What Causes The Pain Under My Ribs in The Right Upper Quadrant of My Abdomen?

Overview

Your abdomen is divided into four quarters, or quadrants. Imagine a vertical line that divides your abdomen in half. Then, imagine a horizontal line at the level of your belly button. The uppermost quarter on your right-hand side is your right upper quadrant (RUQ).

The RUQ contains many important organs, including parts of your liver, right kidney, gallbladder, pancreas, and large and small intestine.

It’s important for you to pay attention to pain in your RUQ because it could be an indicator of a number of diseases or conditions.

Symptoms

RUQ pain may vary in intensity depending on the underlying condition. The pain may feel like a dull ache or a sharp stabbing sensation.

If you have had abdominal pains that last more than a few days, you should make an appointment with your doctor to have your symptoms evaluated.

However, some symptoms may indicate a medical emergency. You should seek medical help immediately if you have:

  • severe abdominal pains
  • fever
  • persistent nausea and vomiting
  • blood in your stool
  • swelling or tenderness of your abdomen
  • unexplained weight loss
  • yellowish skin (jaundice)

Causes of RUQ pain

Kidney problems

Kidney problems such as kidney stones, a urinary tract infection (UTI), a kidney infection, or kidney cancer can lead to RUQ pain.

Symptoms that can accompany RUQ pain due to a kidney problem include:

  • pain that radiates to the lower back or groin
  • painful urination
  • foul-smelling urine
  • frequent urination
  • blood in your urine
  • fever
  • nausea or vomiting

If you have RUQ pain and suspect it may be due to a kidney problem, you should make an appointment with your doctor.

Liver conditions

Liver conditions can also lead to RUQ pain. Examples include hepatitis, a liver abscess, or liver cancer.

In addition to RUQ pain, other symptoms of a liver condition can include:

  • yellowish skin (jaundice)
  • abdominal tenderness
  • nausea or vomiting
  • darkened urine
  • fever
  • fatigue
  • unexplained weight loss

If you have RUQ pain and symptoms that are consistent with a liver condition, you should see your doctor.

Preeclampsia

Preeclampsia is a condition that typically occurs in women who are at least 20 weeks into their pregnancy. It can also develop earlier in pregnancy, or, in some cases, postpartum.

The hallmark of preeclampsia is a rise in blood pressure, but RUQ pain often occurs as well.

Additional symptoms can include:

  • severe headache
  • nausea or vomiting
  • decreased urination
  • protein in urine
  • kidney or liver problems
  • blurred vision or sensitivity to light
  • shortness of breath

Your doctor should be monitoring your blood pressure as part of your prenatal care visits. However, if you experience preeclampsia symptoms such as RUQ pain, blurred vision, or shortness of breath, you should seek immediate medical care as it can be life-threatening for both you and your child if left untreated.

Gallbladder problems

Gallbladder problems, such as gallstones or choledocholithiasis, can cause RUQ pain. Choledocholithiasis is the presence of gallstones within your bile ducts.

RUQ pain due to gallstones may last several hours and most often occurs after a large meal or in the evening. Additional symptoms to look out for can include:

  • nausea and vomiting
  • fever
  • chills
  • darkened urine or light-colored stools
  • yellowish skin (jaundice)

If you’re experiencing symptoms consistent with gallstones or choledocholithiasis, you should see your doctor. Stones in the bile ducts can lead to serious complications.

Gastrointestinal issues

A variety of gastrointestinal issues, such as indigestion, gastritis, and peptic ulcers, can cause RUQ pain.

Typically, the pain caused by these conditions is a dull, burning type of pain. Other symptoms can include:

  • a feeling of uncomfortable fullness
  • abdominal bloating
  • burping or gas
  • nausea or vomiting

While most cases of indigestion and gastritis are mild and will resolve themselves, you should see your doctor if you have symptoms for a week or longer. If you suspect that you have a peptic ulcer, you should see your doctor.

