Pain in the right side at the waist and lower abdomen: main causes and treatment

Determining the cause of pain by symptoms

The table was compiled by Victoria Druzhikina, a practicing therapist on the AskVracha website, and serves as the most reliable source of information when determining the cause of pain.

Diseases of the biliary organs

Bile synthesized in the liver enters and accumulates in the gallbladder. Then, with the help of muscle contractions, it moves through special ducts into the duodenum. The path passes next to the pancreatic duct. Together they secrete secretions through the sphincter of Oddi.

Acute cramping pain is caused by spastic contraction of the muscle layer. They are called "colic". Localized in the right hypochondrium, spread to the center of the abdomen, in the right lateral zone.

Treated with antispasmodic drugs. At the same time, the patient experiences belching, bitter vomiting, and epigastric pain (biliary gastritis). The pathology is caused by dyskinesia (impaired bladder motility), inflammation, and movement of stones.

Cholecystitis (inflammation of the bladder) is caused by pathogenic microorganisms. Overweight women who do not engage in physical activity are most prone to the disease. Inflammation of the inner lining promotes the production of mucus, thickening of bile, changes the acid-base balance and creates conditions for the precipitation of bile salts (cholelithiasis).

The resulting stones subsequently stick together to a rocky density and cause cholelithiasis. While there are no stones, the pain is dull in nature, but the movement of the stone along the bile ducts causes irritation and local spasm. This manifests itself as an intense pain attack in the upper right half of the abdomen, radiating to the collarbone, scapula, lower back, and shoulder. The attack lasts up to several hours.

Cholangitis is called inflammation of the bile ducts. It is rarely isolated without cholecystitis. Almost always accompanied by cholelithiasis. At the same time, the pain in the epigastrium and right hypochondrium is very strong, cramping with high fever and jaundice.

Gallbladder neoplasms are rare. People with a long history of cholecystitis and cholelithiasis are at greatest risk. The pain syndrome becomes persistent and permanent. The pathology is characterized by a tendency to bladder rupture and peritonitis.

Lesions and gallbladder

The liver and gallbladder are critically important internal human organs. Even the slightest disruption to their work can lead to serious consequences. Regular nagging pain in the right side at waist level may indicate that a pathology of these organs is developing.

Cholecystitis (Inflammatory process in the gallbladder)

It is usually a natural complication of developed gallstone disease and is associated with a disruption of the organ’s ecosystem. In most cases, cholecystitis develops in the presence of stones in the gall bladder. The inflammatory process develops rapidly in the acute form and relatively sluggishly in the chronic form.

Treatment of cholecystitis against the background of cholelithiasis is carried out by a surgeon, without cholelithiasis - by a therapist or gastroenterologist.

In the photo: the formation of stones in the gall bladder

Cholelithiasis

Mineralization processes in the gallbladder lead to the appearance of stones and inflammation. Organ tissues turn yellow

If the formed stones block the free flow of bile, then acute pain appears in the side. If the condition worsens, you must call an ambulance.

There is a wide range of drugs available for drug therapy. These include ursodeoxycholic acid (UDCA) and its generics. In cases where the outlet for bile is blocked, the stone has gone into the duct, surgical intervention is performed to remove the stones. A surgeon treats diseases.

Hepatitis

Hepatitis A, B and C are infectious acute diseases that can lead to significant problems and subsequent complications. Often, pain in the right side is a potential symptom of the disease.

In addition to pain, fever, weakness, aching joints, and an increase in the size and weight of the spleen and liver are possible. For conservative treatment use:

• for hepatitis C, direct-acting antiviral drugs;
• for hepatitis B nucleotides/nucleosides;
• for A and B – vaccination;
• it is possible to use vitamin complexes and hepatoprotectors.

If the symptoms are similar, a general practitioner will be able to identify the disease and prescribe therapy.

Cirrhosis of the liver

Any pain at the waist level should be taken seriously. At waist level are the major vital organs, including the liver. Rapid acute intoxication of the organ and prolonged exposure to toxins can lead to tissue destruction and cirrhosis.

The disease quickly becomes chronic and the damage becomes irreversible. Therapy comes down to maintaining the function of the organ using all possible medications. If you suspect liver pathology, you can consult a hepatologist.

