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Pain under right rib cage: Causes, treatment, and diagnosis

Pain under the right rib cage can be minor or severe depending on the cause, and sharp pain under the right rib cage can be frightening. If you experience pain on the right under the rib cage, there could be a simple explanation such as an injury. It could also be related to a serious medical issue.

There are many vital organs protected by the right rib cage, so you shouldn’t ignore the pain. Getting a thorough physical exam is important to help determine the exact cause. Understanding pain right under the rib cage can give you a sense of relief as opposed to panic. For example, some people may simply be experiencing pain under the right rib cage due to postural changes. When some people have pain on the right side under the rib cage, they fear they are having a heart attack. While this is not entirely out of the question, it is rare that pain in this location is heart-related.

Being aware of the type of pain, when the pain occurs, and whether the pain is associated with movement, eating, or a certain food item can assist the doctor during their assessment and might help identify the cause.

Pain under the right side of the rib cage can feel like an aching, stabbing, or burning sensation. Some individuals have described it as feeling like something is squeezing their chest, while others say they experience a sharp pain under the right rib cage when breathing in. While not all pain under the right rib cage is life-threatening, it is a good idea to get it checked out, especially if it just won’t go away.

Causes of pain under the right rib cage

The cause of pain under the right rib cage can be the same as pain on the left. Many people jump to conclusions based on where the pain is situated, but they could be way off base. Here we look at the many different causes of pain under the right rib cage.

Injury: Injuries to the ribs are common and can cause chest pain. This pain can be mild or severe depending on the extent of the injury. Some injuries to the rib cage can lead to serious problems such as a collapsed lung or kidney damage.

Liver pain related causes:

  • Liver trauma: During surgical or diagnostic procedures, sharp force can injure the abdominal wall.
  • Viral hepatitis: This is an infection of the liver.
  • Alcoholic liver disease: A broad term used to describe many stages of liver disease caused by excessive alcohol consumption. The end stages of cirrhosis of the liver normally do not include pain.
  • Fatty liver disease: The accumulation of fat in the liver can be linked to obesity, high blood cholesterol, hypertension, and diabetes mellitus.
  • Liver abscess: This is a buildup of puss in the liver and can be accompanied by other infections in the abdomen.
  • Liver cancer: Liver cancer or hepatocellular carcinoma is a malignant tumor. It can occur due to the spread of cancer from elsewhere in the body. Liver cysts or hepatic cysts, which are fluid filled sacs in the liver, have also been linked to pain under the right rib cage.
  • Intrahepatic cholestasis: This is a condition where bile gets backed up in the liver. It can be due to problems in the bile ducts.
  • Hepatic arterial occlusion: A blockage or narrowing of the hepatic artery can reduce oxygen to the liver tissue and lead to pain under the right rib cage.

Gallbladder pain related causes:

  • Gallbladder: Gallstones, inflammation of the gallbladder, and inflammation of the bile ducts can cause pain on the right side under the rib cage.
  • Gallbladder cancer: Much like liver cancer, this is a malignant tumor that can occur as a result of a metastatic spread from somewhere else in the body.

Kidney pain related causes:

  • Kidney stones: Large stones can become lodged and cause sharp pain under the right rib cage. Many people who experience this also feel back pain.
  • Pyelonephritis: This is an infection of the kidney, likely due to bacteria entering the urinary tract. Bleeding in the kidney due to severe trauma or hydronephrosis, which is the accumulation of urine in the kidney, can also cause pain under the ribs.
  • Polycystic kidney disease: The accumulation of small fluid-filled sacs in the kidney. Polycystic kidney disease has a genetic link.

Colon pain related causes:

  • Colon problems: Diverticulitis, which is inflammation of the pouches that form the walls of the colon; irritable bowel disease, which impacts bowel habits colonic polyps, trapped gas; and inflammatory bowel disease, which is a chronic inflammation of the wall of the large intestine, are all potential causes of pain under the right rib cage.
  • Fecal impaction: When colon contents accumulate and a person experiences severe constipation, fecal impaction occurs.
  • Colorectal cancer: This is a malignant growth in the large intestine and usually impacts the lower parts of the colon and rectum.
  • Gastrointestinal problems: Acid reflux and ulcers can lead to burning and pain sensations. Sometimes, the discomfort is under the right rib cage.
  • Gas: When you overeat, it doesn’t allow for the proper digestion of food, so excess gas can build up. Gas can cause abdominal pain, including pain under the right rib. This will eventually pass but be a good reminder to chew your food and eat slowly.

