After eating there is pain in the right hypochondrium. Pain in the right hypochondrium after eating: causes, pathological signs, complications. Relief and pain relief

In the area of ​​the right hypochondrium are the liver and gall bladder. The head of the pancreas is also located here. Pathologies of these organs and the stomach cause pain on the right side after eating.

Usually there is pain in the right side after eating if:

• inflammation of the head of the pancreas;
• gallbladder dyskinesia;
• gastritis;
• peptic ulcer stomach;

Does your right side hurt after eating?

The symptoms of all these diseases are similar. However, the intensity of the painful attack and its characteristics vary. Let's take a closer look at how the right side hurts after eating, depending on the specific disease:

1. Pancreatitis gives quite strong pain, which begins abruptly after violating the recommended diet. The pathology is characterized by a gradual increase in cramping pain that can torment a person for several days.
2. If the ulcer is located on the right side of the stomach, the pain also begins after a heavy meal. However, after eating, the right side under the ribs does not hurt so much. The sensations may increase with physical activity or consumption of alcoholic beverages. In this case, the pain becomes acute and unbearable.
3. Inflammation of the gallbladder and the formation of stones in its cavity cause pain in the right side after eating. It's heavy It's a dull pain, which becomes sharp, for example, when a stone comes out into the duct.

If after eating your right side hurts under the ribs, it is necessary to conduct a thorough diagnosis and begin treatment of the pathology.

Pain is the main reason for seeking medical help. Few people consider it necessary to consult a specialist if less danger signs diseases. The trend is quite sad, but these are the characteristics of the mentality. Previously undetected pain requires special attention. It may indicate acute pathological processes requiring emergency medical attention. If for a long time after eating under the ribs, then this is typical for chronic pathology digestive system.

Causes

The reasons for this after eating can be varied. If such symptoms appear, you must make an appointment with a gastroenterologist. During the examination, the doctor will determine the probable cause of the pain syndrome. As a rule, organs involved in the production and secretion of bile contribute to the development of this pathological condition. The connection between pain and food intake is observed with inflammation of the gallbladder, with hepatitis and with impaired muscle contraction of the biliary tract. To confirm the diagnosis, more detailed research methods must be performed.

Inflammation of the gallbladder is the most common disease that contributes to the appearance of such symptoms as pain in the right hypochondrium after eating. Cholecystitis is divided into acute and chronic. In the first case, the pain will be intense, cramping, radiating under the right shoulder blade, shoulder or lower back. In some cases, the intensity of the pain is so high that patients lose consciousness. From a pathogenesis point of view, discomfort in the right hypochondrium are caused by spasms of the gallbladder. Causes of spasms:

• Blockage of the outlet with a stone;
• Formation of scars on the wall of the bladder;
• Direct inflammation of the organ wall;
• Functional disorder such as dyskinesia.

With catarrhal cholecystitis, pathological processes develop only in top layer mucous membrane. With the right diet and prescription of anti-inflammatory drugs, the pain syndrome can go away. If the cause of inflammation is gallstone, then more will be required serious methods treatment, such as ultrasound lithotripsy or surgical techniques. If a stone disrupts the flow of bile for a long time, then irreversible processes occur in the wall of the gallbladder. In this case, patients complain of acute pain in the right side, deterioration in general health, and an increase in temperature to 39 ° C. The leading method of treatment in such cases is cholecystectomy.

Pathogenesis of acute cholecystitis

The disease is associated with inflammation of the liver parenchyma. In most cases, the cause of hepatitis is viral infection. The long course of the disease leads to suppression of all liver functions, as well as to the replacement of parenchyma with fibrous tissue. Exists whole line viruses that cause this disease, but we are only interested in three of them, A, B and C.

Viral hepatitis A, or Botkin's disease. It is characterized by an acute onset and the route of transmission is fecal-oral. In terms of treatment, it is considered the most favorable.

Viral hepatitis B. The mode of transmission is sexual, parenteral (through blood). Many of the patients became infected during various manipulations contaminated instruments. Particularly dangerous are nail scissors in beauty salons and tattoo needles. The disease is often combined with HIV infection. Treatment consists of the use of antiviral and immunoenzyme drugs.

Viral hepatitis C, also known as the “gentle killer”. The disease is characterized by long-term asymptomatic. For large gap over time (several years), the liver tissue is slowly but surely replaced by connective tissue. The liver gradually loses a number of its functions, digestive disorders develop, suppression of protein synthesis and detoxification of harmful chemical compounds. After the first clinical signs patients quickly decompensate, they develop ascites, varicose veins veins, bleeding from the esophagus, hemorrhoids and hepatic coma.

In addition to viruses, the development of hepatitis is facilitated by long-term consumption of alcohol substitutes, toxic damage to the liver (medicines, poisons) and autoimmune processes. With inflammatory processes in the liver, the right side often hurts after eating fatty meat, coffee and alcohol.

Pancreatitis

- This is a very important component of the digestive system. Conventionally, it can be divided into two parts. The first is responsible for synthesis digestive enzymes, necessary for the digestion of proteins, fats and carbohydrates. The second releases biologically into the blood active substances(insulin and glucagon). Insulin is a hormone that lowers the concentration of glucose in the blood. When there is a deficiency, the plasma sugar level is always high and in such cases the patient develops diabetes.

Pancreatitis is a disease caused by inflammatory processes in the pancreatic parenchyma. In most cases it develops with long-term use alcohol-containing drinks. Very often pancreatitis is combined with calculous cholecystitis. The pancreas and gallbladder are connected to each other by a common excretory duct. If a gallstone blocks this duct, then pancreatic excretion will not be able to exit into the lumen of the duodenum and will have to return. It must be said that excrement is very active and is capable of breaking down both food bolus, and the parenchyma of the pancreas.

