Dull pain in right hypochondrium. What hurts under the right rib? What to do, which doctor to contact

Pain under the ribs on the right can have a different character:

strong;
acute;
sharp;
aching dull, pulling;
stabbing.

Depending on the nature of the pain and its accompanying syndromes, it is possible to determine the affected organ.

Severe pain right under the ribs

intolerable, strong pain in the right hypochondrium is characteristic of diseases of the gallbladder, liver and kidneys.

Inflammation of the gallbladder (cholecystitis). Severe pains on the right under the ribs make a person rush about in search of a comfortable position. In addition, he is tormented by:

fever;
nausea;
repeated vomiting that does not bring relief;
often - yellowing of the skin and whites of the eyes.

Sharp pain right under the ribs

Sharp girdle pain - the first symptom acute pancreatitis. The reason for the exacerbation of the disease is the use of large amounts of alcohol with fatty and sweet foods. Sharp pain in acute pancreatitis is distinguished by its intensity - it does not decrease with a change in body position or coughing. Pancreatitis is accompanied by the following symptoms:

nausea;
repeated vomiting;
severe intoxication (cyanosis of the face and body, marble skin abdomen, small hemorrhages on the sides and around the navel).

Sharp pain under the right ribs in the region of the scapula and collarbone occurs when pus accumulates under the diaphragm (subdiaphragmatic abscess). The pain is aggravated by coughing and sneezing, sudden movements, breathing; relief comes in the supine position on the right side. Associated signs:

fever;
body intoxication.

A sharp pain between the ribs, which is felt at the slightest touch to the skin, is characteristic of herpes zoster - viral disease, which manifests itself in the form of painful rashes on the skin along the nerves affected by the virus (most often in the intercostal part). Before the rash appears, a person may feel aching pain in the right or left hypochondrium, weakness, fever.

Aching dull, pulling pain under the ribs on the right

Drawing, dull aching pain in the right hypochondrium speaks of chronic liver diseases that provoke its increase (hepatitis). In addition, it can be a sign of the formation of malignant and benign tumors.

In addition to blunt and pulling pain observed:

jaundice;
liver failure;
circulatory disorders.

Also, aching dull pain can be a symptom of such diseases:

polycystic right kidney;
malignant tumors lung, gallbladder, kidney, pancreas;
inflammation small intestine;
inflammation of the appendages (in women).

Stitching pain on the right under the ribs

Stitching pain under the right ribs, which is aggravated by coughing and taking a deep breath, is characteristic of right-sided pneumonia. Often the pain spreads all over the right side, and exact time its occurrence is rather difficult to name. Associated symptoms:

fever;
shortness of breath;
pale blue nasolabial triangle;
constipation and diarrhea;
herpetic eruptions on the right side.

Pain in the right hypochondrium behind

Pain under the ribs on the right back, speaks of problems with the kidney and pancreas.

With inflammation of the kidneys, the patient has Pasternatsky's syndrome: severe pain with a light blow with the edge of the palm on the lower rib from behind. At renal colic pain in the right hypochondrium has an intense paroxysmal character and torments to such an extent that a person cannot be at rest and constantly changes his position. With urolithiasis, pain spreads throughout the spine to the lower back.

Pain under the right rib with inflammation of the pancreas (pancreatitis) occurs suddenly, has a surrounding character, and its intensity does not change.

The causes of inflammation of the pancreas can be the abuse of alcohol and fatty foods, metabolic disorders, complications after surgery, exacerbation of chronic diseases.

Pain in the right hypochondrium in front

If the pain radiates to the front of the ribs, then this is the cause of the disease:

Lungs (pneumonia, inflammation).
Gallbladder (acute or chronic cholecystitis).
Liver (hepatitis, fatty degeneration of cells, cirrhosis, tumors).
Duodenum and stomach (erosion, peptic ulcer, gastritis).

When the lungs are affected, the pain in the right hypochondrium is stabbing, it becomes stronger when inhaling or coughing, and it is also accompanied by typical symptoms of fever (temperature, weakness), which distinguish it from other diseases internal organs right hypochondrium.

In diseases of the gallbladder, severe pain is felt in the epigastric region and in the right shoulder blade. In acute cholecystitis, the pain moves to the lower part of the right hypochondrium.

If the pain under the right rib is aching or dull, then this indicates liver disease. As a rule, it is accompanied by signs of jaundice ( yellowish color skin and whites of the eyes), except for benign tumors.

For stomach ulcers and duodenum the pain is localized in the anterior part of the right and left hypochondrium, flowing into the back and lower back. They dull slightly when pressed, so the patient feels relieved when lying on his stomach or squatting.

Pain in the right hypochondrium below

Pain on the right under the ribs below is a sign of inflammation:

intestines (namely, the appendix). The first sign of appendicitis is acute sharp pain in the right side. The nature of the pain indicates a possible rupture of the appendix, so you should immediately consult a doctor.
right kidney. Basically, with renal colic, the pain does not have a clear localization and spreads throughout the right hypochondrium, touching, including the spine and lower back.
duodenum and stomach - with an ulcer, the pain moves down the right hypochondrium from the epigastric region.

In addition, pain on the right under the ribs can occur in completely healthy person when moving. This happens when people are exposed to loads unusual for them. The vena cava, which runs under the lower right ribs, increases blood flow and swells. Also, pain can occur with sharp bends and turns, when the internal organs are in contact with the costal bones.

