Pain in the right side of the abdomen

Pain in the right side of the abdomen is a fairly common complaint of patients. It is in this zone is the innervation of many organs that can cause pain in case of disruption of work.

If a child or an adult has a stomach ache on the right, then even doctors do not suspect an attack of appendicitis. However, this is not the only disease that requires attention. We will consider diseases that cause pain to patients, the role of internal organs.

Right-sided anatomical structures of the abdominal cavity

If you divide your abdomen vertically in half, some organs fall into both sides, because they occupy a central position:

• stomach (antrum and pyloric department) and duodenum (bend);
• pancreas (head and body);
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• small intestine;
• bladder;
• Large intestine (blind, ascending and half of the transverse colon).

Therefore, when studying pathological changes, it is difficult to separate the right-sided and left-sided position. Sometimes the source of pain is not located where it hurts, there are migratory sensations when a person is unable to pinpoint a specific place and speaks of "pains all over his belly".

Some diseases have a "favorite" localization. The liver of the left lobe enters the zone of the left half and is capable of causing pain throughout the upper abdominal region. Directly in the right area of ​​the abdomen lie the gallbladder with ducts, the right kidney and ureter, the appendix.

The cause of pain can become ailments:

• abdominal wall;
• vessels;
• right lower ribs.

Knowledge of the structure of the organs made it possible to distinguish the features of the pain syndrome:

• parenchymal organs (liver, kidneys) have a dense protective capsule with an abundance of nerve receptors; any undesirable effects such as trauma, inflammation, edema, cause tension of the capsule and send signals to the brain for pain;
• hollow organs (stomach, gallbladder, ureter) are provided with receptors only in the submucosa, so they react to muscle spasm, sprain, perforation, ulceration, rupture, but rarely contribute to pain with mild catarrhal inflammation.

The capsule of the kidney consists of a dense connective tissue

This mechanism is necessarily taken into account by the doctors in the diagnosis. To find out why the abdomen hurts on the right is difficult, because a violation of the function of one organ leads to a malfunction of the general process of digestion.

How to evaluate the nature of pain?

Patients describe their painful feelings in different ways. The doctor has to analyze the subjective information, ask additional questions about the conditions for the appearance of right-sided pain in the abdomen, their change, prescription, connection with food. We present an evaluation algorithm for the nature of pain in accordance with the formulation of complaints.

On the right the stomach or belly hurts at run and walking

Movement of the legs is accompanied by intense work of the muscular apparatus of the abdominal press, change in intra-abdominal pressure, massaging action on the intestine, so atony arises in the absence of physical activity.

Various diseases in the latent (latent) stage are manifested during movement. In such cases, you can not force yourself to walk and endure. Pain on the right side of the abdomen indicates activation of the pathology, can quickly lead to complications.

Pain occurs after a trip in transport

Any movement in a vehicle, whether sitting or standing, causes the body to shake. This effect promotes the movement of stones, salt conglomerates through the gall bladder, passageways, ureter. Patients with cholelithiasis and urolithiasis often associate the onset of an attack with sharp jerky movements of the body. In addition to travel in transport, a similar effect is provided by jumping, running.

The stomach hurts only when you press

This is what patients say when the doctor palpates the abdomen. They hope that if they do not touch, there will be no illness.

Palpation is safe, performed in a gentle technique

The method of palpation makes it possible to determine the localization of pain, to reveal the patient's reaction. Any pressure on the abdomen promotes an increase in intra-abdominal pressure. It also provokes hidden pain.

In addition, the outer peritoneal leaf is pressed against the inflammation zone, this causes local soreness in the right side of the abdomen and helps to distinguish local inflammation from reflected pain (with myocardial infarction, croupous pneumonia, pleurisy).

Pain on palpation of the lower abdomen on the right makes you suspect a sharp appendicitis. Women should always exclude gynecological diseases (adnexitis, ovarian cyst). With the upper subcostal localization of pain when pressing on the right, one should think about inflammation of the gallbladder, hepatitis, less often the duodenal ulcer is manifested. This principle is based on the symptoms of irritation of the peritoneum.

A woman's stomach hurts right below at monthly

Pain in the abdomen in front of menstruation and during - a common complaint of girls and women. Usually it is located above the pubis, irradiates in the groin, in the navel. Gynecologists associate them with hormonal disorders.

If the pain in the abdomen is disturbed to the right, then right-sided adnexitis (inflammation of the appendages) is assumed. Severe pain occurs with ectopic pregnancy, with a twist and rupture of the cyst, gives in the lower back. By nature, the pain can be confused with an attack of appendicitis.

Noises in the abdomen on the right

The aching pain in the abdomen on the right indicates an inflammatory process of moderate intensity. Often accompanies a peptic ulcer. It begins 1.5-2 hours after eating and lasts all night.