What to do if there is pain in the right side

For pain in the side, if the doctor cannot “by eye” determine the cause of the ailment, he sends the patient for an ultrasound of the abdominal cavity, ultrasound of the kidneys or ultrasound of the pelvis. Ultrasound waves with a frequency of over 20,000 Hz penetrate the skin into the abdominal cavity, where they are either absorbed by internal organs or reflected back. Special sensors (with abdominal ultrasound) analyze the reflected sound, and based on it, conclusions are drawn about the patient’s condition.

1. When tissues become inflamed, they soften and absorb ultrasound more than healthy areas.
2. Various lumps, tumors, and stones reflect radiation better, and it can be reliably stated that the cause of the pain is a stone or neoplasm.
3. Doppler ultrasound allows you to evaluate the speed of blood flow to exclude compression of the inferior vena cava.

Gastrointestinal pathologies

The main parts of the gastrointestinal tract system are located in the abdominal cavity, and therefore they often become the cause of pain syndromes

Inflammation of the appendix (Appendicitis)

In scientific circles, appendicitis is an inflammatory process with a focus in the appendix with the accumulation of pus inside the appendix at the narrowed bottom. This can not only cause pain in the right side at the waist level, but also many other unpleasant symptoms.

The disease develops rapidly, and acute forms are fraught with fatal outcomes. Localization of pain in the right side or bottom is sometimes caused by pylephlebitis (this is an inflammatory process involving the portal vein, which leads to direct damage to the liver).

A consultation with a surgeon will help confirm suspicions of appendicitis.

Intestinal inflammation

Disruption of the microflora, bacterial and viral invasions, as well as the entry of foreign objects into the intestines provoke inflammation. The disease is accompanied by defecation disorders, the appearance of stool mixed with mucus or blood, flatulence and pain of various types.

For treatment, if necessary, antibiotics of different groups are used, depending on the disease (Enterofuril, Oleandomycin, Amoxicillin, etc.).

Oncological diseases of the intestine

Nowadays, cancer is detected quite early. Colonoscopy and MRI can identify suspicious clusters of cells and quickly reveal their nature. If you notice symptoms (pain, change in color of stool, defecation disorders), you should immediately consult a doctor.

The therapeutic plan is developed depending on the stage of the cancer. It is possible to use chemotherapy or surgical removal of malignant tissue. Read about polyps in the intestines here.

Treatment

Help before diagnosis

Mild pain in the right side associated with hypothermia or physical activity does not require drug treatment. Mostly they go away on their own after 1-3 days. If the pain syndrome bothers you for a long time or the intensity of the pain increases quickly, you should immediately seek medical help. For excruciating pain, the doctor uses analgesics at the prehospital stage.

Conservative therapy

To relieve pain, nonsteroidal anti-inflammatory drugs, narcotic analgesics, and antispasmodics are used in practical medicine. For quick pain relief, blockades are made with local anesthetics. These measures provide a temporary effect, so subsequently, to eliminate pain in the right side, etiotropic therapy is prescribed that affects the underlying disease. The following groups of medications are used in surgery and gastroenterology:

• Anti-inflammatory drugs.
  Inflammation is controlled not only by classic NSAIDs, but also by 5-aminosalicylic acid derivatives and corticosteroid hormones.
• Probiotics.
  Medicines are needed to restore microflora and normal intestinal function, which helps reduce pain and eliminate dyspeptic disorders.
• Infusion solutions.
  Necessary for correcting dehydration of the body, removing toxic breakdown products from the blood, maintaining normal hemodynamic parameters.
• Antibiotics.
  The drugs are prescribed for generalized forms of salmonellosis, for the prevention of purulent complications of inflammatory diseases of the digestive organs.
• Cytostatics.
  Taken for severe forms of Crohn's disease when hormonal therapy is ineffective. They are also included in chemotherapy regimens used for malignant neoplasia of the colon.

To improve the patient's condition, symptomatic therapy is carried out. Antidiarrheal or laxative drugs, drugs with pancreatic enzymes, and prokinetics are selected. In order to correct metabolic processes, vitamin and mineral complexes containing iron are indicated. During the recovery period of chronic diseases, courses of physiotherapy, drinking mineral waters, and sanatorium-resort treatment are recommended.

Surgery

Urgent surgical intervention is performed for acute appendicitis (laparoscopic or classic appendectomy), strangulated hernia (revision of abdominal organs and hernioplasty). When fistulas and abscesses form in those suffering from Crohn's disease, their opening and sanitation is indicated. If total damage to all layers of the intestinal wall develops, the operation of choice is resection of the intestinal section.

