Why are there pains in the right and left hypochondrium while radiating to the back? Diseases accompanied by pain in the right side

If you have ever had a pain under the right rib, then in response to complaints, you probably heard from others many explanations of what exactly might be troubling there. Indeed, the list of organs that are located under the lower rib on the right is quite solid. In front there is a diaphragm (its right dome), a liver, gall bladder and the intestines, in the depths of the abdominal cavity - the pancreas, and behind - the right kidney. Therefore, regular pain in the right side can be a sign of many diseases.

About the cause of pain in the right hypochondrium - hepatitis

Most often, under the right rib hurts in people with problems with the liver or gallbladder. And the most common liver disease is hepatitis - its inflammation. This process can be caused by any adverse impact. external environment, because, unfortunately, each of them, directly or indirectly, always affects the named organ, which is designed to purify the blood.

A feature of hepatitis is that most often people learn about it by accident, during examinations for other reasons. And the disease in such cases is indicated only by the test results (namely, an increase in the activity of certain enzymes in the blood).

Depending on what cause caused hepatitis, it is divided:

• for viral (hepatitis A, B, C, etc.);
• bacterial;
• allergic (appearing against the background of a severe reaction of the body to any agent);
• medicinal (more precisely, toxic, caused by exposure to the liver of drugs);
• alcoholic;
• autoimmune.

In addition, the named disease can be secondary and accompany diabetes mellitus, thyroid pathology, pregnancy, etc.

Symptoms of various liver diseases

But besides the aching or pressing pain characteristic of most pathological processes in the liver, its diseases can be accompanied by a certain set of other symptoms. And by the way, their presence should tell the patient that it's time to see a specialist:

Gallbladder disease

The reason that a person has repeatedly hurt under the right rib may be a very common pathology - cholelithiasis... All her symptoms do not appear immediately, but already on early stages the patient may experience painful sensations in the hypochondrium, and they usually increase after eating.

The inclusion of fatty foods in the menu, as a rule, causes diarrhea, belching, and nausea in such patients. In addition, patients experience abdominal tension, general weakness, and itchy skin... And in the case when the stone moves along the bile duct, very painful hepatic colic can develop.

Often the cause of the pain described is cholecystitis, an inflammation that affects the inner lining of the gallbladder. In this case, the pain symptom manifests itself in different ways, depending on the type of pathology. In the absence of stones, the pain is dull, accompanied by nausea, belching, and an unpleasant taste in the mouth. If there are stones in the ducts, then the patient periodically has acute attacks of pain.

Inflammation of the pancreas

With a disease of the pancreas, pain under the ribs on the right is atypical. But this organ partially enters the right hypochondrium, and in the case when bile is thrown into the pancreatic ducts and pancreatitis develops in the region of the gland head, the patient's pain can be localized there.

True, even in this case, the patient rarely says that he had a pain under the right rib, since the named symptom most often spreads to the left hypochondrium and gives it under the scapula and in the back. In addition, stool disorders appear (it becomes abundant and fetid), signs of general intoxication are noticeable, the temperature may rise, and headache and repeated vomiting.

All these signs require immediate medical care and conducting adequate therapy to avoid the need for further surgery.

Why else does it hurt under the right rib in front?

Other pathological processes may also be the source of painful sensations in the right hypochondrium:

1. For example, a duodenal ulcer in some cases is manifested by a dull pain in the side, which also radiates under the scapula. The mentioned disease occurs due to abnormalities in the work of the stomach, provoking the ingress of poorly digested food into the intestines. This changes the alkaline environment in it to acidic and leads to the appearance of ulcers on the walls.

In this case, the patient has pain under the right rib after eating (about an hour) or on an empty stomach. In addition, there is an increased formation of gases, the stomach is swollen, and diarrhea occurs. The patient is nauseous, and at night (at about 2 o'clock) there are so-called hunger pains, which can be extinguished by eating. All these signs require immediate medical attention.

