Abdominal pain right
definition
Under stomach pain right one understands in the area of the right Under- or Upper abdomen specified pains, which can have different causes and different pain characteristics.
introduction
stomach pain are a very common and unspecific symptom of various diseases. The cause can be a "harmless" constipation (Constipation) up to a life-threatening organ perforation.
All of these disorders can be considered Basic symptom right abdominal pain in the upper or lower abdomen. However, they then differ in the course and severity of the general symptoms and the occurrence of other accompanying symptoms.
In the following, individual clinical pictures are briefly explained. A distinction is made between diseases in the right upper abdomen and diseases in the right lower abdomen.
causes
Painthat are in the area of the right abdominal area can be subdivided into
- upper abdomen Pain and
- lower abdomen Pain.
Depending on the area in which the pain is reported, others may Underlying diseases be causative and must be excluded.
Illustration of right side abdominal pain
- Liver - Hepar
- Gallbladder -
Vesica biliaris - Stomach - Guest
- Large intestine, transverse part -
Transverse colon - Small intestine -
Intestine tenue - Colon, ascending part -
Ascending colon - Appendix - Caecum
- Appendix -
Appendix vermiformis - Fallopian tubes - Tuba uterina
- Ovary - Ovary
- Uterus - uterus
You can find an overview of all Dr-Gumpert images at: medical illustrations
Upper abdominal pain on the right
Of the right upper abdomen denotes the area between belly button and Ribs On the right side.
In this area there are mainly:
- the liver
and - Gallbladder
such as - parts of Large and small intestines.
Accordingly, a breakthrough (perforation) of all these organs can become strongest sudden abdominal pain on the right to lead.
As a rule, the pain initially gets a little better after the perforation and then increases again up to Full image of the acute abdomen.
Such a perforation is usually due to inflammation, for example:
- Ulcers in the small intestine (Ulcer perforation)
- a Inflammation of the gallbladder (Cholecystitis)
or - Tumors in the colon.
As a rule, this type of illness is also accompanied by a fever and a very poor general condition. The gallbladder inflammation leads to abdominal pain on the right typical Murphy characters. The examiner presses his fingers under the right costal arch and asks the patient to take a deep breath.
A inflamed gallbladder is clearly enlarged and then presses against the examiner's fingers. As this is very painful for the patient, inhalation is suddenly interrupted.
By Tumors or Metastases in the liver this can swell and thereby the so-called Liver capsule pain cause. This is also created in the right upper abdomen and can also be triggered from outside by palpating the liver. The pain is described as a dull, persistent visceral pain.
There is also the right one diaphragm high and fever is common. As a rule, all of the above diseases must be treated surgically, as a perforation in the free abdomen is always a life-threatening disease.
Also one Inflammation of the gallbladder can be treated surgically and removed because the Quality of life without gallbladder not restricted and this is the easiest and most effective method of treatment.
Only abdominal pain caused by tumors or pain in the liver capsule must be treated by other means.
Often the aim is to alleviate the symptoms, a complete cure is not always possible.
The Constipation (constipation) is one of the most common causes for abdominal pain and can occur in any part of the abdomen as there is a buildup of stool in the Large intestine acts.
The reason for this can be:
- Insufficient fluid intake
- Transport disorders (peristalsis) of the intestine
or - Be medication.
You can experience pain in any position. For example, some patients complain about Abdominal pain while sitting.
Read more on this topic at: Upper abdominal pain on the right
The stool in the intestine can be palpated if the findings are pronounced and leads to colic-like pain, as the intestine tries to move the stool through increased intestinal movements against resistance. Therapy consists of performing an enema, as well as regular intake of laxatives and sufficient fluid.
In the area of the right upper abdomen, individual sections of the intestine may also have been displaced and also in one Intussusception or Diverticulitis Cause pain.
In most cases, however, the abdominal organs located directly in the upper abdominal area are affected, which become ill and so on Pain being able to lead.