Classic pain with pancreatitis has an acute girdling nature, however, this localization is now rare. When visiting a doctor, most patients note the appearance of pain in the epigastric region, right and left hypochondrium. TO associated symptoms applies:

• Nausea and vomiting;
• Abnormal stool;
• Temperature increase;
• Tachycardia;
• Fall in blood pressure.

The pain intensity is so high that patients assume a forced body position (fetal position).

The disease is life-threatening and requires emergency medical care. Pancreatitis can masquerade as other pathological processes gastrointestinal tract(perforated ulcer, acute cholecystitis, appendicitis).

Diagnostics

In the arsenal modern doctor There are many techniques to determine the cause of the development of pain. At the first meeting, the doctor evaluates appearance patient, color skin, body type, condition of hair, nails, etc. All this can tell about the patient’s habits and lifestyle. Then physical examination methods (auscultation, percussion, palpation) come to the rescue.

Of particular importance in the diagnosis of diseases abdominal cavity occupies an ultrasound examination. This technique allows you to visualize internal organs, assess the condition of their parenchyma and record the presence of stones or pathological formations.

is a technique that involves using a special optical device endoscope to assess the condition of the mucous membranes of the upper sections digestive tract. FGDS allows us to exclude the presence of a perforated gastric ulcer and the development of carcinoma.

Laparoscopy. Also applies to endoscopic methods research, but in this case the device is inserted into the abdominal cavity. Thanks to this manipulation, it is possible to diagnose cholecystitis, pancreatitis, hepatitis and collect biological material. In addition, if the surgeon is sufficiently qualified, laparoscopy can be performed for therapeutic purposes.

Treatment

Treatment should be carried out only after diagnosis has been established. For example, if after an attack of acute cholecystitis the patient drinks a painkiller, this will blur the clinical picture and make it more difficult for the surgeon to make a diagnosis. Etiological treatment is carried out in different ways, but for all diseases of the digestive system a specific diet is prescribed. If pain in the right side after eating occurs due to the fault of the gallbladder, then you need to limit your consumption of fatty, smoked, and sweet foods. For exocrine pancreatic insufficiency, enzyme replacement therapy is prescribed (

Pain in the right hypochondrium after eating is an unpleasant manifestation varying degrees intensity, which occurs regardless of age category and gender.

The main reasons for the development of such a symptom are diseases of the digestive system; a little less often, its appearance is caused by other ailments. In addition, there is a small group of physiological predisposing factors.

Since, in the overwhelming majority of cases, a pain syndrome of similar localization and time of manifestation indicates a disease, it is natural that other symptoms will develop against its background. To establish what was the source of such a sign, the patient is advised to undergo a complex of laboratory and instrumental diagnostic examination. Treatment tactics will be fully consistent with etiological factors.

Etiology

Before talking about the causes of pain, patients need to know what internal organs are located in this area. These include:

• liver;
• right kidney and adrenal gland;
• gallbladder;
• the pancreas, namely its head;
• part of the diaphragm;
• appendage of the cecum;
• bile ducts.

These are the main organs, damage to which certainly causes pain after a meal. However, pain can occur with pathologies of the stomach and duodenum or of cardio-vascular system, as well as the inferior vena cava.

Among the diseases of the digestive system that can cause pain, highlight:

• hepatitis is a pathological process that is characterized by inflammation in the tissues of this organ. In such cases, the pain will be aching in nature;
• Gilbert's disease is a hereditary disease that can be asymptomatic, but in most cases it is expressed by jaundice of the skin and pain under the ribs on the right after eating;
• cholecystitis is an inflammation of the gallbladder, which is often accompanied by the formation of stones in this organ or its ducts;
• GSD is a pathology that represents the appearance of stones in gallbladder or bile ducts. The disease mainly occurs in chronic form, and the manifestation of symptoms, in particular pain under the right ribs, occurs during periods of exacerbation;
• Pancreatitis is an inflammation of the pancreas, but it is worth considering that pain in the right hypochondrium after eating is caused only by inflammation of the head of this organ. The pain syndrome varies from dull to acute;
• peptic ulcer of the duodenum or stomach;
• bulbitis - characterized by inflammation of the duodenal membrane. Damage to the duodenal bulb leads to the appearance of a similar symptom. Soreness can be expressed not only a few hours after eating, but also at night;
• gastritis;
• acute inflammation appendicitis.

In addition, there are less common causes of pain that are not related to the digestive system. For example:

• kidney disease - the pain will be girdling;
• pneumonia - pain under the right ribs occurs several hours after a meal, and also increases significantly when coughing;
• osteochondrosis;
• chronic form of heart failure;
• myocardial infarction – with this disease, patients report severe and stabbing pain;
• gynecological problems, for example, ectopic pregnancy;
• mental disorders– in this case, diseases of the gastrointestinal tract in humans are not observed.

The physiological reasons for the appearance of pain in such localization after eating are:

• attack severe cough– in such cases, the pain goes away on its own, after certain time;
• pregnancy period - the development of pain occurs against the background of an increase in the size of the uterus and active growth of the fetus, eating food is only an irritating factor;
• ending menstrual cycle– at this time there is a decrease in progesterone levels and an increase in estrogen. This is what leads to spasms bile ducts which cause pain under the ribs on the right and in front after eating;
• reception by female representatives hormonal contraceptives;
• intense physical activity immediately after a meal;
• consuming large amounts of fatty and spicy food;
• habit of washing down food with carbonated and alcoholic drinks, as well as strong coffee.

