When should you seek medical help?

Pain in your abdomen is sometimes difficult to examine because it holds many organs in the area, and is not specified in one organ only.

Overview

The abdomen is divided into 4 quarters or quadrants. It is divided in half with a vertical line. The uppermost quarter on the right hand side is the upper quadrant. It is essential to pay attention to the RUQ because it might be an indicator of several diseases and conditions. The upper part of the abdomen is a place for several essential organs in the human body, including: (Dan Brennan, 2021)

• Parts of the small intestine called the duodenum

• Stomach

• Gallbladder

• Spleen

• Pancreas

• Liver

• Kidneys

• Part of the colon

• Adrenal gland

The upper abdominal pain is usually caused by minor causes like a pulled muscle, which will heal by itself.

Symptoms

Pain in the upper right abdomen can vary in intensity, that also depend on the conditions. The pain can feel like a dull ache or a stabbing feeling. If the abdominal pain lasts for more than a few days, then it is essential to visit the doctor in order to examine the symptoms evaluated. The symptoms depend on the organ that is related to the pain, these symptoms are different along with the abdominal area. The symptoms can include:

• Pain when breathing

• Fever

• Nausea

• Tenderness in the abdomen

• Diarrhea

• Blood in the stool

• Yellow skin

• Swollen abdomen

• Constant vomiting and nausea

• Fever

• Unexplained weight loss

Abdomen pain can be felt in different forms where most of the time, the pain is minor and feels very uncomfortable. Depending on the organ and the issues, these symptoms can become serious.

• Somatic Pain

  This kind of pain results from nerves that respond to a problem in the abdominal cavity. There is a membrane in the abdomen called peritoneum where the nerves respond to cutting or irritation in the body. This gives a very sharp pain which is easy to specify the location. This kind of pain is caused by infections in the organs causing liquids to ooze out and irritating the linings, and causing pain with a condition called peritonitis.

• Referred Pain

  Problems in the organs in the abdomen can cause pain in different parts of the body. For instance, a problem in the gallbladder can cause pain in the abdomen and in the right shoulder. This is called referred pain.

• Severe Abdominal Pain

  Severe pain in the abdomen can hit quickly and severely. It is a kind of pain that something very serious happening in the body.

• Visceral Pain

  The pain that comes from the organs called viscera. Visceral pain is the response to the organs that stretch towards the surrounding of the contracting muscles. This pain is usually:

  • Difficult to point out

  • Dull

  • Nauseating

  • Vague

• Causes

  There are many causes for pain in the upper right quadrant, these include:

  • Inflammation

  • Gallbladder problems

  • Abscess

  • Infection

  • Liver problems

  • Gastritis

  • Kidney stones

  • Indigestion

  • Urinary tract infection

  • Peptic ulcers

  • Cancer

  • Pancreas problems

  • Stomach problems

  • Pancreatitis

  • Peritonitis

  In several cases, indigestion and gastritis can cause mild symptoms such as gas, bloating, pain and burping. This are caused by eating foods and can be minor. But, in conditions that have severe pain and serious condition, such as pancreatitis and peritonitis are serious, causing severe and sudden symptoms.

• Kidney Problems

  Kidney problems such as, urinary tract infection, kidney infection, kidney stones or kidney cancer come with a severe pain the right side of the abdomen. Symptoms to pain that is caused by kidney problems are:

  • Blood in urine

  • Pain that hits to the lower back and groin

  • Fever

  • Painful urination

  • Blood in urine

  • Stinky smelling urine

  If the pain persists and the patient is suspected of having a kidney problem, it is important to assign an appointment with a doctor.

