Causes of Pain in the Upper Right Abdomen & When to Seek Care

Upper right abdominal pain can be caused by gallstones, a gall bladder infection, or a stomach ulcer. Inflammation or irritation of the organs can also cause pain in the upper right abdomen. Read below for more information on causes and treatment options.

This symptom can also be referred to as: upper right belly pain

Pain In The Upper Right Abdomen Symptom Checker

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Contents

  1. Symptoms
  2. Causes
  3. 9 Possible Conditions
  4. Treatments and Relief
  5. FAQs
  6. Questions Your Doctor May Ask
  7. Statistics
  8. Related Articles
  9. References

Pain In The Upper Right Abdomen Symptoms

Are you experiencing pain in your upper right abdomen? The abdomen can be separated into four quadrants, each having different structures. Abdominal pain often resolves on its own; however, it can be due to serious causes as well. If you do seek care from a physician, try to provide as many details as you can.

Upper right abdomen anatomy

The upper right quadrant of the abdomen contains the liver, the gallbladder, the duodenum, the head of the pancreas, the right kidney and the part of the small intestine that connects to the stomach (duodenum).

  • Liver: The liver is the largest abdominal organ responsible for multiple metabolic processes of the body. The liver processes food into energy, removes toxins from the body, and stores nutrients.
  • Gallbladder: This is a small organ under the liver that stores a fluid called bile, which helps break down fat.
  • Pancreas: The pancreas makes enzymes for digestion and hormones, such as insulin, for maintaining blood sugar levels.
  • Duodenum: This is the first part of the small intestine that connects to the stomach.
  • Common bile duct: The common bile duct is a tubal structure that connects with the organs above and allows for bile to flow properly through the digestive system. It carries bile from the liver and gallbladder through the pancreas into the duodenum.

See this image here and here for a visual representation of these multiple components.

Common characteristics of upper right abdominal pain

Due to its complexity, the upper right abdomen is susceptible to multiple conditions that can cause pain [1]. The pain may remain in the upper right quadrant or spread to other quadrants of the abdomen or the back. The pain may be sharp, sudden, dull, or achy.

Common accompanying symptoms of upper right abdominal pain

It's possible to experience the following symptoms in addition to your abdominal pain.

  • Fever
  • Nausea and vomiting
  • Constipation and/or diarrhea
  • Tenderness of the right upper quadrant
  • A bulge in the upper right quadrant
  • Bloating
  • Pain that changes with eating or hunger
  • Jaundice: This is a yellow tint or appearance of the skin.

If you experience these symptoms, you should consult a physician for a definitive diagnosis and the best course of treatment.

Pain In The Upper Right Abdomen Causes

The upper right quadrant is complex. Inflammation, obstruction, or injury to any of its structures can result in serious pain. Common causes are detailed below; however, you should seek care if your symptoms do not resolve on their own.

Obstructive causes

Obstructive causes of pain in the upper right abdomen may include the following.

  • Stones: Gallstones can form inside the gallbladder. Stones can vary in size and cause many different issues as well as pain [2,3]. When gallstones obstruct the common bile duct, this is a condition known as choledocholithiasis [4]. This obstruction can prevent the gallbladder, liver, and even pancreas from draining properly.
  • Ulcer: Sores in the lining of the stomach or duodenum can cause an obstruction in the upper abdomen and pain when eating.

Inflammatory causes

Any of the structures of the upper right abdomen can become inflamed due to infectious causes or irritation from other related issues.

  • Infectious: There are many pathogens, both bacterial and viral, that can infect the organs of the right upper abdomen. For example, hepatitis is a viral infection that can infect the liver [7].
  • Irritation: Since the upper abdomen is the primary location for processing food for digestion, it is susceptible to irritation in multiple ways. Gallstones can cause irritation to any of the organs. Toxic substances, such as alcohol and smoking, can cause irritation, inflammation, and swelling. Furthermore, acid needed for digestion can irritate the components of the digestive tract, including the upper abdomen.

Traumatic causes

Trauma to the upper abdomen from a direct blow or motor vehicle accident can cause pain, bruising, or internal bleeding.

9 Possible Pain In The Upper Right Abdomen Conditions

The list below shows results from the use of our quiz by Buoy users who experienced pain in the upper right abdomen. This list does not constitute medical advice and may not accurately represent what you have.

Gallstones

Gallstones are small, round deposits found in the gallbladder, the organ where bile is stored. Gallstones can be subclassified a number of ways. Oftentimes, gallstones will be referred to as either cholesterol stones or pigment stones depending on the makeup of the gallstone.

Gallstones can also be class...

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Gall bladder infection (cholecystitis)

Gallbladder infection, also called cholecystitis, means there is a bacterial infection of the gallbladder either with or without gallstones.

The gallbladder is a small organ that stores bile, which helps to digest fats. If something blocks the flow of bile out of the gallbladder – gallstones, damage to the bile ducts, or tumors in the gallbladder – the bile stagnates and bacteria multiplies in it, producing an infected gallbladder.

Risk factors include obesity, a high-fat diet, and a family history of gallstones.