Pain in the side on the right side, right under the ribs, was felt at least once in a lifetime by every person. This is not necessarily a sign of a serious illness - a completely healthy person can suddenly get sick on the right side. The explanation for these pains, lying on the surface, - high density contact of the hypochondrium with the organs that are in the right side and the peculiarity of their structure. But if the symptom is repeated repeatedly, the pain is strong, it is urgent to consult a doctor for a clear diagnosis.

Most often, despite the fact that all high school students without exception studied human anatomy at school, there are few adults who are not professionally related to the field of medicine who will immediately answer the question of which internal organs are located on the right under the ribs.

Important! In the right hypochondrium are two vital important body: liver and gallbladder. Also passes here right part diaphragm, which is a muscular septum that separates chest cavity from the abdominal cavity, and part of the intestine.

To the right, although not under the ribs, but behind, is the right kidney, and from right to left is the pancreas. It is worth taking into account the appendix, as well as the right lung, problems with which give rise to pain in the right hypochondrium.

Liver

This organ is active participant metabolism, in which blood is filtered and bile is formed, sugar is maintained, compounds are formed, and fermentation takes place. A kind of chemical laboratory that allows you to keep the constituent components of blood plasma in balance. For the normal functioning of the body, the liver is very important. Inflammation of this organ can occur for various reasons, which will be discussed below. The first symptom of such inflammation is pain on the right under the ribs.

gallbladder

Should a person overeat or consume a lot of fatty foods, the digestion of which requires a large amount of bile, he will feel pain in his right side under the ribs, the reason for which will be an inflamed gallbladder. In addition, stones can form in the gallbladder, which will also cause pain.

This organ, although it is not entirely located on the right under the ribs (only its head is located here), should be considered as a source of pain in the right side. The pancreas produces enzymes gastric juice, insulin, and when it is inflamed (pancreatitis), the right side hurts.

Bud

The right kidney, located behind, on the right, in the lower back, can also become inflamed. In addition, stones, purulent formations, and tumors may appear in the kidneys. In case of damage to the right kidney, pain, including, can be localized in the right hypochondrium.

Appendix

Not at all under the ribs, but in the lower abdomen, but also on the right is such an organ as the appendix. It becomes inflamed so often that at the first concern it is removed surgically. Pain in the right hypochondrium can be one of the signs of inflammation of the appendix.

Lung

Inflammatory processes affecting the right lung give pain under the right ribs.

Why does the right hypochondrium begin to hurt in front

Provoke pain at this point human body may be several factors. But first of all, when pain occurs, it is necessary to differentiate its severity. Sharp pain can become a threat to human life if immediate medical measures are not taken. Therefore, it is necessary to carefully study and remember the following table.

Table. Differentiation of pain in the right hypochondrium and the necessary measures.

The nature of the pain	Measures taken
Severe aching pain on the right under the ribs, which lasts more than an hour.	Call an ambulance.
Sudden sharp pain.	Immediate call for an ambulance.
Pain in the right side accompanied by nausea.	Seeing a doctor on the same day.
Stitching pain that occurs with any movement, if it lasts more than half an hour.
Pain on the right under the rib, caused by trauma.	Seek immediate medical attention.
Pain that constantly occurs when walking and subsides after the cessation of movement.	It is advisable to see a doctor as soon as possible.

Physiology and pathology

The right hypochondrium can hurt due to physiological or pathological causes. In the first case, there are no visible disturbances in the functioning of the body. In the second they are present.

Physiological causes

If the physical condition of a person is normal, pain in the right side may occur due to physiological reasons. Such pain is the result natural processes occurring in the body. An example is pregnancy or menstruation in women, the uneven formation of the skeleton in adolescence in both sexes, indigestion or improper exercise.

The most common case that can cause pain in the right side of both men and women is non-compliance with the diet resulting in the formation of fecal blockages in the intestines. Unprocessed foods that remain and settle in the large intestine put pressure on the diaphragm and cause pain.
Pregnancy at a certain stage, it almost always causes periodic pain in the right hypochondrium, especially when walking. With an increase in the term, the uterus enlarges, presses on other organs, in particular, the liver, which gives pain to the right side.
Menstruation- another "female reason" to feel pain in the right side. Since the death and rejection of the endometrium occurs during menstruation, with an increase in the load, which increases during walking, physical actions or when running, the rejection rate also increases. As a result, the discharge of blood becomes more abundant and accompanied by pain.
Physical exercises, if they are performed incorrectly, can cause physiological pain under the right rib if they are performed a short time after eating. On a full stomach, you should not do any exercises; after eating, at least three hours should pass. There is also pain when using incorrect breathing technique. If breathing during exercise is superficial, blood stagnates in the liver and contributes to its increase.

Advice. In all cases of physiological pain, they should not be ignored, especially with regular repetition. They can be a harbinger dangerous diseases, which are easier to prevent at the first symptoms.

Pathological causes

Pathological pain is always based on the presence of a disease or some kind of disorder. For example, if you can consider normal pain in the side that occurs when walking on later dates, shortly before the appearance of the baby, then the pain during pregnancy, which develops outside the uterine cavity, is a pathology and requires immediate therapeutic or surgical intervention.

Cholestasis is a disease of the liver in which the flow of bile is disturbed and its stagnation is formed. There are intrahepatic and subhepatic cholestasis.

