What Causes Right Upper Quadrant Pain?

In Diagnosis & Treatment by Dr. Clinton Osborn

The right upper quadrant of the abdomen contains the liver, gallbladder, part of the small intestine, part of the colon, the upper part of the stomach, and some structure of the pancreas. If the top right area of the abdomen is affected, any of the aforementioned organs might be causing the problem. 

If you experience some pain in that location, it’s best to talk to a medical professional. Here, you can familiarize yourself with some of the main associated problems with right upper quadrant pain before you talk to a medical professional at GuruMD.

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What Can Cause Right Upper Quadrant Pain?

If you experience severe pain in the right upper quadrant location of the abdomen, here are some possibilities to consider.

Hepatitis

A viral infection can cause hepatitis, which is the inflammation and swelling of the liver. There are three common viruses that infect the liver. 

Hepatitis A is obtained through contaminated food or water, which can lead to severe diarrhea. Luckily, Hepatitis A tends to go away on its own.

 Hepatitis B is a severe liver infection that can lead to liver failure and cirrhosis. Hepatitis C is a chronic viral infection that spread through infected blood and can cause severe liver damage and inflammation. 

The symptoms of Hepatitis are appetite loss, jaundice, itchy skin, dark colored urine, joint pain, fever, poor appetite, weakness, fatigue, and nausea/vomiting. If you think you have Hepatitis, get online with GuruMD and tell us about your symptoms.

Gallstone

Gallstones are a combination of bile and digestive fluid combined to form a solid deposit. This deposit tends to get stuck inside the gallbladder or the cystic duct that serves as the neck of the gallbladder. Whenever the gallbladder contracts, it moves the stone around the cystic duct, causing pain and obstruction when the bile is stuck in the gallbladder. 

This can result in nausea, vomiting, back pain between the shoulder, and intense right upper quadrant pain when pressure is applied to it. The doctor will most likely have to perform a surgical procedure called cholecystectomy to remove the gallbladder.

Other Gallbladder Issues

Since the gallbladder is located in the upper right quadrant of the abdomen, then any gallbladder problems can lead to pain in that area. There are many conditions that can affect the gallbladder, such as:

  • A tumor in the bile duct or gallbladder 
  • Injury to the bile ducts
  • Inflammation and scarring of the bile duct and outside the liver (also known as primary sclerosing cholangitis)
  • Narrowing of the bile duct caused by AIDS, and 
  • Cholecystitis (or gallbladder inflammation). 

The common signs and symptoms of gallbladder issues are jaundice, fever/chills, nausea/vomiting, light colored stool, and chronic diarrhea.

GERD

GERD stands for gastroesophageal reflux disease, which is when the stomach regurgitates acid towards the chest through the esophagus and out the mouth. This can lead to a burning sensation on the chest, backflow of sour liquid, a lump in the throat, trouble swallowing, worsening asthma, laryngitis, sleep problems, and chronic cough. Fortunately, this can be treated with a proton pump inhibitor to decrease the acid content in the stomach.

Liver Abscess

A liver abscess occurs when the liver fills with pus. The abscess contains a significant amounts of bacteria that can lead to a blood infection, and liver damage if not treated right away. 

The symptoms of a liver abscess are dark-colored urine, clay-colored stool, pain in the upper right quadrant of the abdomen, nausea/vomiting, appetite loss, jaundice, weight loss, weakness, fever, chills, and night sweats.

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Gastritis

Gastritis is an inflammation of the stomach lining that is often caused by excessive alcohol, pain relievers, and bacterial infection. The condition often leads to upper abdominal pain that worsens when you consume food. The common symptoms are feeling fullness after eating, nausea, and vomiting.

Gastroparesis

Gastroparesis often occurs in diabetes and nerve damage in the G.I. system. It’s a condition that slows down the movement of food, therefore, interfering with digestion. It can be caused by opioids, antidepressants, allergy medication, antihypertensive drugs, and various other medication conditions. 

The main symptoms are upper abdominal pain, fullness, bloating, nausea, vomiting, acid reflux, change in blood sugar level, appetite loss, weight loss, and malnutrition.

Peptic Ulcer

A peptic ulcer occurs on the inside of the stomach lining, and it’s often part of the duodenal lining. It can be caused by aspirin, other painkillers, and bacterial infection. Peptic ulcers can result in a burning sensation in the upper part of the abdomen, fullness, heartburn, nausea, and intolerance to fatty food.

