Causes of Right Upper Quadrant Abdominal Pain


 by Tanya Feke

More than 10.4 million visits were made to U.S. emergency rooms for abdominal pain in 2010, reports the Centers for Disease Control and Prevention. The causes of abdominal pain are many and range from self-limited to life-threatening.

Approximately 12 million people visited emergency rooms in the United States for abdominal pain in 2015, reports the Centers for Disease Control and Prevention. The causes of abdominal pain are many and range from minor, temporary conditions to life-threatening disorders. Pain in the right upper region of the abdomen -- known as the right upper quadrant (RUQ) -- usually arises from organs in the area. But more distant organs may also produce RUQ pain.

Gallbladder Disease

Located beneath the liver within the RUQ, the gallbladder is a small organ that stores bile. Gallstones sometimes block the flow of bile out of the gallbladder, causing stretching of the organ and RUQ pain.

Inflammation of the gallbladder, known as cholecystitis, may also cause pain in the RUQ. Fever, nausea and vomiting typically accompany the pain during acute cholecystitis. Although rare, cancer of the gallbladder or major bile ducts is another possible cause of RUQ pain.

Liver Disease

Located in the RUQ, the liver is the largest solid organ in the body. Its surface is covered by a thick capsule, which contains many nerves. Conditions that stretch the liver capsule often trigger pain.

Liver inflammation, or hepatitis, is one of these conditions. Hepatitis has many possible causes, including virus infections, abnormal fat accumulation in liver cells and excessive alcohol consumption. Pockets of infection -- called liver abscesses -- and liver cancer can also stretch the capsule and trigger RUQ pain.

Pancreas Disorders

The pancreas is located in the upper middle abdomen but may sometimes cause pain in the RUQ. Pancreatic inflammation -- called pancreatitis -- may occur when gallstones block the ducts leading from the pancreas. Less commonly, pancreatitis is caused by alcohol abuse, viruses, certain medications or high calcium levels.

Other Digestive Tract Disorders

Ulcers in the stomach or first part of the small intestine, called the duodenum, may also cause RUQ pain. This pain often feels like a burning sensation. Ulcers are commonly caused by a bacterium called Helicobacter pylori. Stomach inflammation, known as gastritis, and stomach cancer are other possible causes of upper abdominal pain, which may sometimes be felt in the RUQ.

Though a less common cause, inflammation of the colon -- known as colitis -- can trigger RUQ pain. This may be the result of infection or inflammatory bowel disease, such as Crohn disease. Irritable bowel syndrome may cause generalized or local abdominal pain, which may involve the RUQ.

Lung Conditions

The diaphragm and right lung sit directly above the RUQ. Although the lungs are not in the abdomen, pain arising from disorders in the right lung are sometimes interpreted by the brain as coming from the RUQ, a phenomenon known as referred pain. Pneumonia in the lower part of the right lung, in particular, can result in RUQ pain.

Inflammation of membranes surrounding the lungs, called pleurisy, may also trigger abdominal pain. Pleurisy is often caused by a viral infection, according to a review article published in the May 2007 issue of "American Family Physician." It can also result from more serious conditions, such as a pulmonary embolism -- a blood clot in the lungs.

Kidney Conditions

The kidneys are a pair of organs located deep within the abdomen. Diseases that cause inflammation of the right kidney may lead to RUQ pain. Right kidney infections can produce back pain, fever, nausea or vomiting in addition to RUQ pain.

Kidney stones can irritate the urinary tract or block urine flow from the kidneys. This blockage may cause the kidneys to become inflamed and enlarged, triggering pain. Cysts on the kidneys can also cause discomfort by stretching the tissue over the kidneys.

Other Causes

Similar to lung conditions, a heart attack sometimes produces referred pain that is felt in the RUQ. Herpes zoster, or shingles, produces pain along the path of a nerve. It commonly occurs in the chest or abdomen, including the RUQ. The pain usually begins 2 to 3 days before the appearance of a rash and may persist after the rash resolves.

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