The most common cause of these abdominal pain right are disorders of the Gallbladderlocated in the area. Often they are Gallstoneswhich are located in the gallbladder and can cause discomfort every time they come into contact with the gallbladder wall.
Especially after eating, when the gallbladder contracts in order to squeeze out the bile acids it contains, the gallstones can be pressed against the gallbladder wall and cause sharp pain in the area of the right upper abdomen.
It can also happen that the stones are so large that they obstruct the exit of the gallbladder and become one Bile acid build-up comes. This can also lead to severe pain.
Chronic gallstone disease can also lead to inflammation of the gallbladder. In this case, the gallbladder wall thickens, inflammatory changes and sometimes very severe pain occur in the area of the right upper abdomen. Liver disease can in some, albeit rare, cases also lead to discomfort in the area of the right upper abdomen.
Malignant tumor diseases usually do not cause any complaints, unless they are well advanced. In the entire abdominal area but also isolated on the right upper or lower abdomen, discomfort can occur Intestinal obstruction (Ileus) or Peritonitis (Peritonitis) come.
Even with one Liver tear, which usually arises as a result of a previous trauma, it comes to violent, right-sided upper abdominal pain.
Lower abdominal pain on the right
Probably the best known cause of right-sided abdominal pain (right) is one inflammation of Appendix (appendix), also called Appendicitis referred to as. The pain is localized in the right lower abdomen and can either be pinpointed or radiated into the area above the right Hip joint until belly button out.
This area also contains shares:
- of Small and large intestines
- as well as the Ureter
- Cecum (appendix)
U.N - in the woman fallopian tubes (tuba uterina) and Ovary (ovary)
The most common disease with pain in the right lower abdomen is that Appendicitis (appendicitis).
Appendicitis involves increasing, wandering pain from the left to the right lower abdomen. At the same time, many patients suffer from fever, vomiting and nausea. Straight Abdominal pain and nausea are a common combination of symptoms. If the appendix ruptures (appendix perforation), the pain can no longer be localized in a quadrant but takes the form of the acute abdomen Here, the operation and removal of the inflamed appendix is the only therapeutic method.
Since the area of the right lower abdomen especially from Small intestine and Large intestine is filled out, most can Diseases of the intestine also trigger right-sided abdominal pain.
Intussusception, i.e. invaginations of the large intestine, can also lead to cramp-like right-sided lower abdominal problems.
In addition to the intestinal sections, the ureters also run from the kidney in the back area forward to the urinary bladder. A Kidney or urinary stonethat has loosened in the kidney area can become jammed in the ureter shortly before entering the urinary bladder colicky cause very severe pain in the area of the right lower abdomen. These pains are stated to be wavy, sometimes very massive. These are often colicky in the Right lower abdomen localized and let the patient wander, as many patients then find the pain more bearable.
In the left lower abdomen (left), pain can usually be triggered by protuberances in the bowel if they become inflamed (Diverticulitis). In some exceptional cases it can also happen that these are congenital or acquired Sacs of the intestine inflame on the right side of the intestine. In this case, there is moderate to severe discomfort on the right side of the lower abdomen. These pains tend to be felt as dull.
Chronic bowel disease again Crohn's disease occur in all parts of the intestine, but particularly often in the area of the terminal ileum (End of the small intestine).
This is located on the right side of the lower abdomen and leads to persistent dull pain from the inflammation of the intestinal wall.
Furthermore, pelvic pain to the right can be triggered by various structures of the female internal genitalia.
These include the Fallopian tubes (tube) and the Ovaries (ovaries). Ovarian cysts can occur completely painlessly, but if these cysts burst or if the situation is complicated, sudden severe pain in the lower abdomen occurs on the right. This is usually accompanied by strong general symptoms and fever and requires quick surgery.
Also one pregnancy except for uterus (Extrauterine pregnancy) can sit in the area of the fallopian tubes or the ovary and lead to severe inflammation and pinching of the structures there. In this case, signs of shock and loss of consciousness often occur very quickly after the severe persistent pain has occurred for a short time.
