Pain in the right hypochondrium in front. Causes, possible diseases. Treatment, diagnosis

Causes of pain under the ribs in front

On the front side of the abdominal cavity, directly below the ribs, are the vital organs.

The occurrence of acute, aching, spasmodic, throbbing pain in this part of the body can be caused by the following reasons:

• receiving a mechanical injury to the bone tissue of the ribs, the surface of the abdomen, or bruise of internal organs, which occurred as a result of a fall from a great height, blows, or collision with blunt objects;
• the presence of benign or malignant neoplasms in the tissues of the liver and stomach;
• stretching of abdominal muscle fibers;
• stones in the gallbladder, as well as obstruction of its ducts;
• adhesions in the abdominal cavity that arose as a complication after surgery;
• foci of chronic infection that develops in the internal organs of the abdominal cavity;
• pathological tissue processes caused by alcohol and drug abuse (liver cirrhosis, alcoholic or intoxicated hepatitis);

  

• concomitant diseases of the internal organs of the digestive system.

Pain that occurs in the right hypochondrium in front should not simply be eliminated with the help of analgesics. It is necessary to diagnose the patient’s abdominal cavity as quickly as possible, establishing the cause of the pathology.

Manifestation of pain in the right hypochondrium behind

If the patient complains that there is pain in the back under the right shoulder blade, the causes of this phenomenon may be associated with injuries to the lower ribs, damage to the intercostal nerves. Pain appears from behind under the right shoulder blade from the back and with lesions of the right kidney and adrenal gland. The causes of back pain may also be associated with diseases of the inferior vena cava.

For urolithiasis

Burning and severe pain can bother people with urolithiasis . When moving, stones or sand scratch the renal pelvis, and later the ureter. Consequently, with renal colic there is pain in both the lateral abdomen and the lower back. Painful attacks are observed, spasms radiate to the genitals, to the thigh, and is felt in the groin. If you hit the lower back a little with the edge of your palm, it hurts even more, and blood may appear in the urine. Sometimes vomiting occurs.

For pyelonephritis

The development of acute infectious inflammation of the kidney is accompanied by pain in the kidney area, intoxication, and fever. It also hurts when urinating, periodic false urges are noted, and swelling appears on the face.

With apostematous pyelonephritis, purulent inflammation develops in the kidneys. I am concerned about prolonged nagging pain, the temperature increases, and the amount of urine excreted per day decreases.

With necrosis of the renal papillae

This phenomenon becomes a consequence of oxygen starvation of the kidney tissue if the vessels become clogged. Constant pain is accompanied by the appearance of blood in the urine. There is a possibility of death from septic shock.

For acute upper paranephritis

The inflammatory process of fatty tissue in the area of ​​the upper part of the kidney manifests itself as a consequence of infection from carious teeth, tonsils, etc. First, the patient’s temperature rises and there is moderate pain in the lower back. After a few days, there is already pain in the right hypochondrium, the pain intensifies with a deep sigh, the condition worsens and physical efforts - pain is noted when moving, walking, sharply straightening the body.

For kidney cancer

This condition may not appear for a long time. Mild pain and bleeding appear already in the last stages of the disease. Sometimes the tumor interferes with the outflow of urine, then acute pain is noted.

Pain in the hypochondrium also occurs with tumors of the right adrenal gland , provided that the tumor is large.

For intercostal neuralgia

The reason that a person’s right side feels tight and numb in the hypochondrium area may be intercostal neuralgia . In this state, sometimes there is a pulling from the back, the ribs hurt on both sides in front. With neuralgia, there is a strong tingling sensation in different areas, even to the point of limited mobility. The pain becomes stronger when bending or turning. Also, the cause of a sudden tingling sensation in the pit of the stomach or twitching on both sides may be myositis , when a person’s muscles are inflamed.

For bruised ribs

Severe aching pain, aggravated by coughing, pressing, bending, sighing, occurs with bruises of the posterior segments of the ribs. When rib fractures occur, a characteristic crunch is felt.

