Abdominal pain on the right

Definition

Abdominal pain on the right side means pain in the area of the right lower or upper abdomen, which can have different causes and different pain characteristics.

Introduction

Abdominal pain is a very common and unspecific symptom of various diseases. The cause can range from “harmless” constipation to life-threatening organ perforation. All these diseases can cause abdominal pain in the right upper or lower abdomen as a basic symptom.

However, they differ in the course and severity of the general symptoms and the occurrence of other accompanying symptoms. In the following, individual clinical pictures will be briefly explained. A distinction is made between diseases in the right upper abdomen and diseases in the right lower abdomen.

Causes

Pain that is indicated in the right abdominal area can be further subdivided into Depending on the area in which the pain is indicated, other underlying diseases can be the cause and must be excluded. – pain on the upper abdomen and

Upper abdominal pain on the right

The right upper abdomen describes the area between the navel and the ribs on the right side. This area is mainly: Accordingly, a breakthrough (perforation) of all these organs can lead to the strongest sudden abdominal pain on the right side. As a rule, the pain after the perforation first gets a little better and then increases again until the full picture of the acute abdomen is obtained.

Such a perforation is usually caused by inflammation, for example: Usually this type of illness is also accompanied by fever and a very poor general condition. In addition to abdominal pain, gall bladder inflammation leads to the typical Murphy’s sign on the right. Here, the examiner presses his fingers under the right costal arch and asks the patient to breathe deeply.

An inflamed gall bladder is clearly enlarged and then presses against the examiner’s fingers. As this is very painful for the patient, the inhalation is suddenly interrupted. Due to tumours or metastases in the liver, it can swell and thus cause the so-called liver capsule pain.

This pain also develops in the right upper abdomen and can also be triggered by palpation of the liver from the outside. The pain is described as a dull, visceral permanent pain. In addition, the right diaphragm stands up and fever is often present.

As a rule, all the upper diseases must be treated surgically, since a perforation in the free abdomen is always a life-threatening disease. Even an inflammation of the gall bladder can be treated and removed surgically, as the quality of life is not restricted without a gall bladder and this is the simplest and most effective method of treatment. Only abdominal pain caused by tumours or liver capsule tension pain must be treated by other means.

Often the symptoms have to be alleviated, a complete cure is not always possible. Constipation is one of the most common causes of abdominal pain and can occur in all parts of the abdomen, as it is a collection of stool in the large intestine. The cause of this can be one: you pain can occur in all positions.

For example, some patients complain of abdominal pain while sitting. – the liver and

  • Gall bladder and
  • Parts of the large and small intestine. – ulcers in the small intestine (ulcer perforation)
  • An inflammation of the gall bladder (cholecystitis) or
  • Tumors in the colon.
  • Insufficient fluid absorption
  • Transport disturbances (peristalsis) of the intestine or
  • …be medicine. The stool in the intestine is palpable in pronounced findings and leads to colicky pain, as the intestine tries to transport the stool by increased intestinal movements against resistance. The therapy consists of an enema, as well as regular intake of laxative and sufficient fluid.

In the area of the right upper abdomen, individual sections of the intestine may have been displaced and may also cause pain in the event of an intussusception or diverticulitis. In most cases, however, the abdominal organs located directly in the upper abdomen area are affected, which can become diseased and thus cause pain. The most common cause of these abdominal pains on the right is diseases of the gallbladder, which is located in that area.

Often it is gallstones that are located in the gallbladder and can cause discomfort whenever they come into contact with the gallbladder wall. Particularly after eating, when the gallbladder contracts to squeeze out the bile acids it contains, it can happen that the gallstones are pressed against the wall of the gallbladder and can cause stab-like, very severe pain in the area of the right upper abdomen. It is also possible that the stones are so large that they obstruct the exit of the gallbladder, causing a build-up of bile acid.

This can also lead to severe pain. Chronic gallstone disease can also lead to inflammation of the gallbladder. In this case the wall of the gallbladder thickens, inflammatory changes occur and sometimes very severe pain in the area of the right upper abdomen.

Liver diseases can in some, albeit rare, cases also lead to pain in the area of the right upper abdomen. However, malignant tumour diseases do not usually cause complaints unless they are already well advanced. In the entire abdominal area, but also isolated on the right upper or lower abdomen, symptoms of intestinal obstruction (ileus) or peritonitis can occur. A rupture of the liver, which is usually the result of a previous trauma, also causes severe pain in the upper abdomen on the right side.