Such predisposing factors can cause pain under the right ribs after eating in completely healthy people.

Symptoms

Given that in almost all cases such a symptom indicates gastrointestinal diseases, the clinical picture may consist of various signs characteristic of a particular disease.

If the cause of the main symptom is hepatitis, then pain in the right hypochondrium after eating will be accompanied by:

• yellowness of the skin and mucous membranes;
• constant feeling of nausea;
• belching with unpleasant smell;
• changes in the color of urine and feces;
• increased body temperature;
• severe itching of the skin;
• increased weakness and fatigue.

In situations where the source is Gilbert's disease, the clinical picture will consist of:

• sleep disorders;
• decreased appetite;
• bitter taste in the mouth;
• bitter belching;
• dizziness;
• increased gas formation;
• nausea and vomiting;
• burning sensation in the chest area;
• stool disorders.

When the cause is cholecystitis or gallstones, then against the background of the main symptom the following appear:

• itchy skin;
• attacks of severe headache;
• bitter and metallic taste in the mouth;
• increase in abdominal size;
• significant increase in body temperature.

For pancreatitis clinical manifestations, in addition to pain, will serve:

• lack of appetite;
• flatulence and bloating;
• alternating diarrhea and constipation;
• weight loss;
• pain;
• dry mucous membranes;
• strong thirst.

In cases of pain under the right ribs due to peptic ulcer, symptoms may also include:

• severe heartburn;
• nausea and flatulence;
• belching with a bitter and sour smell;
• decreased appetite;
• increased sweating;
• the appearance of plaque on the tongue.

It is worth noting that the symptomatic manifestation of a particular disease will be individual for each person.

Diagnostics

If you experience pain in the right hypochondrium after eating, you should seek help from a gastroenterologist. In order for the clinician to establish the cause of such a symptom, the patient is prescribed a number of laboratory and instrumental diagnostic measures. However, before performing them, the doctor must independently perform several manipulations. Thus, primary diagnosis will consist of:

• conducting a detailed survey to determine the availability additional symptoms;
• familiarization with the patient’s medical history and life history;
• carrying out a physical examination, with mandatory palpation of the abdomen.

Only after this is execution shown laboratory research blood, urine and feces.

However, the basis for diagnosing any disease is instrumental methods examinations, among which it is worth highlighting:

• radiography;
• FEGDS;
• CT and MRI;
• cholecystoangiography and retrograde cholangiopancreatography;
• biopsy;
• sphincter of Oddi manometry.

If necessary, additional consultation with specialists may be prescribed.

Such events will help the doctor not only find out the causes of the main symptom, but also prescribe the most effective treatment tactics for each patient.

Treatment

Elimination of pain in the right hypochondrium after eating directly depends on what caused it. In most cases it will be sufficient to do conservative methods therapy, namely:

• reception medicines– to neutralize symptoms, inflammation and pathogenic bacteria, as well as to normalize the functioning of the affected organ;
• adherence to a dietary diet - if the cause is gastrointestinal diseases;
• using recipes alternative therapy- this should under no circumstances be the only way treatment.

TO surgical intervention apply when conservative treatment is ineffective, in cases serious condition patient, as well as for cholelithiasis, oncology and peptic ulcer disease.

A common reason for a visit to a gastroenterologist or therapist is patient complaints of pain in the right hypochondrium. Discomfort in this area of ​​the abdomen can sometimes occur in healthy people during physical activity.

This symptom often occurs as a result of stagnation of bile in the biliary tract. When the anterior wall of the abdominal cavity is tense, pressure occurs on the gallbladder and, as a result, it contracts. Such an attack is usually short-lived and usually ends with loose stools and improvement in the patient's condition. In some cases, acute, sharp pain in the right hypochondrium may be an indication that you should immediately consult a doctor to avoid severe consequences and complications.

Possible causes of pain in the right hypochondrium.

Pain in the right hypochondrium can occur as a result of inflammation various organs: small intestine, gallbladder, duodenum and colon, right kidney, diaphragm, pancreas.

Pain in the upper abdominal cavity and in the area of ​​the right hypochondrium can be caused by injuries to the above organs. The strength and nature of the pain felt are determined by the location and various features pathological process.

There are often cases when sharp pain in the right hypochondrium occurs as a result of diseases of organs that are located in another part of the abdomen. IN in this case pain sensations are transmitted through nerve fibers.

Diseases accompanied by pain in the right hypochondrium.

Most often, acute pain in the right hypochondrium occurs when. Bile, which contains enzymes necessary for digesting food, is produced in the liver. Excess bile is stored in the gallbladder, and from there the bile enters the duodenum.

Eating large amounts of fatty foods various infections, the formation of stones in the gall bladder provokes the occurrence of an inflammatory process -. The main acute symptoms are vomiting, nausea, burning pain in the right hypochondrium, which can extend under the shoulder blade or into the shoulder. In some cases it may start severe itching skin or, surgical treatment is required.

Severe pain in the right hypochondrium is possible with the disease due to the inflammatory etiology of the liver. can occur due to poisoning, various chemical poisons or as a result of infections. may be accompanied by an increase in body temperature, intoxication of the body and a sharp deterioration general condition.

A nagging pain in the right hypochondrium is characteristic of chronic pain, accompanied by an enlarged liver and intolerance to fried foods. For a long time, with chronic disease, the patient does not show any symptoms, since the liver usually does not hurt. However, at this time, a gradual process of replacing liver cells with connective tissue occurs, as a result of which it develops. Therefore, if you suspect liver problems, your course of treatment should include drugs to support the liver - the most effective of which are drugs based on.