Symptoms include fever; chills; right upper quadrant abdominal pain radiating to the right shoulder; and sometimes nausea and vomiting. A gallbladder infection is an acute (sudden) illness, while the symptoms of gallstones come on gradually.

Untreated cholecystitis can lead to rupture of the gallbladder, which can be life-threatening.

Diagnosis is made through physical examination, ultrasound or other imaging, and blood tests.

Treatment involves hospitalizing the patient for fasting with IV fluids, to rest the gallbladder; antibiotics; and pain medication. Surgery to remove the gallbladder is often done so that the condition cannot recur.

Rarity: Uncommon

Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation

Symptoms that always occur with gall bladder infection (cholecystitis): abdominal pain (stomach ache)

Symptoms that never occur with gall bladder infection (cholecystitis): pain in the upper left abdomen, pain in the lower left abdomen

Urgency: Hospital emergency room

Stomach ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)

Symptoms that never occur with stomach ulcer: pain in the lower left abdomen

Urgency: Primary care doctor

Hepatitis a

Hepatitis A is a contagious infection of the liver caused by the hepatitis A virus (HAV). HAV causes swelling and inflammation of the liver that impairs its normal function. Hepatitis A can cause gastrointestinal upset, fever, malaise and other symptoms, and the infection can last from weeks to months....

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Pain In The Upper Right Abdomen Symptom Checker

Take a quiz to find out what might be causing your pain in the upper right abdomen

Hepatitis b

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). There are other hepatitis viruses (A, C, D, E) that may behave and be transmitted differently. HBV causes swelling and inflammation of the liver that prevents its normal function. HBV can cause a short-term, acute illness t...

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Acute hepatitis c

Acute Hepatitis C is a liver inflammation caused by Hepacivirus C. The acute form of the disease means that it arises suddenly, within six months of exposure.

Hepatitis C is spread through infected blood, usually through sharing hypodermic needles for intravenous drug use or from sharing personal items such as toothbrushes or razor blades. It can also be sexually transmitted.

Most susceptible are intravenous drug users; hemodialysis patients; HIV patients; and babies born to infected mothers.

Early symptoms may mild, with fatigue, fever, pain in the upper right side of the abdomen, and loss of appetite. Some patients will develop dark urine, pale white stools, and jaundice, which is yellowing of the eyes and skin.

Diagnosis is made through patient history, physical examination, and blood tests.

About half of all cases clear spontaneously, but it is still important to see a medical provider to prevent further liver damage from inappropriate medicines, supplements, or alcohol.

Otherwise, treatment involves antiviral and other medications. In severe and complicated cases, a liver transplant may be necessary.

Rarity: Ultra rare

Top Symptoms: fatigue, nausea, loss of appetite, muscle aches, fever

Symptoms that never occur with acute hepatitis c: pain in the upper left abdomen, pain in the lower left abdomen, pain in the lower right abdomen, pain around the belly button

Urgency: Primary care doctor

Acute pancreatitis

Acute pancreatitis is the inflammation of the pancreas, which creates and releases insulin and glucagon to keep the sugar levels in your blood stable. It also creates the enzymes that digest your food in the small intestine. When these enzymes accidentally get activated in the pancreas, they digest the pancreas itself, causing pain and inflammation.

Rarity: Rare

Top Symptoms: constant abdominal pain, nausea or vomiting, being severely ill, severe abdominal pain, fever

Symptoms that always occur with acute pancreatitis: constant abdominal pain

Urgency: Hospital emergency room

Appendicitis

Appendicitis refers to inflammation of the appendix, a small finger-like structure in the lower right corner of the belly. Appendicitis is extremely common, occurring in about five to 10 percent of people at some point in their lifetime. While it can occur at any age, the most commonly affected group...

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Indigestion (dyspepsia)

Indigestion, also called upset stomach, dyspepsia, or functional dyspepsia, is not a disease but a collection of very common symptoms. Note: Heartburn is a separate condition.

Common causes are eating too much or too rapidly; greasy or spicy foods; overdoing caffeine, alcohol, or carbonated beverages; smoking; and anxiety. Some antibiotics, pain relievers, and vitamin/mineral supplements can cause indigestion.

The most common symptoms are pain, discomfort, and bloating in the upper abdomen soon after eating.

Indigestion that lasts longer than two weeks, and does not respond to simple treatment, may indicate a more serious condition. Upper abdominal pain that radiates to the jaw, neck, or arm is a medical emergency.

Diagnosis is made through patient history and physical examination. If the symptoms began suddenly, laboratory tests on blood, breath, and stool may be ordered. Upper endoscopy or abdominal x-ray may be done.

For functional dyspepsia – "ordinary" indigestion – treatment and prevention are the same. Eating five or six smaller meals per day with lighter, simpler food; managing stress; and finding alternatives for some medications will provide relief.

