Causes
Abdominal pain in the right upper abdomen Among the most common causes of abdominal pain in the right upper abdomen are diseases of the gall bladder. Particularly in older patients, if symptoms occur in this region, a possible impairment of the gallbladder or the draining bile ducts should be considered. An inflammatory change in the gallbladder (cholecystitis) or the obstruction of the bile ducts by a stone (choledocholithiasis) is usually manifested for the affected patient by the sudden development of pulling or stabbing abdominal pain in the upper abdomen.
The intensity of these complaints is described by most of those affected as hardly bearable. Furthermore, it can be observed that abdominal pain in the right upper abdomen caused by an impairment of the gall bladder often occurs immediately after meals. This fact can be explained by the fact that the gallbladder contains a signal for emptying in the course of eating.
If the draining bile ducts are blocked by a small stone, the bile cannot be transported into the duodenum or can only be transported inadequately. The stones located in the bile ducts or in the gall bladder come into close contact with the mucous membranes and trigger pain in the upper abdomen. Other causes of right-sided upper abdominal pain can be diseases of the liver.
In most cases, however, the typical liver diseases (hepatitis, liver cirrhosis, liver tumours) lead to pain phenomena much less frequently. Abdominal pain in the area of the right upper abdomen caused by the liver usually occurs due to swelling of the organ. Since the liver is surrounded by a rather rough capsule, it cannot expand.
The pain perceived by the patient therefore originates less from the liver itself than much more from the liver capsule which is under strong tension. Abdominal pain in the middle upper abdomen Abdominal pain in the middle part is comparatively rare. Nevertheless, its cause should be urgently determined and, if necessary, appropriate treatment should be initiated without delay.
If a patient experiences abdominal pain in the middle upper abdomen, this is usually caused by a problem in the stomach. The pain is often caused by irritation or inflammatory processes of the stomach lining (gastritis). In addition, diseases of the pancreas are considered to be possible causes for the development of abdominal pain in the middle upper abdomen.
Inflammatory changes in the pancreas (pancreatitis) in particular often lead to upper abdominal pain, which radiates in a belt-shaped manner into the back. Patients suffering from an acute inflammation of the pancreas usually show further symptoms (fever, deterioration of the general condition). In addition, darkening of the urine and lightening of the stool (acholic stool) can be observed in those affected.
A further cause of pain in the middle upper abdomen can be an acute heart attack. In this clinical picture, the affected patients experience complaints in the area of the chest, the left shoulder or arm, the neck and the jaw much more frequently, but corresponding abdominal pain can also occur. Abdominal pain in the left upper abdomen Because the spleen is located directly in the left upper abdomen, it is often responsible for pain in this area.
Inflammatory processes of the spleen are a medical rarity and are almost never seen in clinical routine. Left-sided upper abdominal pain originating from the spleen is usually caused by other diseases. In most cases, these trigger a severe swelling of the organ and a consequent tension of the spleen capsule.
The pain in the left upper abdomen is therefore caused by the capsule apparatus and not by the spleen itself. The most common diseases that lead to an enlargement of the spleen (splenomegaly) include blood diseases such as leukaemia and infections such as Pfeiffer’s glandular fever. Abdominal pain in this area, which occurs immediately after a trauma (accident or kick), can be a first indication of a rupture of the spleen.
If pain in the left upper abdomen occurs immediately after heavy physical exertion or sport, it can usually be assumed that it is a harmless side sting. Furthermore, left-sided upper abdominal pain can be caused by the kidneys and/or the draining urinary tract. Especially kidney stones that are flushed out of the calyx system of the kidney and block the ureters can lead to strong, colicky pain symptoms.
Another possible cause of pain in the left upper abdomen is an ascending infection originating from the bladder. The spread of this urinary tract infection can ultimately even lead to inflammation of the renal pelvis (pyelonephritis). Both kidney stones and the ascending urinary tract infection can potentially provoke pain in the right and left upper abdomen.