2. Another serious cause of pain in the right side may be diaphragmatic hernia... They arise as a result of congenital or acquired weakness of the tissues of the diaphragm and represent a protrusion or hole in it through which organs can penetrate from the abdominal cavity into the chest cavity. This pathology is usually accompanied by heartburn, constant belching of air and bloating.

What hurts under the right rib, gives it to the back

If the described pain is localized mainly behind, then the reason for this most often lies in the pathological processes in the right kidney. One of the most common of these is infection caused by E. coli and called pyelonephritis. This ailment can manifest itself in both acute and chronic forms.

In the first case, under the right rib it hurts quite strongly and almost constantly, the symptom is usually aggravated by light tapping with the edge of the palm in the lumbar region (the so-called Pasternatsky symptom). In the second case, it is less pronounced, aching, but intensified in damp weather.

The disease is usually accompanied by fever, chills, nausea, and general weakness. Small swelling and frequent urination also indicate the need to contact a specialist.

Urolithiasis disease

The described syndrome is also characteristic of urolithiasis. Depending on what size stone is in urinary tract, as well as from its location, the patient may complain that he only had pain from time to time under the right rib in the lumbar region, or that the pain became constant. In this case, the symptom may be aggravated by any shaking (driving in transport, jumping) or from a large number liquid drunk by the patient.

By the way, all this can provoke the onset of stone movement, which is usually accompanied by severe pain - renal colic.

Osteochondrosis

People suffering from lumbar osteochondrosis are unlikely to wonder why it hurts under the right rib in the back. Since this symptom in this case is constant, and the pain is characterized as pulling, aching and sometimes acute. As a rule, it is accompanied by muscle tension and stiffness of movements in the lumbar region. And in advanced cases, it generally makes it impossible to stand or sit for a long time. It is especially difficult in such cases to bend your back.

When you cough, sneeze, or try to lift something, severe pain tends to worsen.

Pain during exercise

The diseases listed above, we hope, will not make you think for a long time what to do if it hurts under the right rib. As you can see, they are all very serious and require examination and adequate treatment. Therefore, if you have gathered a bouquet of the signs described above, do not hesitate, contact your doctor!

And only in one case, the pain in the right hypochondrium should not be very depressing. This happens when untrained people take on hard work or start playing sports. The fact is that at this time in a person, as a rule, the degree of filling with blood of the liver increases, due to which its capsule (outer shell) begins to stretch. In addition, due to the release of adrenaline, the tone of the bile ducts decreases, which leads to their stretching of stagnant bile. Together, this causes the described pain.

Therefore, if you have a pain under the right rib while running or walking, do not worry, as a rule, breathe deeply enough, drawing in your stomach as you exhale, so that the discomfort disappears completely. In addition, it is worth making sure that physical activity begins no earlier than 2 hours after eating. Do not be ill!

Pain in the right hypochondrium, acute or periodic, manifests itself in some form in about a third of the population of our planet. Very often patients are interested in what is on the right side of a person and why it presses, twitches, aches or hurts in the area of ​​the right hypochondrium. According to medical statistics, in about ninety percent of cases, pain is a consequence of pathological changes. internal organs... So, most often these symptoms cause diseases. biliary tract and gallbladder , and the second most frequent place is occupied by liver pathologies and development swelling of the liver in case of circulatory disorders.

What's under the right rib?

To determine what is under the ribs on the right side of a person, one should refer to topographic anatomy. The right hypochondrium is part of the anterior abdominal wall, which is limited by:

Extending the lower border of this area to the back, we will see that it runs along the 12th rib and the third lumbar vertebra.

You can practically determine where the right hypochondrium is located in the following way: palm right hand should be placed horizontally on the ribs, doing this so that the wrist is in the middle of the side, while the edge of the little finger should coincide with the edge of the ribs below. If you leave your wrist in the same position and clasp your back with your palm, you can get a posterior projection of the right hypochondrium.

In this area, pain may occur due to damage to such organs:

• gallbladder, liver;
• right kidney (upper part);
• large intestine (part of it is the bend) colon);
• the peritoneal part of the right half of the diaphragm;
• adrenal.

