Right Side Abdominal Pain - Causes, Diagnosis and Treatment

Pain is a warning sign that something is wrong in the body. However, it can be confusing if the pain is located in the abdomen because many major organs are situated in that area of our body, and identification of which organ causes this is a major factor in relieving the pain.

To ease the patients and health care providers on precisely identifying which part of the abdomen is painful, the so-called abdominal quadrants are devised. The four abdominal quadrants are upper right quadrant, upper left quadrant, lower left quadrant, and lower right quadrant.

As the scope it too broad, this article will only focus on right side abdominal pain.



Image shows upper right and lower right abdomen.

Source: official.health.org

 

Organs on the Right Side of the Abdomen

It order to fully understand why you experience abdominal pain on the right side, you have to know the structures and organs located in that area.
  • Skin that covers right abdominal region
  • Gallbladder
  • Right kidney
  • Pancreas
  • Duodenum
  • Appendix
  • Right adrenal glands
  • Right fallopian tube
  • Right ovary
  • Muscles in the abdominal wall
  • Right ribs
  • Nerves and blood vessels

Aside from the right side, the pain may be felt in the left side especially if the matching organ on the left is also affected.

 

Most Common Causes of Right Side Abdominal Pain

Right side abdominal pain is caused by a range of factors. It may be because of an underlying medical condition, foods and drinks that you ingest, trauma, stress, etc.

The most common medical conditions that can cause right side abdominal pain are the following: [1]

Apart from the common causes of abdominal pain, there are also some rare causes. Some of them are: [1]
  • Testicular erosion
  • Sport hernia
  • Carconoid tumor
  • Cecitis
  • Tietze syndrome
  • Spigelian hernia
  • Osteogenic carcinoma of iliac bone
  • Tuberculosis of the bowel

Identifying the cause is of prime importance. To identify the proper treatment, the cause must be known first.

 

Understanding Referred Pain

Along with referred pain, there are also two types of pain that could be felt in the abdomen: visceral pain and parietal pain.

 

Visceral Pain

Visceral pain in the abdomen occurs when the pain directly involves an organ in the abdomen. Normally, major organs do not have many nerve fibers. Because of this, a patient may experience mild pain. The visceral pain is characterized as poorly localized and the pain is usually very dull.

 

Parietal Pain

This type of abdominal pain occurs when the peritoneal lining is irritated. The pain experienced by the person can be more debilitating since this area has the largest number of nerve endings.

 

Referred Pain



Organs that are found in the right abdominal quadrant

Source: anatomynotes.blogspot

This is the type of visceral pain that is experienced in another location of the body but can be felt somewhere else since the organs share common nerve cavities. Because of this, the pain can be poorly localized and constant in nature. [2]

Another possible explanation of referred pain is due to many nerve signals. The brain can get confused so instead of making you think that one side of your body is hurting, the brain signals may mistakenly send brain impulses that the whole abdomen itself is responsible for the pain.

There is no clear sign why referred pain occurs but it is believed that it affects a person due to the high sensory stimuli that are found under the skin and the low sensory stimuli that are found in the organs. When both of the stimuli converge on the spinal cord, referred pain is felt. [3]

One example of referred pain is liver problems. A person suffering with liver disease may experience pain not in the abdomen but may feel discomfort in the neck area.

Another example is shoulder pain. You may feel pain in your shoulder but it may not be related to injury. It can be because of underlying medical conditions involving gallstones, gastric ulcer, liver problems and even heart attack.  See : About Liver pain

Differential Diagnosis

There are different kinds of abdominal pain and specific causes in some cases can be hard to determine. The person may feel the abdominal pain radiating from several areas of the abdomen.