Dull pain in the right hypochondrium indicates chronic inflammation gallbladder, accompanied by nausea after eating, yellowing of the sclera and skin. In this case, treatment is carried out using antispasmodics, antibiotics, and diet.

Aching pain in the right hypochondrium is provoked by a disorder of the biliary system - resulting from a violation of its motor function. This disorder most often has a psychosomatic origin. The patient experiences pressing pain in the right hypochondrium, bitterness in the mouth, decreased appetite, fatigue, and bad mood.

Stitching pain in the right hypochondrium can be provoked by pathology of the right kidney, accompanied by nausea, vomiting, increased body temperature, intoxication, weakness, and painful frequent urination. With urolithiasis and pyelonephritis, painful sensations occur in the side and back, radiating to the stomach. With the formation of a pronounced destructive process and stones large sizes required surgery. At conservative treatment antispasmodics, antibiotics, and detoxification are used.

Throbbing pain in the right hypochondrium bothers patients, which is characterized by shingles strong pain in the epigastric region, nausea, constant vomiting mixed with bile, bloating, diarrhea and increased body temperature. Chronic is accompanied by bursting pain in the right hypochondrium, enzymatic deficiency, and flatulence. Therapeutic therapy is carried out using fasting, anti-enzyme drugs, cytostatics and antispasmodics. In case of an acute process, therapy is carried out only in a hospital setting to avoid serious complications.

The appearance of night pain in the right hypochondrium is characteristic of a duodenal ulcer, the symptoms of which also include pain on an empty stomach or immediately after eating, flatulence, nausea, bloating, belching, and sometimes vomiting with blood. If the patient is worried, stabbing pain, dizziness and weakness should be called immediately ambulance, as this may indicate perforation of the ulcer.

Other causes of pain in the right hypochondrium:

• cholangitis;
• colitis;
• tumor of the liver and gall bladder;
• liver abscess;
• cardiac cirrhosis of the liver;
• helminthic infestation(giardiasis, echinococcosis, ascariasis).

So, reasons painful sensations there may be many in the area of ​​the right hypochondrium. To accurately clarify the problem, you need to contact a qualified specialist, in this case a gastroenterologist, to undergo an examination and prescribe appropriate treatment.

Pain in the right hypochondrium is a symptom that occurs in a number of diseases and pathological conditions internal organs. In a person on the right under the ribs there is a liver, part of the pancreas, gall bladder, right part diaphragm, duodenum and small intestine, upper pole of the right kidney and appendix, so to diagnose the disease you need to know the nature of the pain, its severity and accompanying symptoms.

What can hurt in the right hypochondrium?

Pain in the right side under the ribs can be caused by organs, muscles and nerve endings, which are located in the area of ​​the right hypochondrium, as well as organs that are located in the abdominal and thoracic cavity (referred, radiating pain).

The source of pain may be:

• liver (the lower part of the organ reaches the lower ribs, and the upper edge stretches from the right nipple to the left and is located in the upper part of the peritoneum - under the diaphragm);
• pancreas (head, pancreatic notch and uncinate process, as well as part of the omental tubercle of this organ located in the right side of the abdominal cavity);
• gallbladder (localized under the lower surface of the liver);
• right side of the diaphragm;
• right lung;
• heart and mediastinum;
• duodenum ( primary department intestines, localized under the liver and located on the right side of the abdominal cavity);
• ileum (the part of the small intestine that follows the jejunum and is located in the lower right part of the abdominal cavity);
• cecum and appendix (located in the lower part of the abdominal cavity, below the junction small intestine thick);
• ascending colon (initial part of the large intestine);
• right kidney and ureters (the upper pole of the kidney reaches the level of the 12th rib);
• right adrenal gland;
• right appendages of the uterus in women (pain in the right hypochondrium is radiating);
• spine (pathologies of the spine lead to compression of the nerves that pass in the area of ​​the right hypochondrium);
• the ribs, muscles and peripheral nerves located on the right.

Acute or recurrent pain in the right hypochondrium occurs in approximately 30% of the adult population of the planet.

Types of pain in the right hypochondrium

Painful sensations are a physiological reaction of the body, which is aimed at mobilizing various functional systems to protect against the influence of damaging factors.
According to its characteristics, pain in the right hypochondrium can be:

• Visceral. This type of pain occurs when stretching, compression, inflammation and other irritation of internal organs (observed with intestinal spasms, etc.). Pain of this type is pressing, deep, dull and diffuse (generalized), can be permanent in nature or occur in the form of colic (a series of rapidly alternating attacks of acute pain). It is difficult for the patient to establish the localization of visceral pain; pain often radiates to other parts of the body.
• Somatic (peritoneal). Occurs when the peritoneum is irritated, which occurs during the development of a pathological process (perforation of a stomach ulcer, etc.). This type of pain is described as sharp, cutting. It is distinguished by its constant nature and clear localization, in most cases accompanied by tension in the muscles of the anterior abdominal wall (“ acute stomach"). The pain intensifies with breathing and movement.
• Neuropathic (deafferentation). Pain is caused by damage or irritation of the nerves. At this type disorders, there is constant or unstable (shooting) pain, which can be sharp, stabbing, cutting, burning, or simply felt as some discomfort in the affected area.
• Reflected. Develops with pathology of organs that are distant from the source of pain as a result of irradiation of pain.