Lung pain related causes:

  • Lung disease: There are a number of lung conditions that can cause pain under your right rib cage. The pain is most noticeable when breathing in. Pleurisy, caused when fluid builds up between the layers of tissue that cover the lungs, is one example. Pleurisy can be the result of a lung infection, rheumatoid arthritis, or even a rib fracture.
  • Pneumonia: This usually leads to sharp, stabbing chest pains that get worse when breathing in deeply. Depending on which lung is affected, you could have pain under the right rib cage.
  • Lung cancer: May cause aches and pain in the chest area or shoulders. Although it doesn’t happen in all cases of lung cancer, some people do experience discomfort under the right rib cage.

Appendicitis: The appendix is a part of the intestine on the right lower side of the abdomen. If it becomes infected and inflamed, it can cause right side pain.

Tuberculosis: The dangerous bacterial infection known as tuberculosis is contagious and can spread to the spine and brain. In the 20th century, TB was a leading cause of death in the United States. Thankfully, there is a cure for TB.

Peritonitis: The peritoneum is a double-layered sac that houses most of our abdominal organs. Inflammation of this sac is dubbed peritonitis.

Shingles: An infection of nerve and skin surface caused by the varicella-zoster virus. It is the same virus that causes chickenpox. Anyone who has recovered from a case of chickenpox has the potential to get shingles.

Pancreatitis: Inflammation and infection of the pancreas can result in pancreatitis which will signal itself as pain under your right rib. This pain may also travel to your back. Other symptoms include yellowish skin, increased heart rate, and vomiting.

Musculoskeletal problems: Osteoporosis or costochondritis, which is inflammation of the costal cartilage, has been linked to pain under the right rib cage. The costal cartilage is a structure connecting each rib to the sternum at the costosternal joint.

Intercostal muscle strain: The intercostal muscles are those that connect the ribs. If you strain the intercostal muscles on your right side, this can lead to pain. When these muscles become strained, it is quite noticeable because the muscles appear inflamed and very painful. Relaxation and medication can help reduce intercostal muscle strain.

Treatment for pain under the right rib cage

As you can tell, diagnosis is not always quick. In some cases, it can take a detailed investigation for doctors to pinpoint exactly what is leading to the pain right under the rib cage. Once a diagnosis is made, treatment may include rest and specific medications to control the pain.

If you have experienced pain under the right rib cage due to an injury, rest will be vital to ensure muscles and soft tissues can heal. When it comes to medications, depending on the cause, you may receive prescriptions to address pain, fever, infections, or gastrointestinal conditions. There are situations where medications and rest are not enough and additional measures, such as surgery, are required.

Diagnosis and when to see a doctor

After you get a physical and your medical history is taken, laboratory tests, chemical analysis, and imaging studies may be done to help view structures, fractures, organ enlargement, or tumors.

Some people will experience pain under the right rib cage that doesn’t last very long and is probably food related. Adjusting your diet ensures this doesn’t happen again. There are, of course, those who have recurring, constant, or severe pain under the right rib cage. If you have sudden, unexplained pain, you should see a doctor.

Most physicians agree that if pain under the right rib cage radiates to the left arm, back, or jaw, is accompanied by rapid heart rate, rapid breathing, a squeezing or tightness feeling, nausea, fever, chills, dizziness, or very low blood pressure, immediate medical attention should be sought.

Since our rib cage keeps many of our internal organs safe, there is a tendency to worry when we experience pain in this location. In the vast majority of cases, pain under the right rib cage is related to an injury or lifestyle factor, such as eating spicy and greasy foods. Just be sure to visit your physician if you think it’s serious.

Related: Right flank pain: Causes and symptoms


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