For osteochondrosis of the lumbar region

If there is muscle tightness, limited mobility, signs of tension, pain in the right shoulder, in the arm, then the causes of this condition may be associated with osteochondrosis of the lumbar region . Painful sensations can have different intensities, be both aching and shooting in nature, and appear above and below.

For shingles

In this case, herpetic eruptions along the nerve in the form of bubbles with cloudy liquid, and the skin turns red. Itching, burning, and pain develop at the site of the lesion. This means that you need to see a dermatologist.

With thrombosis of the vena cava

If a blood clot comes from the iliac veins, after which it clogs the vein trunk, pain occurs in the lower back on the right side of the back. The clinical picture is similar to that of a late-stage kidney tumor. If thrombosis of the liver segment , intense bursting pain occurs in front in the right hypochondrium and radiates under the scapula on the right. Jaundice also develops and fluid accumulates in the abdominal cavity.

Types of diseases that cause pain under the ribs in front

Pain in the right hypochondrium in the front, the causes of which may be associated with diseases of the internal organs, manifests itself in the form of acute spasms, or is aching and occurs periodically. The table below shows diseases, the presence of which provokes the appearance of pain from the front of the ribs.

Pain in the right hypochondrium in the front, the causes of which are caused by the above pathologies, should be eliminated using complex therapy. As the patient recovers, the pain syndrome will disappear, and the tissues of the internal organs will begin to gradually recover.

Intestinal diseases

Pain under the right rib can occur with intestinal diseases such as ischemic colitis, diverticulitis (inflammation of a diverticulum - a protrusion in the form of a bag on the intestinal wall), Crohn's disease, a symptom of irritable bowel.

With appendicitis, there is usually pain in the lower abdomen on the right. But the vermiform appendix has different lengths and different locations in different people. Sometimes it is located above its usual place, right under the liver.

Sometimes the cause of symptoms is a malignant bowel tumor.

Symptoms of diseases that cause pain under the ribs in front

Pain in the right hypochondrium in the front, the causes of which are directly related to the presence of concomitant diseases of the internal organs, is accompanied by the following external and internal signs.

They are as follows:

• feeling of heaviness in the right hypochondrium;

  

• bitterness in the mouth;
• loss of appetite, nausea, vomiting;
• discoloration of stool;
• change in the color of urine, which takes on a rich dark brown hue, resembling black tea in appearance;
• a feeling of spasm on the front side of the ribs (the pain can be both acute and aching in nature);
• stool disorder, alternating with diarrhea or prolonged constipation;
• the opening of internal bleeding, if the cause of pain from the front of the ribs is the presence of ulcerative formations on the gastric mucosa;
• physical weakness, fatigue, loss of vital energy;
• headaches, drowsiness during the day and insomnia at night.

The most common cause of pain in the right hypochondrium is pathological conditions of the liver and gallbladder. Therefore, in addition to all the above signs of the disease, there is also a symptom such as yellowness of the skin and whites of the eyes. This is due to an increase in the level of bilirubin in the blood and systemic dysfunction of liver tissue.

Dull pain

Dull pain very often indicates the development of an inflammatory process. They manifest themselves in the following pathologies:

• hepatitis in acute and chronic form;
• liver cancer , cirrhosis , parasitic lesions of the right lobe of the liver ;
• the period between exacerbations of cholecystitis , cholangitis ;
• adrenal tumors;
• intestinal diverticulosis , colitis ;
• hydronephrosis , pyelonephritis , late stage of kidney tumors , apostematous nephritis .

In the iliac region there is constant pain due to tumors, metastases of internal organs, rib fractures, and parasitic liver cysts.

Diagnosis of pain under the ribs in front

Pain in the right hypochondrium in the front, the causes of which are caused by diseases of the internal organs, should be eliminated only after a thorough examination of the body. The diagnosis of a patient with the indicated symptoms and the presence of a pain syndrome of characteristic localization is carried out by a general practitioner, gastroenterologist or surgeon.

It all depends on the accompanying symptoms, as well as on what particular disease caused the pain.