Pain under the right rib may feel like:

• Sharp, cutting. Requires immediate medical attention because it is intense, appears suddenly and is often associated with life-threatening conditions (liver or gallbladder rupture, acute appendicitis, acute pancreatitis etc.).
• Burning. Accompanies biliary dyskinesia, initial stage acute pyelonephritis, chronic pancreatitis, diseases of the spine. During attacks of angina or in a pre-infarction state, a burning sensation can be felt both under the left and under the right rib. A burning pain in the right side under the rib that occurs when moving may be a sign of the presence diaphragmatic hernia.
• Dull, tugging. Occurs during development chronic diseases(hepatitis, pyelonephritis, enterocolitis, etc.) or with an atypical course of acute appendicitis.
• Aching, bursting. It is observed in cases of indolent chronic diseases or heart diseases.
• Pulsating, stabbing. Occurs during heavy physical exertion vegetative-vascular dystonia and inflammatory diseases.

Pain in the right hypochondrium in a healthy person

Although pain in most cases is a sign of pathology, sometimes it hurts in the right side under the ribs in healthy people.

Pain in the right hypochondrium may occur:

• In an untrained person who began to exercise intensively or took up hard work. A sharply increased load leads to the release of adrenaline, which causes a decrease in the tone of the bile ducts and their stretching due to filling with stagnant bile. The liver capsule also stretches due to increased filling of this organ with blood, which causes stabbing pain in the right hypochondrium.
• In pregnant women in the last trimester. At this stage of pregnancy, the greatly enlarged uterus puts pressure on the organs with which it comes into contact - the liver and gall bladder are pressed (in combination with the expansion biliary tract under the influence of the hormone progesterone, bile stagnation occurs), intestinal loops are displaced, and these processes may be accompanied by pressing or stabbing pain under the right rib.
• In women at the end of the menstrual cycle. A stabbing sensation in the right hypochondrium occurs due to spasm of the biliary tract, which develops as a result of a sharp imbalance between increased level estrogen and decreased progesterone levels during this period.
• In women, when taking hormonal contraceptives, the flow of bile is disrupted, which causes pain under the ribs on the right and in front.

Pain in the right hypochondrium anteriorly

Pain under the right rib in the front occurs when:

• Liver diseases. The pain is dull and prolonged or bursting, occurs due to swelling and a rush of blood, which causes stretching of the fibrous membrane of the liver ( fibrous membrane contains pain receptors).
• Diseases of the gallbladder and biliary tract. At acute form diseases intense pain is acute or cutting, cramping in nature, pain is localized in epigastric region, can give to right shoulder And left hypochondrium. With a chronic disease, the pain is dull, aching, sometimes radiating to the shoulder blade.
• Diseases of the pancreas. The pain can be dull and aching in the chronic form of the disease and acute, intense in the acute form of inflammation. It can be felt below the right rib and is often encircling in nature.
• Diseases of the digestive system. Chronic diseases are characterized by increased pain during palpation; the acute inflammatory process is accompanied by sharp, severe pain.
• Heart diseases. There may be a burning or stabbing intense pain under the right rib in the front, or a feeling of heaviness in this area.
• Respiratory diseases. Rapidly increasing sharp pain when lung damage, pleura or diaphragm worsen when coughing, during breathing movements, when turning the body.
• Neurological diseases. The pain is different aching character at chronic course illness, and sharp pain on acute stage diseases.
• Diseases of the spine and musculoskeletal system. The pain is aching in nature and intensifies when bending over, coughing and taking a deep breath.

Liver diseases

The cause of pain in the right hypochondrium in front may be:

If there is pain under the ribs on the right, and the pain is intense, cutting or stabbing in nature, the cause of the pain may be:

• Cholelithiasis (cholelithiasis), in which stones form in the cavity of the gallbladder itself or in the biliary tract due to stagnation of bile. Characteristic pain symptom the disease is colic - sudden attack sharp, stabbing or cutting pain, which is localized under the right rib, can radiate to the back, neck, right shoulder, to the area of ​​the right shoulder blade and sometimes to the heart area (causes angina). The pain syndrome is accompanied by nausea, vomiting that does not bring relief, and intoxication of varying degrees of severity. When a bile duct is blocked by a stone, obstructive jaundice develops. The attack is provoked by the consumption of hot, spicy and fatty foods, stress, physical activity - these factors cause spasm of the gallbladder and irritation of its wall with stones.
• Dyskinesia of the bile ducts - a disorder motor functions gallbladder and ducts in the absence of organic pathology. Contraction of the gallbladder can be excessive (hyperkinetic form) and insufficient (hypokinetic form). The hypokinetic form of the disease is accompanied by prolonged dull, aching pain in the area of ​​the right rib, which radiates to the right hand or a spatula. In the hyperkinetic form, the pain is short-term, acute and cramping. The pain intensifies after eating fatty and spicy foods, as well as when eating a large amount of food at once. In the morning, patients have a bitter taste in the mouth, during attacks there may be arrhythmia, numbness of the limbs, and a feeling of fear may be present.
• Cholecystitis is an inflammation of the gallbladder that develops when the outflow of bile is disrupted and the presence of microflora in the gallbladder (most often a complication of cholelithiasis). Can be acute or chronic. Acute cholecystitis is divided into catarrhal form of the disease, phlegmonous and gangrenous. In the catarrhal form, there is constant intense pain in the epigastric region and in the right hypochondrium, which radiates to the lumbar region, in right shoulder blade and on the right side of the neck. In the phlegmonous form, intense pain is observed, which intensifies with coughing and changes in body position, accompanied by nausea, repeated vomiting and deterioration of general condition. The gangrenous form is characterized by severe pain, which is accompanied by nausea, vomiting, high temperature, general weakness, pallor, headaches, tachycardia, dizziness and fainting. The chronic form of the disease is characterized by nausea and dull pain in the right hypochondrium that occurs after eating. A complication of cholecystitis can be hepatic colic, which is characterized by severe pain and jaundice.
• Cholangitis is an inflammation of the bile ducts, which can be chronic or acute. In the acute form, body temperature rises sharply, sweating and chills are present, weakness progresses and intoxication increases. Pain in the right hypochondrium, in the neck, right shoulder and shoulder blade, diarrhea, nausea and vomiting are present. A little later, jaundice develops and itchy skin. In the chronic form of cholangitis, there is increased fatigue, weakness, low-grade fever, discomfort and a feeling of fullness in the epigastrium, dull and weak pain under the right rib.
• Malignant neoplasms, which are accompanied by dull, aching pain in the late stage of the disease.