Symptoms
Depending on which underlying illness triggers the symptoms, there are also different types of pain. At a appendicitis there is stabbing pain of a very strong character and too Pulling in the stomach. The pain can radiate into the upper abdomen but also into the right leg and intensify over time. General symptoms associated with it are also characteristic, such as General condition deterioration, fever and nausea or. Vomit. Most patients cannot lift their right leg. Pressure on the left side of the abdomen is answered with severe pain on the right side.
The typical complaints of a colicas they do with a Ureteral colic or one Gallstone colic present are wave-like complaints that are sometimes stronger or weaker. Here, too, there can be different types of radiation and appear as stomach pain on the right.
At Intussusception are characteristic of cramp-like symptoms, but they go away as quickly as they occurred. The general symptoms, such as nausea and vomiting, are completely absent here. In the case of intestinal obstruction, on the other hand, in addition to very severe pain in the entire abdominal area and also pain on the right side, accompanying general symptoms such as nausea and vomiting can occur.
However, all symptoms and abdominal pain need not necessarily only appear on the right.
diagnosis
When looking for the cause of right-sided abdominal pain, the period since when the symptoms have been present is particularly important. Complaints that have existed for weeks or months tend not to indicate an acute event, while pain that has been present for days or several hours and is steadily increasing tend to indicate an acute inflammatory process.
When observing the patient, the stomach should definitely be examined more closely and whether the area is distended and inflated or is in a normal condition. During the physical examination, the abdomen must first be listened to with a stethoscope and the intestinal noises characterized. Lute, metallic sounding Bowel noises (so-called raised bowel noises) rather indicate a bowel obstruction.
Inflammatory processes in the area of the intestine are mostly not made on the basis of Changes in bowel sounds noticeable.
After examining the intestinal noises with the stethoscope, the abdomen should be palpated and the Belly consistency to be examined. It is important to pay attention to whether the stomach is soft, which suggests a more harmless course of the disease, or as hard as a board, which could indicate an emergency situation. The sensitivity of the abdomen to pain should also be checked. If the patient complains only of slight pain when feeling deeply, it is probably only a minor illness. In the case of acute inflammation, the patient often refuses to allow the abdomen to be touched deeply because of pain.
The inflammation of the appendix is characterized by pain on the right side when touching the left side and the patient's limited ability to stand up or lift the right leg. In the case of appendicitis, jumping or coughing is sometimes associated with severe discomfort or is not possible at all. In addition to the physical examination, you should also look for general symptoms such as fever and ask when the last bowel movement was. Furthermore, an investigation of the Blood done to see if it is too Inflammatory reactions comes in the body. Also one Ultrasound examination can be used. Here the Gallbladder to Gallstones or the ureter can be examined for urinary stones. In some cases the appendix can be examined for possible wall thickening with ultrasound.
treatment
Treatment depends on the type of illness. Appendicitis is most common operational treated. Either laparoscopic or open the appendix (appendix) removed under general anesthesia.
In the case of diverticulitis, one usually waits to see whether it is a chronic form (then rather antibiotic Treatment) or an acute (surgical partial bowel removal).
Depending on the cause, an intestinal obstruction has to be treated surgically in almost all cases. If ureter stones or gall bladder stones are responsible for the right-sided abdominal discomfort, these can either be caused by a small one catheter recovered (ureteral stones) or treated surgically. In the case of gallbladder stones, the entire gallbladder is usually surgically removed. Even in the case of gallbladder inflammation, the entire gallbladder is usually surgically removed laparoscopically.
Right-sided abdominal pain from flatulence
Flatulence (lat .: Flatulence) are a very common and sometimes stressful problem in the population. It is estimated that around 10-30 percent of adults are affected. In many cases, e.g. right-sided abdominal pain, bloating and flatulence together.
But how does flatulence arise?
