Causes of pain under the right rib
Pain in the right hypochondrium in medicine is isolated as a separate syndrome, which often accompanies many diseases of a different nature. This is a surgical, therapeutic, gynecological, skin, parasitic and even venereal pathology. But most often pain in the right hypochondrium is caused by damage to the liver and biliary tract. It is necessary to focus on the following characteristics of pain in the right hypochondrium:
- Start and development;
- Localization and migration;
- Duration;
- Intensity and character;
- Relationship with specific reasons for strengthening and relief.
With the classic development of the right hypochondrium syndrome, patients are worried about aching pain under the right rib, coupled with a feeling of heaviness.
Disease diagnosis starts with the simplest. First of all, attention should be paid to traumatic factors. Perhaps this pain is caused by a fracture, or a severe bruise in the right side of the chest. Sometimes pains appear much later than the previous injury. Delayed onset is due to the formation of a hematoma with its further destruction. A similar manifestation of the syndrome of the right hypochondrium is noted with liver injuries. Initially, the tissue of the organ ruptures and bleeds under the capsule, then the blood breaks through it, and the clinic of an acute abdomen unfolds.
The localization of pain is of great importance, having determined which, one can assume the pathology of certain internal organs.
Pain under the right rib in front
The most common cause of pain under the right rib is biliary tract pathology. Bile is formed in the liver, then it is transported to the gallbladder, where it is concentrated. Bile acids are secreted into the intestines on demand, after a meal. When the cystic duct is narrowed or blocked, pain occurs after eating spicy, smoked, fried foods. This is due to the increased need of the digestive organs for bile acids, which are necessary for the processing of fatty foods. Diseases in which there is pain in the right hypochondrium in front are associated with the pathology of the biliary tract:
- Cholecystitis - inflammation of the bladder walls;
- Cholelithiasis;
- Qualitative changes in the composition of bile: sludge and cholesterosis;
- Inflammatory changes in the intestines, leading to spasm or swelling of the mouth of the bile duct - common bile duct.
Cholecystitis, like any inflammatory process, is necessarily accompanied by aching pain under the right rib. The formed gallbladder stones block the duct, the pain is caused by its blockage. When small stones form, they move freely along the ducts, irritating pain receptors. If there are large stones in the gallbladder cavity, they cannot create a barrier, but they contribute to the formation of bedsores. In such cases, the painful sensations become permanent and often intensify with a change in body position.
An increase in the size of the liver in various diseases: from acute and chronic hepatitis to leukemia and cancer - also provokes the development of pain in the right hypochondrium. The painful area in such cases extends to the axillary lines.
Pain under the right rib in the back
Pain in the right hypochondrium from the back can be associated with both diseases of the gallbladder and pulmonary pathology. Moreover, both conditions are not much different. With right-sided pneumonia, aching pain also occurs under the right rib, and lesions of the liver and gallbladder are accompanied by increased pain during respiratory movements. But with an inflammatory process in the lung, there is no increase after eating.
A fairly common reason for the appearance of pain under the right rib in the back is kidney pathology - pyelonephritis or kidney stones. The right kidney is located under the liver, so the pain receptor field reacts in the same way, both to the pathology of the gallbladder and to the stretching of the renal capsule.
Quite often, pain appears under the right rib in women with the development of right-sided inflammation of the uterine appendages. Especially if it is caused by sexually transmitted diseases. Gonococci and chlamydiae cause a sluggish inflammatory process, which is characterized by the formation of an extensive adhesive process, which involves the greater omentum and hepatic capsule. They grow together, which provokes pain in the right hypochondrium, which is chronic.
Rare causes of pain in the right hypochondrium
The pathology of the organs of the gastrointestinal tract also provokes the appearance of pain under the costal arch, mostly on the right. The causes of the disease may be parasites: opisthorchia, lamblia, roundworm.
Feline flukes and protozoa block the bile ducts, resulting in pain under the right rib that is not associated with food intake. The manifestations of helminthic invasion depend on the life cycle of the parasites and appear at a certain time. Clogging of the ducts with roundworms occurs when the number of adults increases. Worms can cause pain attacks similar to the clinical picture of diffuse peritonitis. Echinococcus cysts are formed in the liver tissue, so pain under the right rib appears with an increase in the lesion. Echinococcosis has a similar clinical picture with liver abscess.
In addition to helminthic invasions, chronic appendicular infiltration or acute inflammation of the appendix with its retrocervical location can lead to the development of a syndrome of the right hypochondrium.
Sharp pain under the right rib
A sudden stabbing pain under the right rib occurs in people playing sports or performing intense physical activity. A similar condition in medicine is defined as hepatic pain syndrome. At first, there is a sharp pain under the right rib after a single overload, then the situation repeats. The mechanism of pain in athletes' hepatic syndrome is associated with the emergency burning of glycogen, the reserves of which are in the liver cells. When liver glycogen is consumed, muscle mechanisms of anaerobic glycolysis are activated - the so-called "second wind" opens. With further stress in an unprepared person, pain in the right hypochondrium is complemented by a similar one on the left side. This is due to the release of blood reserves from the spleen.
Stitching pain under the right rib in women of childbearing age
During ovulation, not only the appearance of an egg occurs, but also the release of follicular fluid into the abdominal cavity. Peritoneal irritation is transmitted through the vagus nerve, which has several celiac plexuses, the most sensitive of which is located near the liver. So there is a sharp pain under the right rib, which lasts no more than a few minutes. Pain syndrome during ovulation is typical for women suffering from chronic inflammation of the appendages.
Pain in the right hypochondrium may appear with premenstrual syndrome caused by hormonal disorders.
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