Pain in the right hypochondrium in women and men

Contents

Physiology of men and women
Causes of pain in the right hypochondrium
Treatment of pain in the right hypochondrium
- Diagnostics
- Modern treatments
Prevention of pain in the right hypochondrium at home
Popular questions and answers

There are many reasons for pain in the right hypochondrium in men and women. Basically, such discomfort hints at problems with the gallbladder, but not only. Let’s discuss this symptom in more detail with the experts.

Pain in the right hypochondrium can occur for no apparent reason, or it can be provoked by eating, drinking alcohol, and simply changing the position of the body. Painful sensations may indicate the development of the disease, and may occur, for example, due to physical exertion.

We asked our experts about the causes of pain in the right hypochondrium in women and men. We learned which diseases are most often accompanied by discomfort in this area. They also clarified what diagnostic and treatment methods doctors can use when a patient complains of pain in the right hypochondrium.

Physiology of men and women

The right hypochondrium is called the area to the right and above the navel, next to the lower ribs and diaphragm. This area contains the liver, gallbladder, part of the colon, and sometimes loops of the small intestine. However, pain in the right hypochondrium is not always associated with a violation in the work of these organs. Sometimes the pain syndrome occurs with diseases of the urogenital area, cardiological diseases and problems with the spine.

The causes of pain in the right hypochondrium in women and men are almost identical with one exception. In women, pain in this area often occurs due to gynecological problems: endometriosis, inflammation in the ovaries and fallopian tubes. For this reason, women with complaints of pain in the right hypochondrium should be examined by a gynecologist to make a diagnosis.

Causes of pain in the right hypochondrium

Most often, pain in the right hypochondrium in women and men appears against the background of problems with the liver, gallbladder and biliary tract^1,2. The most common of them are biliary dyskinesia (BIT), cholelithiasis, hepatitis, acute and chronic cholecystitis.^1,2. Sometimes pain in the right hypochondrium occurs against the background of heart failure. More rare causes are appendicitis and gynecological diseases in women: right-sided adnexitis and endometriosis.

Biliary dyskinesia

Dyskinesia is called increased sensitivity and periodic spasms of the biliary tract. This condition is accompanied by characteristic signs of biliary pain, which:

felt in the right hypochondrium and in the stomach¹;
lasts more than 30 minutes¹;
occurs at different times, including at night¹;
does not depend on body position¹.

Sometimes biliary pain is accompanied by nausea and vomiting that does not bring relief.¹. Between attacks, the person feels normal and does not complain of pain under the right rib.

biliary colic

Gallstone colic is a complication of gallstone disease, which is accompanied by the formation of cholesterol and pigment stones in the gallbladder.². Colic develops if a stone travels to the neck of the gallbladder or the common bile duct and causes spasm².

Usually biliary colic begins an hour and a half after eating fatty or fried foods. The pain is quite intense and constant, increases rapidly, lasts from several minutes to several hours, can give under the right shoulder blade and between the shoulder blades². Often accompanied by nausea and vomiting, stops on its own or after taking antispasmodics².

Chronic cholecystitis

Chronic inflammation of the gallbladder causes moderate pain and heaviness in the right hypochondrium, which persist for several days or even weeks, often “radiate” to the right shoulder and shoulder blade². Unpleasant symptoms are aggravated by drinking carbonated drinks or eating fried and fatty foods. During periods of remission, pain disappears, patients are only concerned about heaviness under the right rib².

Hepatitis

Dull pain under the lower right rib – a symptom characteristic of all types of hepatitis³. Usually patients complain of a feeling of pressure and soreness that is not associated with meals.³. In acute hepatitis, there is a sharp pain, which increases with pressure on the problem area.³. Pain in the acute form of the disease may be accompanied by jaundice, fever, indigestion³.

Appendicitis

An attack of appendicitis may be accompanied by pain in the right hypochondrium. Sometimes painful sensations develop in the epigastric region (between the solar plexus and the lower ribs), and then “migrate” to the right iliac zone⁴. Pain is moderate and constant, aggravated by coughing, walking and changing body position⁴.

Right ventricular heart failure

People with chronic right ventricular dysfunction often experience pain and a feeling of fullness in the right hypochondrium. Unpleasant sensations may intensify after eating. In addition, shortness of breath, bouts of coughing and choking at night often occur.

Right-sided adnexitis

With this gynecological disease, the right ovary and the fallopian tube adjacent to it become inflamed. In patients with an acute form of adnexitis, severe sharp pains in the lower abdomen are observed, which can radiate to the sacrum, anus and right hypochondrium. Sometimes the temperature rises, a feverish state develops.

Treatment of pain in the right hypochondrium

For the treatment of pain in the right hypochondrium, conservative and surgical methods are used. Conservative therapy involves taking medications and following a diet. Surgery is required for acute conditions such as appendicitis and biliary colic. Treatment of pain in the right hypochondrium begins with an examination and diagnosis.

Diagnostics

The initial examination is usually performed by a general practitioner or gastroenterologist, and in emergency cases by a surgeon. The doctor checks the size of the liver, evaluates the degree of irritation of the peritoneum and tension of the abdominal muscles.

After the examination, the doctor prescribes laboratory and instrumental studies:

general blood analysis;
biochemical blood test with liver tests;
Ultrasound of the hepatobiliary zone;
EGDS or gastroscopy – endoscopic examination of the esophagus, upper stomach and duodenum;
ERCP – endoscopic examination of the biliary tract with the introduction of a radiopaque substance;
CT scan of the abdomen.

According to the indications, other examinations are prescribed. To exclude parasitic diseases, feces are analyzed for helminth eggs, and if hepatitis is suspected, serological tests are done. Women should be examined by a gynecologist, tested for infections of the genitourinary system, and an ultrasound of the pelvic organs should be done.

Modern treatments

Modern medicine uses conservative and surgical methods for the treatment of pain in the right hypochondrium, or rather, the diseases that caused these symptoms. Antispasmodics are usually used to relieve pain, and narcotic analgesics are used for unbearable pain. The latter are used in hospitals.

For the treatment of pain in the right hypochondrium, drugs from different pharmacological groups are prescribed:

antibiotics – for a bacterial infection;
non-steroidal anti-inflammatory drugs to reduce pain and inflammation;
cholekinetics, which activate the outflow of bile;
enzyme preparations to improve digestion;
hepatoprotectors to restore the protective functions of the liver;
interferons for complex therapy of hepatitis.

In most cases, a therapeutic diet is prescribed and a list of allowed and prohibited foods is given. As a rule, alcohol, fatty, spicy, fried and salty foods are excluded from the diet. For cooking, sparing processing is used: baking, boiling and stewing.

Prevention of pain in the right hypochondrium at home

Proper nutrition and a normal daily routine are banal, but very effective measures to prevent pain in the right hypochondrium. A balanced diet and food intake at the same time can prevent many diseases of the hepatobiliary system.