The primary stage of the examination is to examine the patient by a specialized specialist, listen to complaints and compile a medical history.

After this, the patient is given a referral for the following types of diagnostics:

• Ultrasound of the liver, stomach, gall bladder, and its ducts;

  

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• MRI of internal abdominal organs;
• electrocardiogram if the patient has signs of cardiovascular system disorders;
• gastroscopy if there is a suspicion of ulcerative lesions of the gastric mucosa;
• clinical analysis of capillary blood to determine its general indicators;
• liver tests to exclude such serious diseases of this organ as cirrhosis, oncology;
• analysis of venous blood for the presence of infectious microorganisms, as well as parasitic life forms (hepatitis virus, tuberculosis bacillus, echinococcus larvae);
• biochemical examination of urine.

Based on the results of the above tests, the doctor gives the patient a final diagnosis and prescribes treatment. The principle of developing and selecting a treatment regimen is based on what particular disease caused the appearance of acute, aching, burning or throbbing pain.

Diagnostics

As already mentioned, on the right side of a person there are very important organs involved in digestion, excretion of waste substances from the body, reproduction, and respiration. Pain syndrome indicates serious problems. Diagnostics will help determine what may be hurting under the right rib in the front. For a comprehensive study of the patient, the following is carried out:

Based on the patient’s general condition and the nature of the pain, the doctor determines a preliminary diagnosis and prescribes the following studies to clarify it:

After studying all the results of the examination, the therapist comes to the conclusion that there may be pain under the right rib in the front, a preliminary diagnosis is made and the patient is sent to the appropriate specialist, who will continue his treatment.

When to see a doctor

Pain syndrome that occurs in the right hypochondrium can be caused by both ordinary stretching of the muscle fibers of the abdominal cavity and pathological processes. Therefore, if pain occurs, as well as a prolonged feeling of discomfort in this part of the body, you should immediately consult a general practitioner.

If there is pain in the right hypochondrium in front, then you need to consult a therapist.

A doctor of this profile will perform an initial examination, prescribe tests, or immediately write a referral to a gastroenterologist or surgeon (if there are good reasons for this). Delay in going to the doctor can cause the patient’s well-being to deteriorate and lead to the development of complications.

What exactly hurts?

In the area of ​​the right hypochondrium, 2 important glands can hurt at once: the liver and pancreas.
The right costal arches cover the right lung, part of the stomach and duodenum, and the right side of the diaphragm. Discomfort in the rib area can come from the spine when the thoracic region is affected by osteochondrosis, when the intercostal nerves are pinched. Pain in the hypochondrium may indicate appendicitis or inflammation of the ascending colon. Referred origin of pain should not be excluded. Under the ribs on the right side there is discomfort due to inflammation of the kidney or ventricle of the heart.

Right-sided hypochondrium colic can provoke a variety of pathologies. Consultation with a specialist will help identify the problem in the shortest possible time and begin to eliminate it, which will relieve the patient of pain.

Prevention of pain under the ribs in front

Pain can occur suddenly and is one of many symptoms of an underlying disease. It is possible to minimize the occurrence of pathologies that cause pain in the right hypochondrium, but for this it is necessary to take preventive measures.

They are as follows:

• promptly eliminate foci of chronic infection in the tissues of internal organs;
• after undergoing abdominal surgery, follow the rules of rehabilitation, as well as the instructions of the attending physician, in order to prevent the development of adhesions;
• stop drinking alcohol, drugs, and avoid contact with chemical vapors;

  

• observe the rules of personal hygiene, always wash your hands with warm water and soap before eating in order to prevent infection of the digestive tract and liver tissue by parasites;
• streamline your diet by excluding fatty, fried, smoked foods from the menu, saturating it with cereal porridges, lean meat, ocean fish, fresh vegetables, fruits and herbs;
• undergo a routine medical examination at least once a year;
• Avoid injury to internal organs as a result of impacts or falls from a height.

People who have blood relatives suffering from pathologies of the liver, stomach, intestines, gallbladder and its ducts are at particular risk, since the tendency to diseases of these organs may be genetic. Therefore, they are advised to pay special attention to their own health.