If an ectopic pregnancy is interrupted, urgent surgical care is required. The type of operation is selected taking into account the severity of complications and the woman’s desire to have children in the future. An organ-sparing tubotomy or radical tubectomy is performed. When an ovarian cyst ruptures, a wedge resection or oophorectomy is performed. Some forms of endometriosis require elective surgical treatment.

Diseases of the spine and kidneys

Painful sensations are not always associated with problems with the liver or gastrointestinal tract. Problems with the spine and osteochondrosis often cause similar symptoms. A neurologist treats osteochondrosis.

Nephroptosis

Nephropotosis – prolapse of the kidney. Mobile kidney syndrome is often accompanied by pain at the waist level.

The disease is divided into three levels (degrees). Nephroptosis appears on the right side more often, and also becomes obvious in the second stage, when the kidney is easily palpable through the skin at waist level in non-obese patients.

Pain in the right side may be an early symptom of the development of level 1 nephroptosis, and therefore pain should not be ignored. Various techniques are used for diagnosis:

• Carrying out complete blood biochemistry;
• Study of the state of biological fluids;
• Ultrasound scan at waist level;
• X-ray scanning.

Conservative forms of treatment: wearing a special corrective bandage at the level of the waist or lower abdominal area, exercise therapy and exercises. Surgery is rarely prescribed. The treatment of kidney diseases in women is described here.

Osteochondrosis and hernia

Discomfort and pain are often associated with nerve compression or inflammation of the skeletal muscles. A characteristic symptom is loss of flexibility, as well as increased discomfort with sudden movements or even breathing.

To relieve some symptoms, medications are prescribed to reduce inflammation, as well as exercise therapy and physiotherapy. Find out about the symptoms of hernia in men from this article.

Doctor's advice

Shingles. The pain of herpes zoster before the appearance of characteristic rashes in the form of blisters along the nerve can be so severe that they are mistaken for a heart attack or renal colic. Having excluded all conditions using examination, laboratory (general and biochemical blood tests, general urine analysis) and instrumental (ECG, ultrasound, MRI) research methods, herpes can be assumed.

Victoria Druzhikina Neurologist, Therapist

Pinched nerve

Heart diseases

With the abdominal form of myocardial infarction, the patient may experience aching pain in the right hypochondrium. This is explained by the fact that tissue necrosis has developed in a certain area of ​​the heart muscle due to the cessation of its blood supply. Sharp pain in the epigastric region may also occur. The pain is sharp and burning, which does not go away when taking painkillers. With these signs, the patient must be urgently hospitalized.

It is impossible to make a diagnosis using a single symptom. You cannot endure pain and wait for it to go away on its own; many diseases require immediate treatment, otherwise serious complications and even death will occur. You should not try to explain to yourself the cause of the pain; only a doctor can make a diagnosis.

Pain in the lower abdomen in women

The lower abdomen may hurt for the same reasons as the side. Pain in the right side of the lower abdomen in women is often a manifestation of the following pathologies: inflammation of the uterine appendages, less often – ovarian cysts and the primary stages of uterine fibroids. The lower abdomen is the main part of the abdominal cavity, but pain can be caused by pathologies of surrounding organs and tissues. Very often, the lower abdomen hurts due to complications of pathologies of the reproductive organs. What are the causes of discomfort in the lower abdomen?

Endometriosis

This is a common disease that often develops in healthy women and mainly affects people of reproductive age. The endometrial tissue (uterine wall) begins to grow and spread into the surrounding tissue. This causes pain in the lower abdomen.

There are two main types of endometriosis: Genital. In this case, endometrial cells are localized in the uterus and ovaries. Extragenital. In this situation, the growth can affect the entire lower abdomen, and the inflammatory process affects the intestines and navel. Based on the nature and severity of the disease, the disease is divided into 4 degrees. Laparoscopy is recognized as the only effective diagnostic method. This is an “exploratory” surgical operation that is performed through an opening in the lower abdominal cavity.

Treatment is with hormonal drugs, painkillers and anti-inflammatory drugs. In some cases, surgical intervention is necessary. If the right side of the lower abdomen hurts in women, this is very often a manifestation of complications in the reproductive system. Other possible causes of lower abdominal pain are described here. If you have similar symptoms, you can see a gynecologist online.

What can hurt in the stomach on the right?