Pancreatic diseases

Pain under the ribs on the right can be caused by pathologies of the pancreas - although this organ is located deep in the abdominal cavity, part of it is localized in the right hypochondrium. Pain on the right side under the rib with:

• Pancreatitis is inflammation of the pancreas, which can occur in acute and chronic forms. The acute form is characterized by sharp, intense pain in the right hypochondrium (most often of a girdling nature), radiating to the lower back. Nausea, lack of appetite, fever, weakness are observed, vomiting with bile is present (may be indomitable and not bringing relief). In the chronic form of the disease, dull, aching pain intensifies if there are errors in nutrition. In the upper part of the abdominal cavity with pancreatitis, there is a feeling of heaviness.
• Tumors of the pancreas. The pain is observed only in the last stages of the disease, is intense and long-lasting, intensifies in the supine position, is felt in the center of the abdomen, and radiates to the right and left hypochondrium.

Diseases of the digestive system

Pain in the right side under the ribs in front can be caused by various intestinal lesions:

Pain on the right side under the ribs in front can also be a sign of appendicitis - inflammation of the appendix ( vermiform appendix cecum). It can be acute and chronic (rare), catarrhal, superficial, destructive, phlegmonous, apostematous, phlegmonous-ulcerative, gangrenous and perforative. The disease is accompanied by acute pain in the right iliac region, which intensifies with pressure, muscle tension and increased sensitivity of the skin on the right under the ribs. When the appendix is ​​located behind the cecum, the pain is muted. There is no appetite, there is nausea, single or double vomiting of a reflex nature, an increase in temperature to 37-38 ° C, possible tachycardia, frequent urination, loose stool and increased blood pressure.

Acute appendicitis is life-threatening, so a patient with such symptoms requires emergency hospitalization.

Heart diseases

Pain in the right side under the rib in front occurs with heart pathologies that cause circulatory failure in a large circle. When blood circulation deteriorates, the liver becomes enlarged, swelling in the legs and front abdominal wall, and fluid begins to accumulate in the abdominal cavity. All these factors contribute to the appearance of pain in the right hypochondrium.

The cause of pain may be:

• Myocardiopathy (cardiomyopathy). This group of diseases includes myocardial lesions of non-coronary and non-rheumatic origin, which are associated with the presence of similar clinical signs (heart failure and enlarged heart). Cardiomyopathy can be congestive, hypertrophic, obliterative and constructive. It manifests itself as increased heart rate, increased fatigue, shortness of breath, pallor and aching, stabbing or pressing pain in the heart area and in the right hypochondrium.
• Coronary heart disease, which occurs when the coronary arteries and impaired blood supply to the heart muscle. It is accompanied by painful attacks that last from 30 seconds to 15 minutes and go away on their own at rest (also eliminated by taking nitroglycerin). Aching, pressing or burning pain manifests itself in varying degrees, there is shortness of breath, rapid heartbeat, a feeling of heaviness and burning in the chest. The pain may radiate to left hand and in the area of ​​the scapula, nausea is possible.
• Endocarditis is an inflammation of the inner lining of the heart, which can be bacterial (in most cases the causative agent is streptococcus) and secondary (develops as a consequence of diffuse diseases connective tissue, rheumatism, tuberculosis and some other diseases). The disease is accompanied by fever, profuse sweating, pain in muscles and joints, weakness, possible fragility of blood vessels and changes in the fingers (beginning to resemble Drumsticks). In patients, the spleen and liver may enlarge (the enlarged organ causes aching, dull pain under the right rib), and valvular heart disease develops, which leads to heart failure (accompanied by a feeling of heaviness in the right hypochondrium).
• Abdominal myocardial infarction, in which very strong, burning or pressing pain is felt in the epigastric region, left or right hypochondrium. Sharp and intense pain occurs suddenly, often radiates to the shoulder blade or behind the sternum, and is accompanied by heart rhythm disturbances, difficulty breathing, decreased blood pressure, pale skin and puffiness of the face. May be accompanied by profuse sweating, nausea, vomiting, severe hiccups and diarrhea. Because this condition is life-threatening, emergency medical attention is required.

Respiratory diseases

Pain in the right side under the ribs in front can occur when it irradiates from the retrosternal space. Referred pain is observed when:

• Lower lobe right-sided pneumonia. The pain is mild, dull or aching in nature, and when coughing it becomes stabbing and more pronounced. This disease causes a dry cough, a slight increase in temperature, severe weakness, increased sweating, shortness of breath, possibly rapid breathing and heart palpitations. Symptoms of acute respiratory diseases are also present.
• Right-sided pleurisy. The inflammatory process can develop directly in the pleural cavity (primary pleurisy) or spread from the lungs (secondary pleurisy). The disease can occur in a dry form (fibrin protein falls onto the surface of the pleura) or in an exudative form (serous, purulent or hemorrhagic exudate accumulates in the pleural cavity). Dry pleurisy is accompanied by increased sweating, rapid shallow breathing and increased body temperature. Pain in the right hypochondrium occurs with persistent coughing, bending and turning the body. At exudative pleurisy There is aching pain, a feeling of squeezing and heaviness in the chest, pallor of the limbs and skin, and a forced position of the body. The neck veins in this form of the disease are swollen, the right half chest lags behind during respiratory movements, and the intercostal spaces protrude.
• Cancer right lung. With this disease, pain occurs on the right side under the ribs only when the pleural cavity and organs that are located nearby are affected by metastases (there is no pain before the development of metastases). At oncological processes in the lung there are disturbances in appetite and digestion, sudden loss weight, decreased immunity and lack of oxygen.

