea, vomiting, sometimes - diarrhea. When you use a highly toxic poison, weakness is quickly replaced by a violation of consciousness.
3) Heart failure, in which there is a stagnation of blood in the liver with its increase. Usually before that person already knows about his heart disease( angina, cardiomyopathy, hypertension), he also has heart problems.
Diseases of the organs of the hepatobiliary system
1) Cholecystitis is an inflammation of the inner membrane of the gallbladder. The pain on the right under the rib can be sharp, develops after eating fatty foods. It is accompanied by weakness, nausea, fever, bitterness in the mouth.
2) Gallstone disease manifests itself in the form of heartburn, alternating constipation and diarrhea. If the stone starts to move along the ducts, the pain becomes very strong, it gives back to the shoulder, shoulder blade, back, neck to the right, it can give to the heart area. Blockage of the bile ducts with a stone is accompanied by icteric staining of the skin and sclera, lethargy, nausea.
3) Pancreatitis. In this case the pain is localized not only under the rib on the right, but extends to the hypochondrium of the left, gives in the back. In this case, the general condition worsens, nausea and vomiting develop, often - diarrhea.
Pain in the right upper quadrant as a consequence of intestinal diseases
Various inflammatory bowel diseases( including infectious diseases) can be accompanied by intestinal colic, which can be manifested by pain in any part of the intestine, including in the right upper quadrant.
It is characterized by:
- spastic character;
- some relief after defecation;
- by changing the consistency and odor of stool.
Diseases of the kidneys
Right under the rib can be sick both with acute and with chronic pyelonephritis. But such a pain will be more localized in the back, accompanied by a violation of urination.
Acute pyelonephritis also manifests itself as symptoms of intoxication( nausea, lethargy, decreased appetite) and increased temperature to high digits. The chronic process is aggravated by hypothermia, accompanied by a subfebrile condition up to 37.1-37.4 ° C;at the same time it is painful.
Appendicitis
Inflammation of an atypically located vermiform appendage( it may be under the liver) can cause pain on the right under the rib. It is intense, accompanied by nausea, 1-2 multiple vomiting, fever, symptoms of intoxication( see the first signs of appendicitis).
Pneumonia
Inflammation, developed in the right lung tissue, can manifest atypically - pain in the right hypochondrium. In addition, there is an increase in temperature, often - cough with sputum, severe weakness, lack of appetite. There may also be a feeling of lack of air( see the symptoms of pneumonia).
Inflammation of the appendages of the uterus
Very rarely, adnexitis can manifest not a typical pain over the pubis, but pain in the rib. In addition, the temperature rises, there are abundant discharge from the vagina, appetite decreases, lethargy appears( see symptoms of inflammation of the appendages).
Osteochondrosis
In this case there is no lethargy, weakness, fever, discharge or stool. Pain can be localized in the hypochondrium, but you can find a point on the spine that will be painful when you press it with your finger( see symptoms of osteochondrosis).
Herpes shroud
Before the appearance of a rash in the intercostal space, the disease becomes painful. In this case, the pain is associated with breathing, the temperature can rise, the reddening area between the ribs can be seen( see symptoms of herpes zoster).
Other diseases
Pain in the right upper quadrant may also be accompanied by:
- cancer of one of the organs of the hepatobiliary zone;
- liver hemangioma;
- cholangitis;
- fatty degeneration of the liver;
- ulcer of the duodenum;
- liver abscess;
- reaction of liver rejection after its transplantation;
- obstruction of that place in the 12-duodenum, where the bile ducts flow.
Diagnosis of pain in the right subcostal area
In order to determine the cause of pain in the right upper quadrant, you need to contact a gastroenterologist or infectious disease specialist. These doctors can prescribe such studies:
- ultrasound of the abdominal cavity, kidneys and pelvic organs;
- chest radiograph;
- X-ray of the spine;
- heart ultrasound;
- ECG;
- hepatic assays;
- hemogram;
- stool analysis.
Treatment
Because the pain in the right upper quadrant is a symptom of the disease, then you need to treat the disease, and not a separate symptom.
Given the variety of reasons, therapy in each case will be significantly different: from manual therapy and taking several medications with osteochondrosis before an emergency surgery with appendicitis.