The causes of pain under the right rib can also be diseases in various organs:

1. Liver diseases
   : hepatitis (inflammation), hepatosis (metabolic disorders), cirrhosis (replacement of parenchymal cells with connective tissue), liver parasites, metastases as a result of malignant tumors of other organs.
2. Heart diseases
   (they cause circulatory disorders): myocarditis, endocarditis, coronary heart disease, abdominal myocardial infarction.
3. Gallbladder diseases
   : cholecystitis (inflammation), cancerous tumors.
4. Intestinal diseases: colitis (inflammation of the mucous membrane of the large intestine), Crohn's disease (severe damage to the entire gastrointestinal tract from the throat to the anus), diarrhea, diverticulosis (protrusion of the intestinal mucosa through the muscle wall), irritable bowel syndrome, intestinal infections.
5. Diseases of the right kidney
   : abscess (purulent inflammation), pyelonephritis (bacterial inflammation), cysts, kidney stones, echinococcosis (presence of helminths in the kidney), tuberculosis (drying) of the kidney, malignant tumor.
6. Diaphragmatitis (inflammation of the pleura covering the diaphragm).
7. Adrenal tumors.
8. Intercostal neuralgia (irritation of the intercostal nerves).
9. Formation of blood clots in the inferior vena cava.

Diagnostic methods

Causes of pain in the right hypochondrium

Pain in the right side of the abdomen does not always indicate any disease. At times they are caused by physiological changes that also happen to completely healthy people.

1. Stitches in the side after jogging
   or other physical activity. This is typical for unprepared people who are not used to playing sports. Physical activity is stressful for their body, and it reacts with a sharp release of adrenaline. The hormone provokes a spasm of the bile ducts, which stretch from the bile overflowing them. At the same time, the liver fills with blood, increases in size, and the organs press on each other, causing pinpoint pain and tingling.
2. Tingling in the right side
   after a heavy meal. On a full stomach you don’t want to move or move. Under the influence of adrenaline, the inferior vena cava expands and puts pressure on the liver, which is also under pressure from a full stomach. This is why you should not exercise immediately after eating.
3. Sharp pain in the right side
   , radiating to the back. This happens in women shortly before the start of menstruation. Hormonal imbalance causes spasm of the bile ducts, resulting in sharp pain that radiates to the back. It goes away on its own, but causes significant discomfort to the woman.
4. Pain in the right side during pregnancy
   . The uterus, stretched under the influence of the growing fetus, puts pressure on neighboring organs. Also, the hormone progesterone, secreted to relax smooth muscles and prevent miscarriage, provokes stagnation of bile (cholestasis in pregnant women). Many pregnant women experience pain in the right hypochondrium, which intensifies with movement. Therefore, women need to limit their loads and walk more at a slow pace.
5. Cramps in the lower abdomen (not menstrual)
   . Hepatic, renal, and intestinal colic are characterized by irradiation—reflection of the pain signal to another part of the body.

Frequently asked questions and doctor's answer

General practitioner Victoria Druzhikina answered questions

Pain in the right side at the level of the lateral ribs - “The most common options for such symptoms are pancreatitis, cholecystitis, osteochondrosis, cholelithiasis, hepatitis. Everything except osteochondrosis can be diagnosed using ultrasound of the abdominal organs. Problems with the spine are confirmed using an MRI or x-ray of the area concerned.”

Pain in the right side from the back - “Pain radiates to the back with the following diseases: pancreatitis, pyelonephritis, osteochondrosis, cholelithiasis, pancreatic cancer, ulcer. Damage to the pancreas is characterized by girdle pain.”

Pain in the right side at the waist level in front in women - “Inflammatory bowel diseases, endometriosis, myositis manifest themselves with just such symptoms. With intestinal pathology, the stool will be disturbed - liquid, frequent, with admixtures of mucus or blood. Endometriosis is accompanied by bleeding and cycle disruption. Myositis occurs only with local symptoms. For pain in women, consultation with a gynecologist is indicated.”

Pain in the right side at the waist level in front in men - “With such pain, one can suspect osteochondrosis, inflammatory bowel disease, myositis. Examination and palpation give a lot - a tense, painful muscle with myositis, a rumbling painful stomach, limited mobility of the spine due to pain with osteochondrosis will help to suggest a pathology and refer for further examination (ultrasound of the kidneys, X-ray or MRI of the spine, general blood and urine tests, stool analysis and etc.)."