The disease is rare, but can occur for several reasons:

virus infection;
pregnancy;
taking certain medications (chlorpromazine);
taking male sex hormones;
blockage bile ducts(stones);
helminths;
mechanical compression;
tumor.

Both types of cholestasis can be recognized not only by painful sensations in the right side under the ribs, but also by altered feces and urine. The stool becomes grayish and strong smelling, the stool becomes more frequent, the urine becomes darker. Also, with the onset of the disease, visual acuity begins to decrease.

By the way. To diagnose this disease, it is necessary to pass a urine test, blood test, pass ultrasound procedure liver or MRCP.

Jaundice

This disease is widespread. Jaundice is also divided into two types: suprahepatic and subhepatic. In the first variant of the development of the disease, there is an increased breakdown of blood. In the second, the outflow of bilirubin is disturbed, due to the weakening of its binding.

Jaundice and cholestasis are almost always combined with each other. As a treatment is used:

drug therapy;
special diet;
taking vitamins;
physiotherapy;
massage.

Important! With continued long time and untreated jaundice may lead to liver failure, then hepatic encephalopathy and sepsis.

Fatty hepatosis

This disease, one of the first symptoms of which is pain in the right side in front under the ribs, is a consequence of metabolic disorders.

Causes of hepatosis:

Important! With fatty hepatosis, there is a dangerous replacement of active structures of hepatocytes with fat, which, in the end, leads to death. In most cases, this process is activated when alcohol addiction. If, after another stormy feast, your right side hurts, immediately stop drinking alcohol and go for a diagnosis.

To diagnose the disease, it is necessary to conduct an ultrasound or computed tomography, as well as donate blood for examination and undergo a liver biopsy procedure.

In order to cure fatty hepatosis, it is necessary to eliminate the factors that negatively affect liver cells. Also shown are moderate physical activity, diet, the use of medicines and herbal restorative preparations.

cirrhosis

This disease is widespread and is the final stage of liver damage, which can be the result of many diseases. The most dangerous ones are chronic hepatitis, metabolic disease.

As a result of cirrhosis of the liver, hepatocytes undergo necrosis.

At the first stage of local necrosis, hepatic coma occurs. In the tissue of the liver, voids are formed, filled with nodular formations. At this stage, the pain is already quite strong and is felt almost constantly.
The second stage is the replacement of dead hepatocytes connective tissue, creating partitions that disrupt blood circulation.
The third stage is characterized by complete closure of the hepatic vessels; the person is experiencing persistent aggressive pain.

Externally, cirrhosis is manifested by yellowing and darkening of the skin, itching, drying and roughening of the skin. From the gums start to go bleeding. Increases, as if the stomach "swells up". The stool becomes very light, and the urine becomes dark. The patient is tormented by constant constipation and diarrhea, belching, heartburn, heaviness in the stomach and abdomen.

It is necessary to diagnose cirrhosis at all stages in stages. First, the patient is questioned, examined visually, and then a complete laboratory, immunological and biochemical study is carried out. Biopsy, ultrasound, tomography and radionuclide scanning are also carried out.

Important! Liver cirrhosis can be cured with medication and diet. But if the disease has passed into the last stage, surgical treatment should be applied.

This is a lesion of the gallbladder, accompanied by the appearance of stones in it and acute paroxysmal pain.

Why does a person amaze cholelithiasis:

irregular meals;
regular overeating;
no load;
infections;
liver disease;
genetics.

Cholecystitis is chronic and acute. The exacerbation is complicated by purulent inflammation or gangrenous death of part of the gallbladder membrane. The chronic acute stage passes if the disease proceeded without complications.

The pain impulse in two forms is different. Although the pain is localized on the right under the ribs in both cases, in an acute attack it is very strong, sharp and intensifying, with concomitant vomiting, a decrease in pressure and an increase in temperature. In the chronic course, the pain is rather aching, not sharp, accompanied by nausea and belching, which has a bitter taste.

Important! In both forms, if one or more stones block the neck of the gallbladder, biliary colic occurs. It can be provoked by overeating, stress, too much exercise or a cold. In this case, the pain is almost unbearable, and it will stop only if the stone spontaneously returns to the gallbladder or passes into the intestines.

For diagnosis, ultrasound, laboratory studies, radionuclide studies are performed.

Treatment consists of drug withdrawal pain symptoms and, if necessary, surgical or shock wave extraction of stones. In some cases, the entire gallbladder is removed. Also, the patient is prescribed a special diet.

This rare pathology, however, can cause pain in the right side under the ribs, and it is not always possible to diagnose it immediately. With this pathology, which is usually congenital or obtained after an injury, the patient not only complains of pain, but experiences nausea, suffers from heartburn, diarrhea, constipation, bloating, and may feel weakness and bitterness in the mouth.

To make an accurate diagnosis, best method will be an ultrasound. In the process of treatment, medication and physiotherapy, a mandatory diet are used.

By the way. If the bending is strong, and timely diagnosis and treatment was not followed, a rupture may occur with the excretion of bile into the peritoneum, which will lead to peritonitis and possible death, if urgent assistance is not provided.

Perhaps the most common and common cause for pain under the ribs on the right is inflammation of the appendix. Arising in the right side, the pain can radiate to the left, be girdle all over the abdomen and back. The pain becomes stronger, and its range is wider with movement. Perhaps fever, defecation disorder, nausea, sweating, blanching of the skin, heartburn.