Pathologies of the diaphragm

It hurts under the right rib in the front and with pathologies of the diaphragm (this muscle separates the chest and abdominal cavities).

Pain occurs with a diaphragmatic hernia. Hernial opening, through which intestinal loops sometimes enter the chest cavity, can be congenital, traumatic and neuropathic.

Small defects do not manifest themselves (they are detected by chance), but when large hernial sacs form, the pathology is accompanied by bloating, heartburn, sour belching, persistent cough, burning behind the sternum and rapid heartbeat after eating. The pain is dull or aching in nature, is observed constantly, and nausea may be present.

When the intestines are strangulated, the pain in the right hypochondrium is intense; stool retention and vomiting are observed against the background of a general deterioration of the condition. Since when a diaphragmatic hernia is strangulated there is a risk of developing peritonitis, the patient needs urgent medical attention.

Neurological diseases

Pain in the right side under the ribs in front occurs when peripheral nerves are damaged.

Painful sensations are characterized by a sharp, intense nature in the acute stage of the disease, and aching in its chronic course.

Pain can be caused by:

• Intercostal neuralgia. It develops as a result of damage or compression of the nerves that run between the ribs. It can be radicular (caused by pinching of the nerve roots in the spine) and reflex (provoked by spasm of the muscles of the intercostal space). The lesion can be unilateral or bilateral, accompanied by burning or stabbing intense pain, but is not life-threatening. The pain becomes more intense when inhaling, exercising, sneezing and coughing, and may radiate to epigastric region, collarbone, arm, lower back and scapula. A characteristic feature pathology is the presence of pain points that respond to palpation of the intercostal spaces. There is a change in skin color and loss of sensation in the affected area, increased sweating, muscle twitching and swelling.
• Vegetative crisis is a paroxysmal state of non-epileptic nature, which is accompanied by polymorphic autonomic disorders. In the absence of heart pathologies, increased heart rate, arrhythmia, increased sweating, anxiety and panic, trembling of the limbs, a feeling of pressure in the chest, pain in the stomach and under the right rib are observed. It is difficult for a patient to determine the exact localization of pain in this condition; the pain can be of a varied nature (dull, sharp, stabbing, aching, encircling). Subjective symptoms with vegetative crises do not coincide with the data of objective studies (severe organic pathology cannot be identified).

Diseases of the musculoskeletal system and spine

The cause of pain on the right side under the ribs may be:

• Osteochondrosis thoracic spine. With this degenerative-dystrophic disease, which develops with incorrect posture or deterioration of metabolic processes in tissues, changes occur in intervertebral discs thoracic vertebrae. The altered vertebrae compress the nerve fibers, which causes pain. Pain sensations range from mild and long-lasting to acute and sharp (causing limited muscle mobility and difficulty breathing).
• Fibromyalgia. This diffuse, predominantly symmetrical musculoskeletal pain of a chronic nature can affect any part of the body. In the affected area there is increased sensitivity, there is stiffness in the body after waking up, swelling and increased fatigue. Temperature surges, spasms and convulsions may occur.
• Tietze syndrome is a rare pathology that is accompanied by aseptic inflammation of the costal cartilages (possibly affecting the left or right cartilage and several cartilages at the same time). With this disease, there is local pain, which is constant, radiates to the forearm and shoulder, and also intensifies with deep breathing and pressing on the affected area. Periods of remission are observed.
• Rib injuries. With fractures on the affected side, there is a sharp pain, which becomes more intense with breathing movements. Breathing becomes difficult, the skin turns pale, and in the affected area it acquires a bluish tint. Shortness of breath, hemoptysis, weakness appear, and the temperature rises. With cracks in the rib, swelling, bluish tissue and excruciating pain are observed in the affected area (exacerbated by inhalation and coughing), there is shortness of breath, a feeling of fatigue and suffocation. When a rib is bruised, soft tissue swelling and pain are observed, which becomes more intense with inhalation, coughing and movement.

Pain in the right hypochondrium behind

Pain under the right rib from behind occurs when:

• Kidney diseases. The pain is intense and paroxysmal in nature.
• Inflammation of fatty tissue.
• Pathologies of the adrenal gland.
• Retroperitoneal hematoma, which occurs due to abdominal trauma.
• Diseases of the respiratory system.
• Heart diseases.
• Acute pancreatitis.
• Thoracic and lumbar osteochondrosis.
• Thrombosis of the vena cava.