In addition, in this area, tingling and pain can be reflected from the duodenum, pancreas, inferior vena cava, bile ducts.

Why is pain manifested in the right hypochondrium in healthy people?

Sometimes discomfort and pulling pain on the side, behind, as well as pain on the right under the ribs in front, can be felt even by a completely healthy person. Such manifestations are associated with certain physiological conditions.

Pain during and due to physical exertion

People who are not used to being exposed to heavy physical exertion, after hard work or playing sports, may notice that they have severe stabbing pain in the right side under the ribs in front. The reason for such manifestations is associated with the next process: when ejected the tone of the bile ducts decreases, their stagnant stretching occurs. Meanwhile, the liver is actively filling with blood, its capsule stretches, and a tingling sensation occurs. There may even be acute pain in the back from the back and front.

Pain after eating, especially dense, manifests itself in the hypochondrium during physical exertion almost always. If it hurts in the right side under the ribs in front, you should pay attention to the fact that after eating it is especially not recommended to run and do push-ups.

In addition, it is known that it can cause dull pain in the right hypochondrium in front and spasm of the diaphragm. A person feels it when he sighs, sometimes when he inhales and exhales. The same sensations can occur when coughing. But this pain is usually short-lived. Sometimes it dulls when pressed. As a rule, if breathing evens out after exertion, this symptom disappears.

However, the explanations of why the ribs on the right side hurt are not always true. Sometimes, why aching pain appears during exercise, some sources explain the expansion of the inferior vena cava due to the influence of adrenaline and its pressure on the liver. Before determining what hurts in the right side under the rib, it should be borne in mind that under the influence of adrenaline, vasoconstriction occurs, and there are no pain receptors in the liver.

Pain in women

V last days monthly cycle a certain part of women may develop a sharp hormonal imbalance ... As a result, a spasm of the biliary tract develops, and a sharp pain manifests itself, radiating to the back in some cases. Therefore, the explanation of what hurts in the right hypochondrium is sometimes precisely the characteristics of the female body.

In some cases, the course premenstrual syndrome worsens when taken hormonal contraceptive ... In this case, both piercing and dull pain, as well as burning sensation are manifested due to a violation of the passage of bile.

During pregnancy

What hurts under the right rib in front is explained by the physiology of the body of the expectant mother.

At and Crohn's disease spasmodic pain sensations develop not only in the hypochondrium, but also in all the lower abdomen. At the same time, bloating is also noted. People with this diagnosis may develop bleeding, mucus and pus are determined in the stool, the condition is sometimes complicated by intestinal obstruction, intestinal necrosis .

In the case of tumor development, it is most often noted intestinal obstruction, there is a picture of an acute abdomen, signs of irritation of the peritoneum, pressure drops, pallor and cold sweat are observed.

At an attack of appendicitis the pain begins to develop in the epigastrium, after which it gradually spreads to the right hypochondrium and descends into iliac region on right.

Manifestation of pain in the right hypochondrium behind

If the patient complains that it hurts behind the right scapula, the causes of this phenomenon may be associated with injuries of the lower ribs, damage to the intercostal nerves. Manifested behind the pain under the right scapula from the back and with lesions of the right kidney, adrenal gland. The causes of back pain can also be associated with diseases of the inferior vena cava.

With urolithiasis

Burning and severe pain can be troubling for people with urolithiasis ... When moving, stones or sand scratch the renal pelvis, and later the ureter. Consequently, with renal colic, it hurts both in the lateral abdomen and in the lower back. Painful attacks are noted, spasms are given to the genitals, to the thigh, it is felt in the groin. If you beat a little on the lower back with the edge of your hand, it hurts even more, and blood may appear in the urine. Vomiting sometimes occurs.

With pyelonephritis

Development acute infectious inflammation of the kidney accompanied by soreness in the kidney area, intoxication, fever. It also hurts when urinating, there are periodic false desires, swelling appears on the face.