Appendicitis can be acute or chronic. Acute attack begins with the shell of the organ, then tissue rupture by purulent masses can occur and pus exits into the peritoneum. At chronic inflammation then fades, then activates, increasing or decreasing pain.

Inflammation of the appendix is almost always treated surgically, complete removal of the organ.

Help with pain in the right side under the ribs

Of course, without being a doctor, it is impossible to accurately determine the cause of the pain that has arisen. Therefore, the primary task of the patient is to understand at least the nature of the cause. Physiological or pathological. If there is menstruation, jogging on a full stomach, and other phenomena that can cause physiological pain, if the pain is not very disturbing and passes quickly, it may be worth waiting and not taking emergency measures. With the disappearance of the physiological cause, the pain will also disappear.

But if everything repeats, intensifies, is present for a long time, is accompanied by accompanying symptoms, one piece of advice - immediately seek medical help.

Advice. The doctor to whom you can contact in case of aggressive pain: therapist, gastroenterologist, oncologist, surgeon - depending on the nature of the existing pathology.

Pending medical assistance You can take the following steps yourself.

Reduce pain by taking antispasmodics(if the pain is very strong, paradoxically, it is not recommended to take medications in order to maintain a clear clinical picture before the arrival of the ambulance).
Apply a cold compress to the affected area(not hot!).
Take a comfortable posture, at which pain is felt the least, and wait for an ambulance.

If the diagnosis is established and drug treatment prescribed, folk remedies can help in recovery and get rid of pain:

diseases of the spleen - a decoction of wild rose;
liver disease - honey mixed with cinnamon;
diseases of the gallbladder - a decoction of potatoes boiled in uniform.

Preventive actions

They exist. To avoid sharp pains in the right hypochondrium and not to be on the operating table, you need to follow the diet and adhere to healthy lifestyle life.

Moderate physical activity.
Absence of alcohol abuse.
Proper nutrition, without excessive amounts of spicy, fatty, salty.
Seeking advice at the very beginning of the onset of pain.
Annual examination of internal organs, especially with disturbing heredity.

Pain under the right rib can be a temporary phenomenon that will occur several times and will no longer disturb, or it may indicate a serious illness that has already “settled” in your body. It is important to prevent its development, aggravation of the situation and consequences, which can be disastrous. That is why, having experienced even once a pain unusual for you, on the right under the ribs, you should be alert and listen to your body.

Video - What hurts in the right hypochondrium

Pain in the right hypochondrium is a symptom that many people suffer from. There are many reasons for its appearance, from serious liver pathologies to banal overeating. The nature and location also varies, usually the pain is dull and aching, with localization both in front and behind. With the chronic appearance of discomfort and severity, it is important to diagnose and find out why it occurs, and then proceed to treatment.

Pain and discomfort in the right hypochondrium is a common complaint among patients. different ages. Painful sensations under the ribs on the right side usually occur in front, are dull and aching in nature, and can either indicate a variety of diseases or appear for one-time reasons in a completely healthy person.

To understand why pain occurs, you need to remember what organ systems located in this part of the human body. Discomfort is usually caused by abnormalities in the functioning of the kidney, pancreas, problems with the gallbladder, liver and diaphragm. In addition, the source of pain is often located elsewhere, and pain only radiates to the right hypochondrium.

The reasons

Consider the most probable factors, which lead to soreness in the right hypochondrium in front:

gallbladder, with cholelithiasis or other types of cholecystitis
Pancreas with pancreatitis or malignancy
Diaphragm with tumor phenomena, hernia
Liver– a fairly common cause of pain due to hepatitis or advanced cirrhosis
Intestines with an inflammatory process of appendicitis or duodenal ulcer
Right kidney with pyelonephritis or urolithiasis

Above, we have listed the organs that are located under the ribs on the right side, respectively, pain is formed directly in this area in front or behind. However, often the pain in the right hypochondrium only radiates, coming from another part of the body, this situation can be caused by:

Cardiac and vascular abnormalities, such as advanced angina and progression of myocardial infarction
Pathologies in the right lung with its pleurisy, pneumonia, malignant tumor
The development of tumors in any of the considered organs

Under these conditions pain is varied, it can be both aching and dull, and sharp and paroxysmal. The causes of non-systemic pain are often associated with trauma to which the right hypochondrium has undergone.

Statistics claim that the most common cause of the pain in question is the pathology of the gallbladder and related organs. Consider the main diseases that lead to pain under the ribs on the right side in front and behind, they symptoms, as well as the main methods treatment.

Cholecystitis

At acute cholecystitis additional symptoms are added to the pain syndrome of the right hypochondrium, for example:

Paroxysmal pain in the area where the gallbladder is located
Bad feeling
Nausea and repeated vomiting
Elevated temperature
Apathy
Digestive disorders due to which constipation, diarrhea, excessive flatulence appear

With the development chronic cholecystitis soreness of the right hypochondrium in the anterior part of the body becomes more prolonged and aching, although paroxysmal exacerbations are sometimes possible. Pain is given to the scapular and shoulder area on the right. Over time, unpleasant pain spreads over most of the chest, as well as the back. During periods of exacerbation, there are additional symptoms of fever, cardiac discomfort, and so on. In the periods between exacerbations, the nature of the pain is dull and aching.

For the treatment of cholecystitis, it is important to undergo a diagnosis to establish the causes of the disease, in most cases it is caused by cholelithiasis.