Rarity: Common

Top Symptoms: nausea, stomach bloating, dyspeptic symptoms, bloating after meals, vomiting

Symptoms that always occur with indigestion (dyspepsia): dyspeptic symptoms

Symptoms that never occur with indigestion (dyspepsia): vomiting (old) blood or passing tarry stools, rectal bleeding, bloody diarrhea, fever

Urgency: Self-treatment

Pain In The Upper Right Abdomen Treatments and Relief

Treatment for your right upper abdominal pain will be dependent on the cause. After your physician makes the appropriate diagnosis, he or she may suggest:

  • Pain medication: Medications such as NSAIDs (non-steroidal anti-inflammatory agents) are often used to help treat this condition.

  • Medications: In the case of gallstones, there are some medications that can break them up without the need for surgery. If your symptoms are due to infection, you may receive antibiotics.

  • Surgery: Surgery to remove gallstones or the gallbladder entirely is a common procedure, especially for people who suffer from chronic gallstones.
  • Bowel rest: Your physician may suggest a lighter diet that will allow your intestines and digestive system to recover.

When it is an emergency

If you experience the following, seek emergency treatment [5,6]. These could be signs of serious obstruction or inflammation.

  • Sudden, severe pain
  • Fever
  • Bloody stools
  • Nausea and vomiting that persists
  • Weight loss
  • Severe tenderness when you touch your abdomen
  • Swelling of the abdomen

FAQs About Pain In The Upper Right Abdomen

Here are some frequently asked questions about pain in the upper right abdomen.

Can I prevent the formation of gallstones?

Yes, maintaining a healthy weight and exercising regularly are the best ways to prevent the formation of gallstones. Studies show that people who are overweight are more likely to develop gallstones.

How can I live without my gallbladder?

Gallbladder removal is a very common surgery. Having your gallbladder removed does not affect digestion significantly because the liver can also make bile to help with digestion of fatty foods. Symptoms after gallbladder removal include gassiness, bloating, or more watery bowel movements. After removal of the gallbladder, there is a small likelihood that gallstones will recur.

Do gallstones have to be removed with surgery?

No. Gallstones do not have to be removed with surgery. There are oral medications that can be taken to break down or dissolve gallstones. The success of oral therapy depends on the size and composition of the gallstones in addition to the functionality of the gallbladder and duct system [2].

What is the treatment for hepatitis A?

There is no medication that treats Hepatitis A [7,8]. Your physician will recommend rest, fluids, and adequate nutrition since it is a short-term infection that often resolves. However, some people with Hepatitis A experience severe symptoms and need to be hospitalized in order to get appropriate fluid and nutrition.

Is pain in the upper right abdomen life-threatening?

Some causes of upper right abdomen pain such as pancreatitis can be very severe. According to a large study in the United States, 15 to 25% of people with acute pancreatitis develop severe pancreatitis [9,10]. Severe pancreatitis can result in fever, hypotension, and organ failure, and require monitoring in the intensive care unit. It is important to not ignore symptoms of pain in the upper abdomen and seek medical attention before the condition worsens.

Questions Your Doctor May Ask About Pain In The Upper Right Abdomen

To diagnose this condition, your doctor would likely ask the following questions:

  • Have you experienced any nausea?
  • Any fever today or during the last week?
  • Have you lost your appetite recently?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your pain in the upper right abdomen. These questions are also covered.

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Pain In The Upper Right Abdomen Symptom Checker Statistics

People who have experienced pain in the upper right abdomen have also experienced:

  • 10% Nausea
  • 5% Diarrhea
  • 4% Abdominal Pain (Stomach Ache)

People who have experienced pain in the upper right abdomen were most often matched with:

  • 42% Gall Bladder Infection (Cholecystitis)
  • 28% Gallstones
  • 28% Stomach Ulcer

People who have experienced pain in the upper right abdomen had symptoms persist for:

  • 41% Less than a day
  • 34% Less than a week
  • 11% Over a month

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Pain In The Upper Right Abdomen Symptom Checker

Take a quiz to find out what might be causing your pain in the upper right abdomen

References

  1. Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008 Apr 1;77(7):971-8. AAFP Link
  2. Bufkin WJ. Nausea, vomiting, and right upper quadrant pain. Baylor University Medical Center Proceedings. 2000;13(3):295-6. NCBI Link
  3. Phillips MM. Acute cholecystitis. U.S. National Library of Medicine: MedlinePlus. Updated July 10, 2017. MedlinePlus Link
  4. Baiu I, Hawn MT. Choledocholithiasis. JAMA. 2018;320(14):1506. JAMA Link
  5. Phillips MM. Abdominal pain. Mount Sinai. Updated January 12, 2018. Mount Sinai Link
  6. Chronic abdominal pain in children. Pediatrics. 2005;115(3). Pediatrics Link
  7. Hepatitis A. World Health Organization. Published September 19, 2018. WHO Link
  8. Matheny SC, Kingery JE. Hepatitis A. American Family Physician. 2012;86(11):1027-1034. AAFP Link
  9. Rau BM. Predicting severity of acute pancreatitis. Curr Gastroenterol Rep. 2007;9(2):107-115. NCBI Link
  10. Fagenholz PJ, Castillo CF, Harris NS, Pelletier AJ, Camargo CA. Increasing United States hospital admissions for acute pancreatitis, 1988-2003. Ann Epidemiol. 2007;17(7):491-7. PubMed Link