Pain in the right side under the ribs radiates to the back - “Symptoms can be observed with osteochondrosis, pancreatitis, cholecystitis, cholelithiasis. All conditions require medical evaluation and care. Hospitalization may be indicated."

Differences in men and women: diseases by gender type - “The cause of pain in the right side differs depending on gender. Women may have pathologies of the reproductive system - endometriosis, inflammation of the ovaries or their appendages. Men are more likely to have liver problems and osteochondrosis.”

Right-sided anatomical structures of the abdominal cavity

If you divide the abdomen vertically in half, some of the organs end up on both sides because they occupy a central position:

• stomach (antrum and pylorus) and duodenum (flexure);
• pancreas (head and body);
• small intestine;
• bladder;
• large intestine (cecum, ascending and half of the transverse colon).

Therefore, when studying pathological changes, it is difficult to separate the right-sided and left-sided positions. Sometimes the source of pain is not located where it hurts; there are migrating sensations when a person is not able to pinpoint a specific location and talks about “pain throughout the abdomen.”

Some diseases have a “favorite” localization. The liver of the left lobe falls into the area of ​​the left half and can cause pain throughout the upper abdominal cavity. Directly in the right area of ​​the abdomen lie the gallbladder with ducts, the right kidney and ureter, and the appendix.

Diseases that can cause pain include:

• abdominal wall;
• vessels;
• right lower ribs.

Knowledge of the structure of organs made it possible to identify the characteristics of the pain syndrome:

• parenchymal organs (liver, kidneys) have a dense protective capsule with an abundance of nerve receptors; any unwanted effects, such as injury, inflammation, swelling, cause tension in the capsule and send pain signals to the brain;
• hollow organs (stomach, gallbladder, ureter) are equipped with receptors only in the submucosal layer, so they respond to muscle spasm, stretching, perforation by an ulcer, rupture, but rarely contribute to pain in mild catarrhal inflammation.

The kidney capsule consists of dense connective tissue

This mechanism must be taken into account by doctors in diagnosis. It is difficult to find out why the stomach on the right side hurts, since dysfunction of one organ leads to a failure of the overall digestive process.

When to see a doctor

Pain at the waist or lower abdominal region indicates the development of hidden pathologies affecting various internal organs (in the absence of injuries or bruises), and therefore, when this symptom appears, it is necessary to visit a doctor for an initial examination and diagnostic measures. The waist level is the location of vital organs and tissues that are vulnerable to a wide range of infectious, bacterial and genetic diseases. Even after an ordinary injury, if you have abdominal pain at the waist level, it is better to go to the doctor for a consultation.

Visit a doctor at the first symptoms. Pain in the side at waist level should absolutely not be ignored. This is an alarm bell that should immediately make you “scurry around” and get ready to go to the hospital. Never put off visiting a doctor. Timely detection of the disease is the key to recovery.

This article has been verified by a current qualified physician, Victoria Druzhikina, and can be considered a reliable source of information for site users.

Rate how helpful this article was

4.3 57 people voted, average rating 4.3

Did you like the article? Save it to your wall so you don’t lose it!

Pain in the right side not associated with internal organs

Abdominal pain with depression

. Depression is accompanied by increased anxiety and increased levels of norepinephrine and cortisol. They cause spasms of smooth muscles, including the intestines. The person experiences symptoms characteristic of indigestion. Moreover, this is not associated with eating low-quality food. Abdominal pain cannot be relieved by medications because it is psychosomatic in nature.

A severe and persistent cough also causes abdominal pain

. This is due to the increased load on the abdominals, which not everyone has trained and strong. Often coughing, the patient strains the muscles, they stretch and put pressure on the diaphragm, causing a dull pain. It goes away on its own after the cough is cured.

Bowel diseases

Diseases of the small and large intestines are rarely localized only in the right half of the abdomen; more often they spread to the central part. The nature of the pain is diffuse and has no clear localization.

With diverticulosis, enterocolitis, Crohn's disease, pain is accompanied by diarrhea or constipation, possible intestinal bleeding (in case of ulceration of the wall), attacks of "intestinal colic", weight loss, and dehydration is typical for children.

Tumors are more typically located in the left side. Intestinal obstruction is associated with blocking of the intestinal lumen by adhesions, tumors, and fecal stones. The pain is very strong, vomiting and lack of peristalsis are possible.