Stones in the gallbladder

With cholelithiasis, the patient may not be aware of the presence of pathology for a long time, until the stone or reaches a certain volume. Pain in the right hypochondrium in front is one of the first signs this disease, among other symptoms, bitterness in the mouth, heartburn, belching, bouts of vomiting and nausea can be distinguished.

An increase in pain under the ribs is usually observed when the calculus enters the cavity of the bile ducts, squeezing and irritating their walls, and also interfering with the normal outflow of bile. Treatment, depending on the size of solid formations, involves either dissolution or surgical removal.

Pyelonephritis

This pathology is divided into chronic and acute, depending on which. The patient has a set various symptoms and require some form of treatment.

General manifestations acute pyelonephritis this is:

Severely elevated temperature, reaching 39-40 degrees
Problems with urination
Pain in the lower back, including in the hypochondrium

In addition, there may be signs of weakness, malaise, nausea, headache, muscle weakness, and increased sweating.

At first, the pain is felt without a clear localization, then it becomes more pronounced in the hypochondrium region on the back on the right side - where the kidney is located. In addition to the area under the ribs, discomfort is often felt in the groin, in addition, during movements, coughing, urination and at night, there is an increase in intensity pain syndrome.

During the chronic course of pyelonephritis, the symptoms are less pronounced, so the pain in the right hypochondrium is aching in nature. Other signs include:

Body temperature can rise sharply for no apparent reason
The patient quickly gets tired and feels weak.
Headache occurs on a regular basis
Due to disturbances in the blood supply to the kidney, there is almost always a cold in the lower back
While walking, the pain in the right hypochondrium becomes more intense.
Frequent urination
Urine has an unnatural cloudy hue and an unpleasant odor

The treatment of this pathology is carried out by a urologist.

Hepatitis

With hepatitis C or B, there are practically no symptoms, the occurrence of pain in the right side of the body in the hypochondrium is possible only in a situation of severe neglect of the disease, when the liver cells have undergone strong pathological changes. On the early stage the disease is detected by a blood test.

Accompanying signs of hepatitis C is the presence of weakness, a person gets tired quickly, in addition, due to a violation of bilirubin metabolism, the skin may acquire a yellow tint. The latter situation is typical for cirrhosis of the liver, which occurs with advanced hepatitis, as well as for other reasons.

Osteochondrosis

With damage to the spine, the focus of pain is located behind the center, or in the area hip joint, while in the right hypochondrium pain only gives. This is usually observed in conditions of exacerbation, when a person abuses physical activity or is motionless for a long time.

Intestinal pathologies

Bowel disease often leads to discomfort in the front or back of the hypochondrium. They are spasmodic in nature, while defecation brings some relief. As a rule, in diseases of the intestine, there are changes in feces changing their texture and smell.

Treatment of pain in the right hypochondrium

As follows from our article, pain in the right side of the body under the ribs is just a signal and one of the symptoms various diseases. Accordingly, it is necessary to treat a specific ailment, which will be detected during the diagnosis. Self-treatment in most cases it will be a waste of time, since most of the pathologies considered are subject only to professional treatment with the help of potent drugs, as well as a surgical method.

Initially, you need to seek help from a therapist, who, after conducting an initial examination and listening to complaints, will refer you to a specialist. Most often, this is gastroenterologist and infectious disease specialist.

Pain under the ribs, which makes a person bend over and forcefully press his hands to his stomach, can be of the most diverse nature, occur due to pathological or physiological conditions and be either really dangerous to health / life, or a short-term spasm.

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Possible causes of pain in the hypochondrium

According to the patient’s only complaint of pain under the ribs, no specialist will make a diagnosis - too many factors can provoke this unpleasant feeling. But there is a certain classification of the considered pain syndrome. For example, most often pain occurs for two reasons - pathological conditions in the organs gastrointestinal tract and problems with the spleen.

Pathologies of the gastrointestinal tract

Pain under the ribs can cause:

any diseases of the duodenum and stomach - for example, acute gastritis or chronic form, pre-ulcerative condition, formed, malignant neoplasms;
pathologies localized in the pancreas - an inflammatory process (pancreatitis) of an acute or chronic form, cancer of the gland;
violations of the functionality of the gallbladder - the formation of stones in the pelvis of the organ, stagnation of bile, inflammation of the gallbladder () of any severity;
liver pathology - cirrhosis, hepatitis, malignant / benign neoplasms.

Spleen pathologies

You should know that pain under the ribs can appear even with a slight increase in the spleen. This process can start when:

diagnosed leukemia;
hemolytic anemia;
acute infectious diseases;
developing sepsis;
infectious pathologies of a chronic type;
disturbances in the body's immune system.

Pain under the ribs can also occur for other reasons - for example, doctors differentiate the following conditions:

osteochondrosis of the spine (pathology can affect any of the sections of the spinal column);
trauma to the spleen or liver (bumps, bruises, falls);
some diseases respiratory system(pleurisy localized in the lower lobe right lung);
myocardial infarction, but proceeding exclusively in gastralgic form;
inflammatory and/or infectious diseases urinary system (, pyelonephritis in acute / chronic forms,);
abscess subphrenic location;
retroperitoneal hematoma;
diagnosed neurocirculatory dystonia.