Pancreatic conditions

You can feel RUQ pain if your pancreas is inflamed, which is known as pancreatitis. The pain that you experience from pancreatitis slowly worsens over time and additional symptoms can include:

  • nausea or vomiting
  • fever
  • increase in heart rate

Most cases of pancreatitis require hospitalization for treatment.

Additional triggers for right upper quadrant pain

In addition to the conditions discussed above, other underlying conditions can trigger pain in your RUQ.

These include an injury or trauma, pneumonia, and shingles.

Diagnosis

In order to diagnose the cause of your RUQ pain, your doctor will request your medical history and also perform a physical examination.

Additionally, they may order some tests to reach a diagnosis, including:

  • a basic or comprehensive metabolic panel (BMP or CMP) to evaluate your liver function, blood cell counts, and electrolyte levels
  • urinalysis to assess your kidney function or to check for a UTI or kidney stones
  • stool culture to see if there are any pathogens present in your stool
  • endoscopy to check for the presence of ulcers
  • imaging tests, such as ultrasound, X-ray, or CT scan, to help see the inside of your abdomen or to check for the presence of stones

Treatment

Treatment for RUQ pain is dependent on what’s causing it. Examples include:

  • pain relievers such as acetaminophen (Tylenol) or ibuprofen to relieve discomfort
  • antacids to help neutralize stomach acid
  • medications such as proton pump inhibitors or acid blockers to reduce the amount of acid in your stomach or intestines
  • antibiotics to kill bacteria that are causing an infection
  • surgical procedures, such as those to remove stones or excise a tumor
  • cancer treatments, such as chemotherapy, radiation therapy, or immunotherapy

Medical procedures and recovery

Typically, your doctor will try to avoid performing a surgery whenever possible. It may be necessary for some conditions in order to avoid complications or the disease worsening.

For example, if gallstones that block a bile duct (choledocholithiasis) are not removed, there can be life-threatening complications. In some cases, your doctor may choose to remove your gallbladder completely.

If your kidney stones are too large to be passed naturally, your doctor may choose to use sound waves to break the stones into smaller pieces that can be passed. They may also use a scope to remove the stones.

If you are diagnosed with kidney or liver cancer, surgery may be necessary to remove a tumor, depending on the cancer’s stage and severity.

Complications

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Since your RUQ contains many important organs, it’s important to monitor RUQ pain and any additional symptoms in order to seek treatment in a timely manner and avoid complications.

Examples of potential complications include:

  • kidney infection due to an untreated UTI
  • high blood pressure, kidney failure, or kidney scarring from an untreated kidney infection
  • low birth weight, preterm birth, organ damage, or death from unaddressed preeclampsia
  • inflammation or infection of the gallbladder or pancreas due to untreated gallstones
  • increased risk of ulcers or stomach cancer from untreated gastritis
  • progression of cancers that are not caught early

Prevention

You can help prevent some instances of RUQ pain by:

  • foods rich in fiber, such as whole grains, fruits, veggies, and beans
    • foods with healthy fats, such as olive oil and fish oil, while avoiding unhealthy fats like fried food
  • avoiding foods that contain refined carbohydrates, sugars, and salt
  • staying hydrated, because drinking lots of liquids can help flush bacteria from your urinary tract
  • using calcium supplements with caution to avoid kidney stones
    • avoiding indigestion by making sure foods have been cooked completely and avoiding food or drinks that are spicy, greasy, or contain a lot of acid or caffeine
  • quitting smoking and lowering your alcohol intake
  • maintaining a healthy weight.

Outlook

The possible causes of RUQ pain can vary. Some of them, such as indigestion, are very common and will often go away on their own. Others, such as preeclampsia or pancreatitis, need to be addressed right away.

Since your RUQ contains a variety of important organs, it’s important to monitor RUQ pain.

If you’ve had RUQ pain for a week or longer, you should make an appointment to see your doctor.

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