After meal

Many people note that they have a tingling sensation in their right side after eating, heaviness in the epigastrium and rumbling develop. Often expectant mothers are also interested in why it hurts in the right side during pregnancy. After eating food, the process of secretion and movement of bile in the body accelerates, the liver fills with blood, and peristalsis is activated. Therefore, with chronic diseases of the liver, intestines, and gall bladder, pain in the lower and upper abdomen often appears after eating. Such manifestations can have a different character: a person feels sick, belches, diarrhea, constipation , and his stomach growls.

Dull pain after eating is observed with cholecystitis , sharp pain with colitis and dysbacteriosis , stabbing pain with cholelithiasis and biliary dyskinesia . Often the pain becomes more intense after heavy drinking or heavy smoking.

Methods for treating pain under the ribs in the front

Before using drug therapy, folk remedies or other methods, you must first undergo an examination and determine the cause of the disease. In general, the following methods can be used to combat acute, aching or burning pain on the front side of the ribs.

Medications

With the help of traditional medicines, you can relieve the inflammatory process, eliminate foci of chronic infection, restore normal functioning of the abdominal organs, and simply relieve pain.

The following drugs can be used for these purposes:

• Gepabene — a natural remedy for relieving pain in the right hypochondrium, as well as restoring the functioning of the liver and gallbladder, take 1 capsule 3 times a day for 14 days (the cost of the drug is 550 rubles per package);

  

• Essentiale - contains phospholipids that restore liver functionality, take 1-2 capsules 3 times a day (immediately during meals), and the general course of therapy is at least 3 months. (the price of 1 pack of medicine is 670 rubles);
• Ketonal is a complex non-steroidal anti-inflammatory drug that has an analgesic effect, 1-2 ampoules are injected into the human body intramuscularly, if the cause of the pain syndrome cannot be established, but it is necessary to quickly alleviate the patient’s suffering (the cost of the drug is 300 rubles for a package consisting of 10 ampoules);
• Allohol - the medicine contains dry bile, is indicated for use in case of digestive system disorders, lack of enzymes, liver tissue dysfunction (take 1 tablet 3-4 times a day after meals with a therapy duration of 4 weeks, and the price of the medicine is 180 rubles. ).
• Odeston is a drug for the treatment of most diseases of the biliary system, because acts precisely in 3 directions. First, it increases the formation and secretion of bile without stimulating gallbladder contractions, so it is safe even for patients with gallstones. Secondly, the medication has a selective (targeted) antispasmodic effect, aimed only at the biliary tract. And thirdly, it reduces bile stagnation, prevents cholesterol crystallization and the formation of gallstones. Thus, Odeston helps restore normal bile circulation, and therefore improve digestion. Odeston is indicated for the treatment of diseases such as biliary dyskinesia, cholecystitis, cholangitis and even gallstone disease (cholelithiasis). It is taken 30 minutes before meals 3 times a day. The course of treatment is 2 weeks.

The prescription of the above medications is carried out by a general practitioner or gastroenterologist, but only after a detailed examination of the digestive system, as well as other abdominal organs, which are located in front of the ribs.

Traditional methods

Alternative medicine offers its own alternative ways to combat pain in the area of ​​the right hypochondrium in front.

For these purposes, it is recommended to use the following recipes:

• cabbage pickle - you will need to take 1 head of cabbage weighing 2-3 kg, chop it, add 3 tbsp. l. table salt and leave for 3 days in the refrigerator so that the juice separates (eat the resulting product as a salad, and take 1 tablespoon of healing cabbage juice 3 times a day 15 minutes before meals for the next 2 months .);

  

• decoction of dill seeds - you need to take 2 tbsp. l. dill seeds, pour 0.5 liters of boiling water over them, and then boil over low heat for 10 minutes. (after cooling, the resulting decoction is taken 100 g in the morning and evening for 20-25 days);
• peppermint tea - normalizes the functioning of the digestive system, restores metabolic processes in the body, relieves inflammation of the walls of the gallbladder, and to prepare it, just take 1 tsp. dried plant, then pour 250-300 ml of boiling water over it (when the tea reaches a comfortable temperature, drink it 20 minutes before meals);
• rosehip compote - this remedy has an excellent choleretic effect, so it will be especially useful for people suffering from pain due to biliary dyskinesia (to prepare it, you need to boil 3 tablespoons of rosehip berries in 2 liters of boiling water, and take the homemade medicine for 5-7 days 2-3 times a day, 300 ml at a time).