• Liver Problems

  Liver problems can lead to abdominal pain such as, liver abscess, liver cancer or hepatitis. In addition, other symptoms to liver problems can be: (Willacy, 2021)

  • Yellow skin

  • Fatigue

  • Abdominal tenderness

  • Dark urine

  • Fever

  • Sudden weight loss

• Gallbladder Problems

  Gallbladder problems like, choledocholithiasis, gallstones can cause a severe stabbing pain in the right side of the abdomen. Choledocholithiasis is having gallstones in the bile ducts. This pain is due to gallstones lasting for several hours and usually occur after a big meal or at night. Symptoms to gallbladder problems are the following:

  • Yellow skin

  • Nausea and vomiting

  • Dark urine

  • Light colored stool

  • Fever

  • Chills

  If someone is experiencing the above symptoms consistently with choledocholithiasis or gallstones, visiting a doctor is important. Stones in the bile duct lead to very serious complications if ignored. If these symptoms were experiences constantly, seeing a doctor is essential because stones in the bile ducts lead to more serious complications. (Scaccia, 2018)

• Gastrointestinal problems

  Several gastrointestinal problems, like gastritis, peptic ulcers and indigestion can cause pain. This pain is caused by these conditions is a burning type of pain. Other symptoms include:

  • Nausea or vomiting

  • A feeling of irritating fullness

  • Burping and gas

  • Abdominal bloating

  Several cases of indigestion are mild and resolve by themselves, visiting a doctor becomes essential.

• Pancreatic Conditions

  Feeling pain in the pancreas means its inflamed, known as pancreatitis. The pain that might be experiences from pancreatitis will slowly worsen with time with more symptoms such as:

  • Heart rate increase

  • Nausea and vomiting

  • Fever

• Preeclampsia

  This is a condition that occurs mostly with women who are around 20 weeks into their pregnancy and can also develop earlier during the pregnancy, or in some cases, postpartum. The major condition is preeclampsia is a rise in blood pressure, and the pain can also happen. More symptoms of preeclampsia can include:

  • Shortness in breath

  • Severe headache

  • Blurred vision or light sensitivity

  • Nausea or vomiting

  • Kidney or liver problems

  • Protein in urine

  • Decreased urination

• Blind loop syndrome

  This is also known as stasis syndrome, which happens when a loop forms in a part of the small intestine where the foods is bypassed during digestion. This condition is a complication of abdominal surgery, which can be caused by some diseases, this syndrome can cause in the upper or lower part of the abdomen.

• More triggers in the upper quadrant pain

  Additional to the conditions that are discussed above, causes in the upper right abdominal pain such an injury from shingles, pneumonia, or trauma.

Diagnosis

In order to examine the cause of the pain, the doctor will request the patient’s medical history while also performing a physical examination. The doctor will order some tests to reach diagnosis, such a:

• Imaging tests, like X-ray, CT scan or ultrasound that can help viewing the inside of the abdomen and check for stone presence.

• A basic metabolic panel that evaluates the liver function, blood cells and electrolyte levels.

• Endoscopy is for checking the presence of ulcers.

• Urinalysis is for assessing the kidney function or check for the UTI or kidney stones.

• Stool culture test to check if there are any pathogens present in the stool.

Treatment

The treatment for upper right abdominal depends on what is causing it. Examples of this include: (Seladi-Schulman, 2019)

• Cancer treatments, like chemotherapy, immunotherapy or radiation therapy.

• Pain relievers like Tylenol or ibuprofen to relieve the pain and discomfort.

• Surgical procedures like those to remove stones or tumor.

• Antacids to help neutralize the acid in the stomach

• Antibiotics to kill bacteria that is causing infection.

• Medications like proton pump inhibitors or acid blockers that reduce the amount of acid in the stomach and intestines.

Complications

The pain in the right side of the abdominal contains several essential organs and it is important to scan the RUQ pain and other additional symptoms to seek treatment in a timely manner and avoid complications.

Some complications might include:

• Progressions of cancer that is not caught early

• Kidney infection caused by an untreated UTI

• Increase risk of ulcers or stomach cancer from untreated gastritis

• High blood pressure, kidney failure, or kidney scarring from untreated kidney infection

• Inflammation or gallbladder infection or pancreas caused by untreated gallstones

• Low birth weight, preterm birth, organ damage or death because of preeclampsia

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