Differentiation of pain syndrome

Since there are really many reasons that provoke the appearance of pain under the ribs, it is worthwhile to independently differentiate the syndrome before visiting a doctor. This will help the specialist quickly navigate the situation and offer targeted professional assistance, which will certainly lead to a speedy solution to the problem. Patients are advised to differentiate the pain syndrome under the ribs according to the following scheme:

Accurate localization of pain. You may experience pain under the right rib, pain under the left rib, pain under the ribs in front, or pain under the ribs in the back.
Direction of irradiation ("recoil"). note: pain under the ribs is almost never “pointy”, usually it “gives” under the left collarbone or right shoulder blade, can mimic pain in the heart and be present even in the anatomical location of the kidneys.
The level of pain intensity. Even if the pain syndrome under the ribs appeared suddenly, it can be intense or not, dull / cutting / stabbing, paroxysmal or constant - there are many options for characterizing the strength of pain, it is worth deciding more specifically.
The nature of the syndrome. We are talking about what kind of pain torments: pulling, aching, “spilled”, strictly localized, constant and dull, paroxysmal and acute.
If pain under the ribs does not occur for the first time, then it will be necessary to clarify:
- in which cases it becomes more intense - when coughing, a sharp turn of the body, physical activity, brisk walking, sneezing and so on;
- what ways can you quickly relieve pain - applying a warm / cold heating pad, using medicines (analgesics or antispasmodics);
- whether the pain is associated with eating - it can appear on an empty stomach, immediately after eating or during bouts of hunger;
- at what time does the pain appear night sleep, morning or afternoon.

note: Pain under the ribs may be accompanied by nausea and / or vomiting, sudden dizziness, a sharp blanching of the skin, increased sweating and other symptoms - they also need to be noted and remembered. It is highly desirable to remember where and how the pain under the ribs appeared in general - perhaps the day before you were very cold or took too much fatty food.

Pain under the ribs in some cases require emergency medical care - this syndrome may indicate the development of a dangerous condition for health and even life of the patient. But most often, the syndrome in question means the presence of any developing pathology which will need to be treated in a hospital.

Pain under the ribs, requiring urgent hospitalization

In medicine, a number of dangerous pathological conditions are classified, which are manifested by pain under the ribs.

Perforated gastric or duodenal ulcer

This condition is accompanied by dagger pain - very sharp and violent attack with localization in front and in the middle. The intensity of the pain is such that the patient takes a forced position - he lies on his side, his legs are bent at the knees and pulled up to his stomach. It is characteristic that when a gastric / duodenal ulcer is perforated, the pain syndrome first occurs “under the pit of the stomach”, and then actively shifts to the right hypochondrium. This is due to the movement of gastric contents through the abdominal cavity.

note: after the pain syndrome moves to the right area under the ribs, the attack ends - the phase of imaginary well-being begins, which, in the absence of professional help always leads to the development of peritonitis.

It is easy to differentiate the perforation of a gastric / duodenal ulcer - usually the patient has a history of long-term gastritis, a pre-ulcerative condition, and the ulcer itself.
In more detail about the symptoms of an ulcer, see this video review:

Acute pancreatitis

Sudden attack of sharp girdle pain that covers upper part abdomen and gives irradiation under the shoulder blades, is always associated with acute pancreatitis (inflammation of the pancreas). Feature of the pain syndrome under consideration - its intensity is not variable and remains within the original limits when the position of the body changes, coughing or sneezing. In addition to the pain syndrome, in acute pancreatitis, nausea and vomiting will be present - the latter appears suddenly and does not allow even a sip of water to be taken.

note: an acute inflammatory process in the pancreas can cause severe intoxication of the body - enzymes produced by the body enter the bloodstream. This provokes cyanosis of the skin, the characteristic "marbling" of the abdomen and small (pinpoint) hemorrhages with localization around the navel.

It is easy to diagnose acute pancreatitis by pain syndrome - it is too pronounced. Moreover, an attack usually occurs after eating a large amount of fatty foods or alcohol.

Read more about the symptoms of acute pancreatitis in the video review:

Acute cholecystitis and hepatic colic

acute attack, cutting pain in the region of the right hypochondrium with irradiation to the shoulder blade and neck may be a reason to suspect acute inflammation of the gallbladder. The patient in this case will literally rush about to find a comfortable position and reduce the intensity of pain - by the way, he will not be able to do this. The general clinical picture will also help in diagnosing:

nausea and vomiting;
yellowness of the skin and sclera;
fever.

With the pain syndrome under consideration, it is important to differentiate acute cholecystitis and hepatic colic. If the stone moves through the hepatic ducts, pain under the ribs will be present, but neither nausea, nor vomiting, nor fever is noted.

note: hepatic colic is short-lived, and the pain is relieved by antispasmodics. In acute cholecystitis, the syndrome lasts for a long time and even after taking specific drugs, relief does not occur.

Subdiaphragmatic abscess

Sudden pain, sharp and paroxysmal, with localization in front under the left and right ribs simultaneously indicates the development of an abscess in the subdiaphragmatic region. The syndrome appears only on a breath, may be accompanied by fever and standard symptoms of general intoxication of the body.

The pain in question has several characteristic features:

radiates to the supraclavicular region;
may have false localization under the scapula;
increases significantly with sudden movements - coughing, sneezing, turning the body.

Diagnosis of a subdiaphragmatic abscess is simple - this condition often occurs in postoperative periods or when diagnosing acute cholecystitis and perforated gastric/duodenal ulcer.