Folk remedies for the treatment of pain in the right hypochondrium are really effective, but they are best used in combination with other medications. In addition, they are not recommended for use in the presence of severe diseases of the liver and other internal organs (oncology, ulcers, echinococcosis, internal bleeding, bruises).

Other methods

Other methods of treating the causes that caused pain in the right hypochondrium include the following treatment regimens:

• surgical intervention - indicated for tumor tumors in the liver, as well as in the case of removal of a cyst that has arisen due to echinococcosis;
• laser crushing - used for grinding stones formed in the cavity of the gallbladder and its ducts;

  

• warming up with electrophoresis if the patient is recovering from surgery.

Depending on the etiology of pain, other therapeutic methods may be used. They are used as an independent direction in the treatment of pathology, or are used in combination with other means.

Treatment

In cases where such a symptom occurs, patients are strictly prohibited from taking measures to relieve pain, as this can only aggravate the course of a particular disease.

To neutralize pain in the lower right hypochondrium, doctors use conservative treatment methods, namely:

• prescription of medications;
• diet therapy - only when the source of the main symptom is ailments of the digestive system. Proper nutrition will not only relieve an acute attack of pain, but will also prolong the remission phase of chronic disorders;
• use of alternative therapy recipes. It is worth considering that such treatment should in no case form the basis of treatment for the disease.

Depending on the patient’s condition, conservative methods are used in a medical facility or at home, but under the supervision of the attending physician.

Surgical intervention is resorted to extremely rarely - in case of ineffectiveness of the above treatment methods, in cases of formation of stones or malignant tumors, as well as in severe condition of the patient, which is expressed in:

• pale skin;
• profuse cold sweat;
• fever and chills;
• loss of consciousness;
• sudden onset of intense pain;
• significant decrease in blood pressure.

Possible complications

The lack of effective treatment of the causative factors that caused pain in the right hypochondrium is fraught with the development of various complications and related health problems.

The occurrence of the following pathologies cannot be excluded:

• cirrhosis of the liver;
• opening of internal bleeding in the presence of gastric ulcer;
• the growth of a cancerous tumor in the liver tissue, as well as the spread of metastases to neighboring organs;
• rapid loss of body weight;
• extensive insemination of the body by parasite larvae, if the cause of the pain syndrome is associated with echinococcosis;
• disruption of metabolic processes in the body caused by the inability of the digestive system to function properly;
• complete blockage of the bile ducts by stones with subsequent onset of necrosis of the gallbladder;
• hepatosis;

  

• blood poisoning and the onset of septic shock, if the cause of acute pain is associated with an inflammatory process in the abdominal cavity (in most cases leads to death);
• accumulation of fluid inside the chest cavity, compression of the lung tissue, which disrupts the functioning of the respiratory system (this complication occurs in patients with a concomitant diagnosis of pleurisy).

Regardless of what causes the pain in the right hypochondrium in front, each of them can serve as a prerequisite for the development of complications and negative consequences. The presence of pain in a given part of the body is only a symptom of the underlying disease.

Therefore, it is very important that the doctor, together with the patient, make the maximum amount of effort and establish the etiology of pain as early as possible. In this case, it will be possible to eliminate not only the symptom of the disease, but also the source of the pathological process itself.