Some of differential diagnosis include the following: [4]
  • Urinary Tract Infection. The pain may begin in the bladder or urethra. This condition is more common in women than in men. Women may also experience pelvic pain and the urge to urinate more often. If the kidney also has infection, the pain may radiate to the back and the person may experience chills.
  • Appendicitis. This may occur when the appendix swells and becomes filled with pus. The person suffering with appendicitis may complain of worsening pain for the next six to twelve hours. This is a serious condition that requires immediate medical attention.
  • Endometriosis. This condition affects women when the endometrium, which grows in the uterus, may suddenly grow in other areas like ovaries and fallopian tube. When it occurs, the endometrial tissue is trapped and may lead to pelvic pain during the menstrual period.
  • Crohn’s Disease. This condition is a type of Inflammatory Bowel Disease that affects the lining of the digestive tract. When the lining is inflamed, the result is diarrhea and abdominal discomfort. The inflammation can affect the tissues, which can be fatal.



Image of Crohn’s Disease, which can cause right abdominal pain

Source: gastro-info.co

 

Right Abdominal Pain and Associated Symptoms

Right abdominal pain can be caused by various medical conditions. It can really be confusing to determine the specific cause. To get the proper diagnosis, associated symptoms are carefully studied.

Here are the most common causes of right abdominal pain and their associated symptoms: [5]
  • Appendicitis. The pain may start niggling followed by a severe pain. An individual suffering with appendicitis may also complain loss of appetite, feeling nauseous and vomiting.
  • Kidney Stones. The pain associated with kidney stones is characterized as sudden pain, which can develop severely. The pain may spread to the lower abdomen and groin area. Feeling nauseous and the urge to vomit are strong when the pain is felt. [1] See : About Kidney Pain in detail.
  • Stomach ulcer. The pain associated with stomach ulcer may start in the upper quadrant, which can spread to the chest. The pain is characterized as sharp and chronic. The abdominal discomfort may get worse if you are not eating.
  • Ovarian Cysts. For women, the presence of ovarian cysts may result to pain in the abdominal area especially during the menstrual cycle. Some ovarian cysts are not really serious but if it ruptures, the infection can be life threatening.
  • Ectopic pregnancy. If a pregnant woman suddenly feels right abdominal pain, which may spread to the pelvis, call a doctor immediately. This can be an indicator of ectopic pregnancy.

 

Treatment

The right abdominal pain may indicate several diseases and disorders. Treatment is based on the underlying medical condition and focused on eliminating the cause and discomfort. [6]
  • If the cause of the pain is stomach ulcer, the individual may take some over-the-counter antacids to sooth the abdominal discomfort.
  • If the culprit of the pain is kidney stones, your health care provider may prescribe medications that can purge out the kidney stones.
  • To lessen the pain, you may take acetaminophen. Do not take any medications that contain aspirin because it can lead to internal bleeding and stomach irritation.
  • For ovarian cysts, surgery may be needed to remove the ruptured cysts, that is, if it ruptured.
  • For ectopic pregnancy, the only way is surgical removal of the “displaced fetus”. This should be done to avoid life threatening conditions because only the uterus is capable to house the growing fetus.
  • If you suspect appendicitis, go to the nearest hospital for surgery to avoid complication.

You may need to seek immediate treatment if you feel that your abdominal pain has these characteristics:
  • Vomiting
  • Fever
  • Blood in the urine
  • Inability to pass stools
  • Abdominal pain that lasts for several days
  • Breathing difficulties

References:

1. http://www.abdopain.com/right-side-abdominal-pain.html
2. http://www.emtresource.com/emergencies/abdominal-pain/types-of-abdominal-pain
3. http://anatomynotes.blogspot.com/2006/10/referred-pain.html
4. http://www.ehow.com/facts_4815260_differential-diagnosis-abdominal-pain.html
5. http://voices.yahoo.com/right-side-abdominal-pain-serious-it-1039979.html
6. http://firstaid.webmd.com/abdominal-pain-in-adults-treatment
7. http://www.gastro-info.co.nz/photos/1-cb40ed.jpg
8. http://www.officialhealth.org/pain-symptoms-charts.htm

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