Liver and spleen injuries

Injury to the spleen or liver is always accompanied by pain under the ribs - this is the main symptom of this condition. Moreover, the localization of the syndrome will depend on which particular organ is damaged - the liver is on the right, and the spleen is on the left. characteristic symptom to rupture these organs - "roly-poly": the patient cannot be in a prone position, as he experiences more intense pain due to blood spilling under the diaphragm.

note: injury to the spleen and/or liver is always accompanied by internal bleeding, so the patient will be unnecessarily pale, may lose consciousness, arterial pressure he falls sharply.

Cases are considered especially dangerous when a two-stage tear of the spleen and liver occurs: first, the parenchyma (shell) of the organ is damaged, blood accumulates in the capsule, and then, even with slight physical exertion, the capsule breaks, the blood accumulated in it spreads into abdominal cavity- this leads to almost instant death of the patient. The difficulty of this condition lies in the short-term pain syndrome under the ribs - in just a few hours it disappears and the patients continue to lead their usual way of life without seeking medical help.

Myocardial infarction of the gastralgic form

Usually, myocardial infarction is diagnosed quite easily - the patient complains of shortness of breath and pressing pain under the heart. But in the case of the gastralgic form of this pathological condition, there will be several other symptoms:

pain in the left hypochondrium;
nausea and uncontrollable vomiting;
persistent hiccups;
stool disorders.

Two characteristic features will help to differentiate gastralgic myocardial infarction from diseases of the gastrointestinal tract:

shortness of breath on inspiration;
blueness and puffiness of the face.

note: after the introduction of drugs with analgesic action, the patient's condition normalizes to the classic symptoms of myocardial infarction.

Doctors distinguish pain under the ribs and from the back - it occurs with renal colic (stone movement) and retroperitoneal hematoma. These two conditions are characterized by a strict localization of the pain syndrome and the absence of irradiation. In this case, the patient will complain about general weakness, increased sweating, lack of appetite.

All of the above pathological conditions require immediate hospitalization of the patient and the provision of professional medical care. Otherwise, the risk lethal outcome increases to 99%.

Pain under the ribs in chronic diseases

Chronic diseases can be manifested by periodic bouts of pain under the ribs. Usually they do not pose any danger to the health and life of the patient, but indicate that some pathological processes are occurring in the diseased organ.

For example, when chronic gastritis non-intense pains in the left hypochondrium will be noted, which are directly related to food intake. This means that the time has come for a seasonal exacerbation of the chronic inflammatory process and the next course of therapeutic / maintenance therapy is required. And for chronic pancreatitis(inflammation of the pancreas) is characteristic not only periodic pain under the ribs, but also an increase in the syndrome in the prone position.

note: knowing about previously diagnosed chronic diseases, you can control pain under the ribs and quickly relieve it with various medicines.

Pain under the ribs with neurocirculatory dystonia

Neurocirculatory dystonia is a disease that gives the most unpredictable in terms of its localization, irradiation and intensity of pain in the hypochondrium. There are two main signs by which the doctor can differentiate the pain syndrome in question, as a result of neurocirculatory dystonia:

indefinite characteristic of pain: the patient literally cannot describe his feelings, because the syndrome can be constant and paroxysmal, sharp and gradually increasing, sharp and dull;
the absence of additional symptoms that appear precisely at the time of the pain attack.

Treatment

It is strictly forbidden to take any painkillers on your own if the pain under the ribs is sudden, acute, and before there was no diagnosis of any of the above diseases!

With the usual pain in the hypochondrium, you can take any antispasmodics - No-shpa, Baralgin, Spazmalgon: usually after the first dose, the intensity of the pain syndrome begins to subside and the condition returns to normal. But this does not mean that this syndrome can be ignored - doctors should conduct an examination and identify the cause of the exacerbation chronic pathology prescribe a course of therapy.
Combining traditional medicine recipes to reduce pain under the ribs with drugs is possible only after an accurate diagnosis has been made and recommendations / permissions have been received from the attending physician.

Pain under the ribs may indicate a dangerous condition for the patient, so it is better to immediately seek help from doctors - emergency surgical intervention save lives and make the prognosis of even a complex pathology favorable.

You will get more information about the possible causes of pain in the hypochondrium by watching this video:

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category.

Pain under the ribs in the right side is one of the most common complaints at a therapist's appointment. In the projection of the right hypochondrium are the liver and gallbladder, the head of the pancreas, the right bend colon, lower lobe of the right lung and pleura, right dome of the diaphragm, abdominal muscles. For differential diagnosis diseases occurring with pain in the right side, you must consult a doctor. The specialist will determine the nature of the pain, prescribe additional methods of examination and determine the tactics of treatment.

The right side hurts under the ribs on the side, what could it be? We will discuss in this article.

Types of pain on the side in the right hypochondrium

The nature of pain is an important diagnostic and prognostic sign of the disease. The pain syndrome determines the therapeutic tactics or becomes an indication for surgical intervention.

Classification of pain syndrome.

1. By intensity, they distinguish:

acute pain - in most cases, a clinical sign of an "acute" abdomen and other emergency that requires surgical care;
chronic pain is a sign of a chronic disease of internal organs, inflammation of muscles and nerve trunks, conservative treatment is indicated.

2. According to the nature of sensations, pain syndrome is distinguished:

aching;
stupid;
bursting;
stabbing, cutting;
cramping;
shooting;
shingles.