During the digestion arise mainly in Large intestine Gases like methane, Carbon dioxide or hydrogen. Large proportions can be absorbed via small blood vessels in the intestinal wall and excreted in the breath without odor. However, when the amount of gas increases for various reasons, they escape the intestines through uncomfortable flatulence. Fine pain sensors in the intestinal wall can be stimulated by excessive production of intestinal gases, so that those affected stomach pain develop. Ultimately, this pain is possible throughout the abdominal area because there are loops of the colon on both the left and right sides.
Very violent, painful flatulence should possibly be examined by a doctor for more serious Bowel disease to recognize in time. Otherwise they are annoying, but rather harmless. The following triggers include known:
Too fast food intake and accidental swallowing of air
Sugary foods
Unusually high fiber food
Food intolerance (e.g. lactose)
Inflammation of the intestines
Irritable bowel syndrome
Frequent consumption of highly carbonated drinks
Changed intestinal bacterial flora after Antibiotics-Therapy
For severe, cramping abdominal pain and excruciating flatulence, you can Medicinal herbs To remedy the situation. These include fennel, anise, peppermint or Caraway seed. As tea or tincture, they relieve discomfort and reduce flatulence. Heat applications (e.g. hot water bottle) provide additional support.
Otherwise, it is advisable to avoid the gas and pain triggers mentioned above (e.g. by eating slowly).
You can find more on this topic on our website Abdominal pain from gas.
Abdominal pain under the rib
In the right upper abdomen, below the costal arch, lies the liver (lat .: Hepar). It is the central metabolic organ of our body and fulfills many tasks, such as detoxification, digestion and the production of body proteins. The pear-shaped one lies on the underside of the liver Gallbladder. Here it is mainly the bile produced by the liver is stored and thickened. Both the liver and the gallbladder can cause discomfort!
The main triggers for right-sided abdominal pain under the rib are Gallstones (lat .: Cholelithiasis). In this extremely common disease, the composition of the bile shifts so that individual components (especially cholesterol) to a hard stone (Concrement) fail. Most of the time this happens unnoticed and without symptoms.
At a Biliary colic on the other hand, a gallstone clogs the ducts in the gallbladder: those affected suddenly suffer from very severe, colic-like pain in the right upper abdomen or under the ribs. Due to the massive, partly almost unbearable pain, pain reliever treatment should be given in the hospital.
Also diseases of the liver itself, such as Hepatitis, or fatty liver, can manifest as dull, aching pain under the ribs. However, accompanying symptoms such as fatigue or jaundice (Latin: icterus) are in the foreground.
Right-sided abdominal pain after eating
Many people complain of right-sided abdominal pain after eating. E.g. Food intolerances, gallstones, or infections Inflammation of the pancreas.
In recent years, the incidence of food intolerances has such as Lactose- and Fructose intolerance increased significantly. Affected people are e.g. because of a Enzyme deficiency unable to digest the relevant food components. As a result, abdominal pain, or flatulence arise diarrhea.
Viruses or bacteria can enter the human body through contaminated food and cause infection of the gastrointestinal tract. If you experience abdominal pain and vomiting a few hours after eating, such an infection may be present.
Abdominal pain on the right in the child
Children often experience abdominal pain due to their delicate digestive system. As a rule, such symptoms are harmless and go away on their own after a short time.
However, caution should be exercised if your child has abdominal pain right lower abdomen complains. Because then it can possibly be a Appendicitis (lat .: appendicitis) act!
In this disease, the worm-like appendix becomes inflamed for various reasons Appendix (lat .: Caecum), which is the first part of the Large intestine represents.
At the beginning, those affected experience dull abdominal pain that cannot be easily localized. Within 8-12 hours "wanders“The pain in the right lower abdomen. Children then complain of burning, severe pain. Frequent accompanying symptoms are fever, Vomit, nausea, constipation or diarrhea. However, especially small children and babies can develop different symptoms! Typically, the pain is caused by the so-called "Mc Burney Point“Strongest: It is located halfway the imaginary distance between the right front iliac spine and the navel.