Dull abdominal pains are typical for hypotonic dyskinesia of the gallbladder and intestines. Caused by overfilling, stretching the muscle layer and breaking the emptying. The most predisposed people with neurasthenia, emotionally unstable, school-age children. Accordingly, localized in the right hypochondrium and near the navel.

Neurasthenia is one of the reasons for the onset of pain abdominal syndrome

Bracing pains

Acute sudden abdominal pains on the right are characterized by patients as "sharp", unstable, in the form of fights. Similar complaints accompany the intestinal obstruction, are caused by peristaltic movements of the intestinal loops. They can appear with a rupture of the intestinal wall (perforation in ulcers, Crohn's disease), capsules of internal organs, thromboembolism of mesentery vessels.

They are not characteristic for the inflammatory process, in which pain in the right side of the abdomen is gradually increasing. Here a considerable area of ​​the peritoneum is immediately irritated, tissues of organs are destroyed. "Cutting" sensations are typical of diseases of the intestines caused by infection or food poisoning.

Something pulsating and yanking

Pulsating pain accompanies the defeat of blood vessels. In elderly people with a widespread atherosclerotic process, there is an aneurysm of the abdominal part of the aorta. The vessel becomes thinner and expands, because the pressure it receives is quite high, the pulsation spreads in all directions evenly. It can be felt by palpation of the zone just above the navel and compared with the pulse.

The "pulling" type of pain is characterized by the development of purulent inflammation. In the lower abdomen on the right, phlegmonous and gangrenous appendicitis is manifested in a similar way. Pain indicates a running process. The process can burst and cause inflammation of the peritoneum (peritonitis).

For experienced doctors, the definition of the nature of pain is a sign of the disease, but is not considered in isolation. The diagnosis is made only after the analysis of the whole complex of symptoms and examination results.

How to treat permanent and periodic pain in the abdomen on the right?

The duration of pain by time is important in diagnosis. If the abdomen constantly hurts from the right side, the pain is usually mild, dull. Chronic appendicitis, cholecystitis, gastritis, hepatitis are characterized by a similar course. Sometimes the pains completely subside, patients mistakenly rejoice in recovery and break the diet. But the symptom appears again.

Sometimes, patients suffer dull constant pain for a long time, they come for help only with strengthening

Periodic pain, resumed after a few days, weeks, months and even years, should be explained by the favorable course of chronic diseases with long periods of remission. Exacerbations appear only under certain conditions: violation of the regime, alcohol intake, stressful situations, in the spring and autumn (peptic ulcer).

Long periods of remission are characteristic of Crohn's disease, ulcerative colitis. They are considered a positive result of treatment. While it is not customary to talk about recovery, as the final causes of diseases are unclear and modern therapy does not solve all problems. Additional signs of diseases of the right half of the abdomen, we consider the symptoms of the most common pathology.

Diseases of the liver

Liver diseases cause pain in the right hypochondrium with irradiation in the lower back. Patients say that "the right side of the abdomen hurts." The cause is a dilated capsule or a ruptured injury.

With inflammation, hemorrhage to the parenchyma, the size of the organ increases, which causes the expansion of the surface shell. The capsule can become inflamed when the infection passes from neighboring organs. Then the pains are of high intensity.

Hepatitis (inflammatory liver disease) is divided by origin. In addition to pain, they differ in clinical manifestations.

Toxic hepatitis - are formed in response to the use of alcohol, certain drugs, poisoning with chemicals, household fluids, poisonous products (mushrooms).

Develop rapidly, accompanied by severe acute pain on the right side of the hypochondrium, nausea, vomiting, yellowing of the skin and sclera. Viral hepatitis - have a chronic course with periods of exacerbations and enlargement of the liver. Constantly the patients feel heaviness, dull "pain in the right side of the abdomen", discomfort along the bowel, loss of appetite.

It is known that viral hepatitis significantly increases the likelihood of transformation of the disease into a cancerous tumor. At the same time the character of pains changes to intense, constant. Hepatitis, associated with infectious diseases (hemorrhagic fevers, rubella, Epstein-Barr virus) does not cause severe pain. The diagnosis is based on other signs of failure.

For general symptoms are typical:

• increased pain in motor activity;
• nausea and vomiting;
• increase in temperature not higher than 37.5;
• loss of appetite;
• bleeding gums;
• jaundice of the skin and sclera;
• light feces and dark urine;
• stool disorders.

Abscess - a cavity containing pus, can be found both in the liver itself and in the subhepatic corner between the ligaments, the right dome of the diaphragm and the loops of the intestine. The patient is observed, except pulling pain in the hypochondrium, high fever with chills, pouring sweat, general intoxication (headaches, muscle pains, dizziness, nausea).