3. Pain syndrome is isolated according to the source of occurrence:

visceral - characteristic of inflammation and injuries of internal organs;
peritoneal - develops with irritation of the peritoneum (peritonitis);
muscular - occurs when inflammatory processes in the muscles of the anterior abdominal wall and chest;
neurological - occurs with inflammation of the nerves;
reflected - the spread of pain along the nerve trunks to the right hypochondrium from distant organs.

After questioning the patient based on the nature of the pain, the doctor narrows the circle possible diseases, determines the list of diagnostic examinations.

Diseases of the liver and gallbladder

One of the most common causes pain in the right hypochondrium on the side is a disease of the liver and gallbladder. Viral hepatitis, cirrhosis of the liver, cholecystitis, cholelithiasis are accompanied by pain under the right rib. In acute hepatitis or cholecystitis, intense pain occurs that can spread to the chest and groin. Characterized by nausea, vomiting with an admixture of bile, fever up to 38 degrees, bitterness in the mouth.

Chronic diseases of the liver and gallbladder occur with periodic aching pains in the right hypochondrium, which increase 1-1.5 hours after eating fatty or fried foods. There is a feeling of seething and transfusion in the intestines, flatulence, relaxation or unstable stools (diarrhea alternates with constipation). Characterized by a taste of bitterness in the mouth on an empty stomach, yellowness of the sclera, the appearance spider veins(telangiectasia) on the skin.

An emergency condition is hepatic colic due to blockage by a calculus or neoplasm of the bile duct. There is a dagger sharp pain in the right side, repeated vomiting, increased heart rate, thirst, bloating, darkening of urine and discoloration of feces. In case of hepatic colic, it is necessary to call an ambulance team or immediately deliver the patient to a medical institution.

Diseases of the pancreas

Chronic pancreatitis is an inflammation of the pancreas. The disease is characterized by pains of bursting, stabbing, girdle nature, which intensify 1-1.5 hours after eating. Exacerbation of the disease causes a predominance in the diet of salty, spicy, fatty foods and overuse alcohol. In addition to pain, diarrhea appears, a fatty stool with undigested food residues, which is associated with insufficient formation of digestive enzymes. There is nausea, sometimes vomiting, heaviness in the abdomen.

Acute pancreatitis refers to diseases of the "acute" abdomen, requiring emergency medical care. Pain appears high intensity under the right rib, which extends into the region of the back and left hypochondrium. Characterized by nausea, vomiting without relief, frequent liquid stool, tachycardia, pallor of the skin. The formation of a tumor in the head of the pancreas is asymptomatic. The first signs of neoplasm develop on late stages cancer - yellowing of the skin and sclera, constant arching or cramping shooting pains on the side under the right rib.

Bowel disease

Inflammatory (enteritis) and oncological (cancer) diseases in the right small intestine lead to blunt chronic pain in the right hypochondrium. Characterized by bloating, a tendency to constipation or diarrhea, weight loss, dry skin, brittle nails, hair loss. With ulcerative lesions of the intestine and Crohn's disease, an admixture of blood appears in the feces. Perforation of the intestinal wall causes Clinical signs peritonitis - severe dagger pain, muscle tension of the anterior abdominal wall, vomiting, sharp deterioration general condition up to loss of consciousness.

Muscle diseases

The inflammatory process in the abdominal muscles and chest (myositis) is accompanied by cramping or shooting pains in the right hypochondrium. Pain is aggravated by bending over left side associated with stretching of the muscle fibers. When feeling, a sensitive compaction is determined in the affected muscle groups. In rare cases, discomfort in the right side causes inflammation of the right dome of the diaphragm (diaphragmitis), swelling and hernia of the diaphragm. The occurrence of pain syndrome is associated with breathing or eating - increased pain at the height of inspiration and immediately after eating.

Intercostal neuralgia

Inflammation of the intercostal nerves in the right half of the chest leads to acute burning pain in the hypochondrium on the side of the lesion. The disease is characterized by an increase in pain during movements and inclinations in right side, redness of the skin in the intercostal spaces, an increase in discomfort during palpation in the focus of inflammation. In the case of herpes zoster, a small vesicular rash with clear contents occurs in the area of pain.

Diseases of the right lung

Inflammation of the right lung (lower lobe pneumonia) involving pathological process pleura leads to sharp stitching pains on the side under the right rib. The pain syndrome intensifies at the height of inspiration and subsides in the position on the right side. Characterized by an increase in body temperature up to 40 degrees, dry or wet cough, shortness of breath, weakness, wheezing when listening to breathing.

With dry right-sided pleurisy, the pain syndrome is identical to pleuropneumonia, but there is no cough, sputum discharge, when listening to breathing, a pleural friction noise is determined. Cancer of the right lung causes pain in the right hypochondrium, rapid weight loss, increasing weakness, hemoptysis.

Acute appendicitis

The appendix is located in the right iliac region. At acute appendicitis there are acute pains in the groin, nausea, vomiting, fever up to 38-39 degrees. The atypical course of the disease causes reflected pain in the right hypochondrium, which occurs against the background of a typical pain syndrome, or is the first manifestation of the pathology. With prolonged discomfort in the right side, it is necessary to urgently seek medical help.

Pain in the right hypochondrium may be the result of acute emergency conditions and chronic diseases internal organs. At the first sign of illness, you should consult a doctor. Timely diagnosis and therapy improve the prognosis of the disease and prevent the development of complications.