Kidney diseases

If you have pain on the right under the rib and behind, you can suspect:

• Renal colic, which is observed with urolithiasis, kidney prolapse, injuries and other pathological conditions. It occurs suddenly and lasts from several minutes to several days. Acute, intense pain is paroxysmal in nature, does not subside at rest, and radiates to the lower back. Pain is often felt along the ureter, in the groin area and in the area of ​​the external genitalia, as well as on inner surface hips. May be accompanied by increased urination and pain in the urethra. Relieving the attack eliminates the acute pain, but dull pain persists in the lumbar region even after the attack.
• Urolithiasis of the right kidney, which is caused by irritation of the renal pelvis and ureter with stones or sand and is accompanied by intense, paroxysmal acute pain. Pain sensations radiate to the lower back and lateral abdomen, thigh and genital area. The pain intensifies if you hit the lower back with the edge of your palm. Blood may be present in the urine and frequent urge to urination, nausea, vomiting, and general deterioration of health are possible.
• Pyelonephritis is an inflammation of the kidney that can be acute or chronic. With this disease there is aching, dull pain, frequent painful urination, general weakness, fever, chills and lack of appetite. Swelling may appear on the face. At purulent inflammation the pain becomes constant, and daily urine output decreases.
• Necrosis of the renal papillae, which develops due to oxygen starvation of the renal tissue due to blockage of the vessels supplying the kidney. Accompanied by constant intense pain, there is blood in the urine. There is a risk of developing septic shock.
• Cancer of the right kidney, which is accompanied by mild pain and bleeding at a late stage of development ( initial stage is asymptomatic). If the tumor obstructs the flow of urine, the pain becomes acute.

Inflammation of fatty tissue

Acute upper paranephritis is an inflammation of the fatty tissue located at the upper pole of the kidney. Inflammation develops when the pathogen penetrates from foci of chronic infection (tonsils, carious teeth, etc.). The disease is accompanied by an increase in temperature to 38°C, moderate pain is observed on the affected side, which after 2-3 days begins to be felt in the right hypochondrium. The pain worsens with deep inspiration, walking and sudden straightening of the body.

Adrenal gland pathologies

Pain in the right hypochondrium from behind occurs when there is a benign or malignant tumor large sizes.

Clinical manifestations of the disease depend on the type of tumor - with pheochromocytoma there is a persistent increase in blood pressure, myocardial dystrophy and disorders heart rate, and aldosteroma is characterized by a change in the body’s water balance. With corticosteromas, metabolism is disrupted, corticoestromes and andosteromas form gender-inappropriate secondary sexual characteristics (male hair type, etc.).

Retroperitoneal hematoma

Retroperitoneal hematoma (localized collection of blood) is a common consequence serious injuries, which manifests itself as pain of varying intensity. The pain is localized in the back on the right under the ribs and intensifies with movements of the hip joint. The cause of hematoma formation can be damage to the pancreas and other internal organs. This pathological condition due to blood loss, it may be accompanied by a decrease in blood pressure, weakness, pallor, increased heart rate, thirst and dizziness (even fainting). Requires urgent medical intervention as it threatens the patient's life.

Respiratory system diseases

Back pain under the right rib can occur with:

• Dry right-sided pleurisy. The pain is cutting or stabbing, intense, radiates to the shoulder, neck and affects the chest area, intensifies with breathing, coughing and any movements.
• Oncological process in the right lung, which is accompanied by excruciating and persistent pain. Pain occurs if the tumor grows into the pleural tissue, shortness of breath and paroxysmal non-productive cough are present.
• Pneumothorax, which occurs when the right lung is damaged and causes gas to accumulate in the pleural cavity and collapse of the lung tissue. Occurs spontaneously or as a result of injury, causing disorders respiratory functions and blood circulation, accompanied by piercing pain. Pain sensations radiate to the arm, neck and chest, becoming more intense when coughing, inhaling and moving. There is shortness of breath, pallor, a dry cough and fear of death may be observed.

Heart diseases

Pain in the right side of the back under the ribs can occur with atypical manifestations of myocardial infarction (accompanied by persistent, wave-like sharp pain that is localized in the interscapular space).

Acute pancreatitis

Pain in the right side of the back in the hypochondrium can occur with an acute form of inflammation of the pancreas, which can manifest itself various symptoms. The severity of pain and the location of pain depends on the severity of pancreatic pathology.

Spinal diseases

Pain in the right hypochondrium of the back can occur with osteochondrosis of the thoracic or lumbar region. They are characterized by an aching character, aggravated by movement and long stay in one position, during physical exertion and hypothermia. There is muscle weakness and numbness in the upper extremities.

Vena cava thrombosis

Vena cava thrombosis is a rare variant of blockage of the inferior vena cava by a thrombus (the thrombus enters the main trunk of the vein from the iliac veins), which is accompanied by pain in the lower back and in the right hypochondrium from the back. The clinical picture resembles the late stage cancer kidney

Pain in the right hypochondrium on the side

Pain in the right side under the ribs occurs when:

• chronic pancreatitis, which is accompanied by girdle pain;
• herpes zoster, which is accompanied by damage to nerve endings;
• initial stage of hepatitis;
• intestinal diverticulosis (protrusion of the intestinal walls, which in symptoms resembles appendicitis);
• intestinal obstruction (pain radiates to the right bottom part abdomen);
• duodenitis;
• chronic cholecystitis;
• cholelithiasis;
• inflammation of the ureters;
• urethritis (accompanied by painful urination);
• inflammations of the genitourinary system.

In women, the cause of pain in the right hypochondrium on the side can be adnexitis (salpingoophoritis), torsion or rupture of the right ovarian cyst, ectopic pregnancy, Allen-Masters syndrome and endometriosis.

Which doctor should you contact for pain in the right hypochondrium?

Urgent hospitalization is necessary if:

• suddenly appeared sharp sharp pains in the right hypochondrium;
• there is a constant aching pain that does not subside within an hour;
• when moving, stabbing pain occurs that does not subside within 30 minutes;
• dull pain appears, vomiting with blood or undigested food particles is present;
• pain of any nature is observed in combination with rapid heartbeat, pallor, decreased blood pressure, difficulty breathing and dizziness.