Functional Dyspepsia

Typical indigestion usually results from something you eat or drink. This can lead to a burning pain in the upper part of the abdomen, bloating, nausea, fullness after a few bites, and other symptoms.

Pancreatitis

Pancreatitis is the inflammation and swelling of the pancreas that is located in the upper area behind the stomach. The pancreas functions to secrete enzymes for digestion and secrete insulin and glucagon to regulate blood sugar levels.

 If pancreatitis occurs, then patients will have symptoms of fever, abdominal pain that radiates to the back, abdominal pain that increases after consuming food, nausea/vomiting, rapid pulse, and tenderness to palpate on the abdomen. Chronic symptoms include weight loss and oily stool.

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Shingles

Shingles are caused by a viral infection that can lead to a painful rash located on the upper part of the abdomen. The common symptoms of shingles are itching, fluid-filled blisters, pain, numbness, tingling, burning, sensitivity, fever, fatigue, light sensitivity, and headache.

Cancer

Cancer in the upper part of the abdomen could include stomach cancer, pancreatic cancer, liver cancer, gallbladder cancer, kidney cancer, and lymphoma. 

Cancer often occurs in the right upper part of the abdomen, or it could be the whole area. The tumor would cause inflammation and bloating as well as other symptoms of fever, fatigue, poor appetite, weight loss, jaundice, nausea/vomiting, stool with blood, bloody urine, indigestion, diarrhea, and constipation.

Blind Loop Syndrome

Blind Loop Syndrome occurs when a loop forms in part of the small intestine where the food passes through the GI tract. The condition arises from abdominal surgery and can cause severe pain in the upper region of the abdomen. The symptoms of Blind Loop Syndrome are diarrhea, weight loss, bloating, uncomfortable fullness after eating, nausea, and appetite loss.

Kidney issues

Kidney problems such as a UTI, renal stones, and kidney infections can also cause right upper quadrant pain. The symptoms of kidney problems are painful urination, foul-smelling urine, pain that radiates to the lower back or groin, blood in the urine, frequent urination, nausea/vomiting, and fever. 

Even though the kidneys are located on the lower posterior part of the abdomen and pelvic region, but anything that happens to it can cause referred back pain that radiates to the right upper quadrant.

Pregnancy

During pregnancy, there could be abdominal pain that can occur in the upper part of the abdomen. This is mainly because, as the baby grows, the abdominal cavity has to stretch to accommodate the size. After taking an at-home pregnancy test, go to the doctor to ensure your results are correct.

How to diagnose right upper quadrant pain

Right upper quadrant pain can be diagnosed with various tasks such as the basic or comprehensive metabolic panel to evaluate blood cell counts, electrolytes, and liver function. 

Stool culture to check for potential pathogens. Urinalysis to assess UTI, kidney stones, and kidney function. Endoscopy to check for ulcers. Ultrasound, x-ray, CT scan to check the entire abdominal region for stones or anything sinister.

Treatment for right upper quadrant pain of the abdomen

The treatment for right upper quadrant abdominal pain depends on the cause. For example, GERD and ulcers can be treated with a proton pump inhibitor. Antibiotics can kill bacteria infections. Stones and tumors require surgical procedures to remove it. Cancer treatments will require radiation, chemotherapy, and immunotherapy.

When to See a Doctor for Right Upper Quadrant Pain?

If you experience any of the following symptoms of fever, weight loss, jaundice, abdominal sweating, nausea/vomiting, severe pain or pressure, tenderness to touch on the abdomen, and bloody stool, then it’s essential to seek emergency medical attention immediately. 

Usually, in mild cases, you can treat this at home by placing an ice pack on the area, especially if it’s from a muscle strain. Try to avoid ibuprofen or aspirin because that can lead to abdominal irritation.

If the pain is severe and lasts for more than a few days, then it’s better to have an appointment with your doctor for a physical exam, imaging exam, and a blood test to find the underlying cause.

Take Home Message

When it comes to right upper quadrant pain, there are various organs that it affects, such as the liver, gallbladder, bile ducts, upper portion of the G.I. system, pancreas, and much more. 

Some of the issues can be treated with over-the-counter medication such as Prilosec, a proton pump inhibitor, while others may require imaging exams to find the underlying causes. 

In some cases, the doctor may prescribe medication such as antibiotics for infections or initiate a surgical procedure to remove the tumor or stone. Whatever the matter is, constant severe right upper quadrant pain requires a physician to diagnose it.

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