If the pain in the right lower abdomen suddenly subsides, it can be assumed that a so-called Ruptured appendix (lat .: perforation) has taken place. The dreaded complication is now the sometimes life-threatening one Peritonitis (lat .: Peritonitis), as germs from the inflamed appendix can get into the abdominal cavity.
To avoid such complications, surgical removal of the inflamed appendix should be sought within a maximum of 48 hours. This so-called "Appendectomy“Takes place under general anesthetic and is one of the absolute routine procedures in German hospitals.
Your child can already drink unsweetened tea on the day of the operation and, on medical advice, start eating carefully (e.g. rusks). As a rule, two to four days of inpatient stay are sufficient.
Right abdominal pain and diarrhea
One speaks of diarrheaas soon as the stool frequency increases to more than three times a day, the stool weight is over 200g per day or has a liquid consistency.
In connection with abdominal pain on the right side, e.g. be an infection of the intestines with bacteria or viruses. Very often diarrhea and abdominal pain can also be caused by a food intolerance.
In some cases, liver diseases are also manifested in right-sided abdominal pain and diarrhea. It could also be appendicitis. Many people also suffer from the so-called Irritable bowel syndrome and are especially in stressful Situations at risk for such complaints.
If symptoms have persisted for a long time, it could indicate an inflammatory bowel disease, such as Crohn's disease. In this autoimmune disease, individual sections of the intestine become inflamed for a previously unexplained cause and cause cramp-like pain, mainly. in the right lower abdomen and slimy diarrhea.
Abdominal pain around the right navel
Abdominal pain to the right of the navel has many causes. In most cases, the symptoms are harmless and go away on their own.However, prolonged or particularly severe pain can be an indication of more serious diseases in our body.
First of all, appendicitis must be safely ruled out. With this disease, those affected describe a dull pain in the region of the navel (lat .: periumbilical). As the disease progresses, the symptoms eventually move to the right lower abdomen.
If the abdominal pain is located to the right below the navel, organs outside of the digestive tract should also be considered. E.g. a Pelvic inflammation (lat .: Pyelonephritis) cause specific pain. Fever is also characteristic of this clinical picture, Problems urinating (lat .: Dysuria), Flank pain and great weakness.
If you have pain on the right side above the belly button, the liver and gallbladder may be the cause (e.g. hepatitis, Fatty liver or Gallstones).
Summary
Abdominal pain right are a very unspecific and general symptom which can have numerous causes.
In most cases the illnesses are harmless, but life-threatening causes can also trigger this pain.
For this reason, an accurate diagnosis of abdominal pain is by means of:
- Anamnesis (medical history)
- laboratory
and - imaging procedures (x-rays, ultrasound, MRI, CT)
indispensable. Conventional therapy was often sufficient. However, in some cases, quick surgery is the only option for treatment.
Right-sided abdominal pain can have different causes. Lower abdominal discomfort on the right are in most cases a inflammation of the appendix (appendicitis) triggered. Typical here is tenderness on the right side when pressure is applied to the left. Furthermore, the patients are only able to lift their right leg to a limited extent. There are also general symptoms such as nausea and vomiting. In most cases, the only type of treatment is surgical removal of the appendix (appendix).
In rare cases, inflammation can occur from Intestinal sacs (Diverticulitis) lead to pain in the right abdominal area (more typically on the left). In acute cases and chronic inflammation, partial removal of the intestine must be considered. In milder cases, antibiotics are used.
Upper abdominal pain on the right side can through Gallbladder stones or caused by inflammation of the gallbladder. In most cases, the gallbladder is surgically removed as a therapy. Sometimes it happens Ureteral stoneswhich get stuck in the ureter shortly before entering the bladder and can lead to right-sided complaints there.
As therapy an attempt can be made to recover the kidney stones through a wire catheter. If this does not succeed, the ureter must be surgically opened and the ureteral stones removed surgically.