Abscess and cyst can be detected on computed tomography

Echinococcal cyst is formed in the parenchyma of the liver during the introduction of a parasite (echinococcus). The size of the cavity can reach a considerable volume. It is then that there are pains of a permanent nature.

Cirrhosis of the liver is the outcome of hepatitis, chronic alcoholism. The parenchyma tissue is replaced with scar tissue. The body shrivels and shrinks in size. Since the capsule can not stretch, strong pain does not arise. Dull aching - are more likely associated with simultaneous dyskinesia of the biliary tract, pancreatic lesions.

Malignant neoplasms in the liver occur during the transformation of hepatocytes or the inflow of metastases from other organs with blood. Gradually violated all the functions of the body. The pains become very intense.

Diseases of bile ducts

Liver synthesized in the liver enters and accumulates in the gallbladder. Further, with the help of muscle contractions, it travels through the special ducts to the duodenum. The path passes next to the duct of the pancreas. They collect secret together through the sphincter of Oddi.

Acute cramping pains are caused by spastic contraction of the muscular layer. They are called "colic". Localize in the right hypochondrium, extend to the center of the abdomen, in the right side zone.

They are photographed with antispasmodic drugs. At the same time, the patient experiences eructations, vomiting of bitterness, epigastric pain (biliary gastritis). Pathology is caused by dyskinesia (violation of the motility of the bladder), inflammation, movement of stones.

Cholecystitis (inflammation of the bladder) causes pathogenic microorganisms. The most inclined to the disease are full women who do not exercise. Inflammation of the inner membrane contributes to the production of mucus, thickening of bile, changes the acid-base balance and creates conditions for precipitation of bile salts (cholelithiasis).

The resulting concrements are subsequently glued to a stony density and are the cause of cholelithiasis. While the stones do not have pain, they are obtuse, but the movement of the calculus along the bile ducts causes irritation and local spasm. This manifests an intense pain attack in the right side of the abdomen at the top, with irradiation in the collarbone, shoulder blade, waist, shoulder. The attack lasts up to several hours.

Cholangitis is the inflammation of the bile ducts. He is rarely isolated without cholecystitis. Almost always accompanied by cholelithiasis. In this case, the pain in epigastrium and right hypochondrium is very strong, cramping with high fever, jaundice.

Neoplasms of the gallbladder are rare. People with long-term course of cholecystitis and cholelithiasis have the greatest risk. The pain syndrome acquires a persistent character, becomes permanent. For a pathology, a tendency to rupture of the bladder and peritonitis is typical.

Appendicitis

Inflammation of the appendix is ​​the most common surgical pathology in surgery. In the classical course, pain is initially located in the epigastric region, accompanied by vomiting, fever, weakness. After a few hours they move to the right iliac zone. So, the disease looks in half the patients.

Another part of the patients needs serious differential diagnosis. This is due to the atypical location of the inflamed process and the manifestation of pain in the navel, in the right hypochondrium, in the back, in the lower abdomen. Running inflammation is manifested by twitching pains, a significant increase in temperature, chills.

Diseases of the intestine

Diseases of the small and large intestine are rarely localized only in the right side of the abdomen, they often spread to the central part. The nature of the pains is diffuse, it does not have a clear localization.

With diverticulosis, enterocolitis, Crohn's disease, pain is accompanied by diarrhea or constipation, possibly intestinal bleeding (in case of wall ulceration), attacks of "intestinal colic", weight loss, for children typically dehydration.

For tumors, the location in the left part is more characteristic. Intestinal obstruction is associated with overlapping of the gut lumen with spikes, a tumor, and calculous stones. The pain is very severe, it is possible to vomit, the absence of peristalsis.

Kidney pathology

The right kidney is anatomically located slightly lower than the left one. She often suffers from omission when losing weight, after giving birth. In this case, patients feel pain in the right side and abdomen, being upright. The decrease occurs in the lying position.

Right-sided pyelonephritis in acute course is accompanied by intense pain in the lower back, frequent urination, cuts, chills with high fever. Chronic disease gradually from the pelvis passes to the parenchyma of the organ and disrupts the function of nephrons. Pains are dull, but intoxication is accompanied by an increase in renal failure.

Concrements are located in the course of urination

Renal stone disease with right-sided colic attacks is activated after shaking, jumping. Pain syndrome is very intense. Irradiation along the ureter in the groin, the scrotum in men, the genitals in women. After an attack, there is blood in the urine.

Right-sided pains in the abdomen are possible with injuries to the liver, kidney and intestines, gastritis, peptic ulcer, pancreatitis. A full examination is necessary with the identification of the exact cause. Only after it can you make a diagnosis and prescribe a treatment.