Article design: Oleg Lozinsky

Causes of pain in the right hypochondrium

The reasons why a person has a stabbing sensation in the right side under the ribs in front can be associated with a number of different reasons. Only a specialist can determine exactly why it stings under the ribs and aches in the side. But the causes of pain may be associated with the following diseases and conditions:

• a number of liver diseases (causes of pain in the liver - infectious and non-infectious hepatitis , hepatosis as a result of alcohol consumption, fatty hepatosis , cirrhosis , hepatocellular cancer , diseases caused by parasites , metastases as a result of cancer of the colon, stomach, breast , etc. .);
• heart diseases in which there is circulatory failure in a large circle ( myocardiopathy , ischemic heart disease , myocarditis , endocarditis , heart defects ), also abdominal variant of myocardial infarction , cardiac cirrhosis of the liver ;
• gallbladder diseases ( cholecystitis , tumors );
• diseases of the colon ( colitis , Crohn's disease , dysbiosis , diverticulosis , intestinal infections , colon tumors , irritable bowel syndrome );
• diseases of the right kidney ( kidney abscess , pyelonephritis , polycystic disease, urolithiasis , tumors , echinococcosis , kidney tuberculosis , metastases from bronchogenic cancer , melanoma );
• pathological changes in the right half of the diaphragm ( tumors , diaphragmatitis );
• diseases of the right adrenal gland ( tumors );
• intercostal neuralgia;
• fractures of the lower ribs;
• shingles;
• conditions in surgery, which are united by the name “ acute abdomen ” (acute pancreatitis , duodenal bleeding , penetration , perforation or perforation of an ulcer , intestinal obstruction , appendicitis , intussusception , etc.);
• thrombosis of the inferior vena cava (some variants).

Ectopic pregnancy

At the beginning of an ectopic pregnancy, a woman does not feel any pain. But as the fetus grows, a tingling sensation appears. This is accompanied by bleeding. The tingling then develops into pain, usually on one side of the abdomen (right or left).

If a pregnant woman experiences such symptoms, she needs emergency surgical care. This condition is extremely dangerous. Without surgery, a rupture of the fallopian tube and severe intra-abdominal bleeding can occur, which often leads to death.

Natural causes

The cause of tingling in the right hypochondrium can be excessive sports activities. This phenomenon is especially common among people jogging at a fast pace. While running, a person’s blood supply to internal organs, including the liver, increases, and the intercostal muscles stretch. This is accompanied by pain.

Typically, such pain occurs in people who have recently started exercising. Their body has not yet adapted to high stress. In such cases, it is necessary to do a short warm-up before jogging. This will help “warm up” the muscles and prepare the body for the load.

If while jogging a person feels a tingling sensation in the right hypochondrium, then it is necessary to change running to fast walking. As soon as the pain subsides, you can resume training.

Pain during physical activity is caused by physiological reasons and is not a sign of pathology. However, if the discomfort does not go away with rest, then you need to visit a doctor and get examined.

Tingling in the right hypochondrium is often observed in women in late pregnancy. During this period, the fetus grows rapidly and the uterus puts pressure on nearby organs. If the unborn child is positioned head down, then his legs can put pressure on the liver and stomach. Therefore, pregnancy in the third trimester is often accompanied by pain and heartburn.

The above reasons are natural and do not require special treatment. Next, we will consider possible diseases that may be accompanied by unpleasant sensations in the right side, as well as the treatment of these pathologies.

Heart diseases

With cardiac pathologies, tingling most often occurs in the left hypochondrium in front. However, stabbing sensations can also be localized on the right. This is due to the fact that with heart disease, blood circulation is impaired and the liver increases in size.

A cardiologist is involved in the diagnosis and treatment of such pathologies. Therapy depends on the type of disease.

How to recognize that tingling in the right hypochondrium is associated with heart disease? Cardiac pathologies are accompanied by a feeling of chest compression, shortness of breath, and dizziness. The pain may radiate to the arms or neck. An increase in blood pressure is often observed.

Pneumonia

If inflammation develops in the right lung, the patient usually feels chest pain. They may be accompanied by a slight tingling sensation under the ribs on the right. Unpleasant sensations intensify with breathing movements. The patient has a fever and a severe cough with sputum.

Pneumonia is treated with antibiotics, antipyretic and mucolytic drugs.