With apostematous pyelonephritis, purulent inflammation develops in the kidneys. Long-term pulling pain worries, the temperature rises, the amount of urine excreted per day decreases.

With necrosis of the renal papillae

This phenomenon becomes a consequence of oxygen starvation of the kidney tissue, if the vessels are clogged. Constant pain is accompanied by the appearance of blood in the urine. There is a possibility of death from septic shock.

With acute upper paranephritis

The inflammatory process of adipose tissue in the area of ​​the upper part of the kidney is manifested as a result of infection from carious teeth, tonsils, etc. First, the patient's temperature rises, there is moderate soreness in the lower back. A few days later, it already hurts in the right hypochondrium, the pain intensifies with a deep breath, the condition and physical efforts worsen - soreness is noted when moving, walking, and sharply straightening the body.

With kidney cancer

This condition may not appear for a long time. Mild pain and bleeding appear already in the last stages of the disease. Sometimes the swelling interferes with the outflow of urine, then there is acute pain.

Soreness in the hypochondrium is also manifested when tumors of the right adrenal gland , provided that the tumor is large.

With intercostal neuralgia

The reason that a person's right side pulls, grows numb in the hypochondrium, may be intercostal neuralgia ... In this state, it sometimes pulls from the back, the ribs hurt on both sides in front. With neuralgia, it tingles strongly in different areas, up to limitation of mobility. The pain becomes stronger when bending, turning. Also, the reason that it suddenly stabbed in the stomach or twitches on both sides may be when a person's muscles are inflamed.

With bruised ribs

Strong aching pains, aggravated by coughing, pressing, bending, sighing, manifested with bruises of the posterior segments of the ribs. At broken ribs a characteristic crunch is felt.

With osteochondrosis of the lumbar spine

If there is muscle tightness, limitation of mobility, signs of tension, it hurts right shoulder, in the hand, then the reasons for this condition may be associated with lumbar ... Pain sensations can be of different intensity, have both aching and shooting character, manifest from above and below.

With shingles

In this case, appear herpetic eruptions along the nerve in the form of bubbles with a cloudy liquid, the skin turns red. Itching, burning, pain develops at the site of the lesion. This means that you need to see a dermatologist.

With vena cava thrombosis

If thrombus comes from the iliac veins, after which it clogs the vein trunk, hurts in the lower back on the right side of the back. The clinic is similar to a kidney tumor in a late stage. If happens thrombosis of the hepatic segment , bursting intense pain arises in front in the right hypochondrium and radiates under the scapula on the right. Jaundice also develops, fluid accumulates in the abdominal cavity.

Sharp pains

The sensation of acute pain in the right lobe of the hypochondrium is associated with the development of acute surgical conditions - the so-called "acute abdomen". In particular, severe cramps are observed in such diseases and conditions:

• damaged internal organs (injury to the kidney, colon, kidney, damage to the gallbladder, hematoma of the kidney, liver);
• bowel perforation, ruptured diverticula ;
• acute inflammatory processes of the gallbladder, acute pancreatitis ;
• initial stage appendicitis ;
• blockage of the bile ducts , intestinal obstruction ;
• thrombosis of veins and arteries , through which the internal organs are nourished.

In such conditions, very intense pain develops, which leads to the development of pain shock, loss of consciousness, a decrease in pressure, and disruption in the work of internal organs.

With an acute abdomen, the muscles of the peritoneum are tense, sometimes the pain is girdle, sometimes it is punctate, but very often unbearable.

Sharp, constricting pain sensations also appear when abdominal myocardial infarction , renal colic , sometimes - at non-specific ulcerative colitis , broken ribs .

Dull pain

Dull pains very often indicate the development of an inflammatory process. They manifest themselves with such pathologies:

Heaviness in the right side

Severity in the right side and lower abdomen, as well as in the upper abdomen, develops when different diseases... Often heaviness in the right side under the ribs in front develops with an edematous liver. In addition, the causes of severity in the right hypochondrium may be associated with the development hepatitis A , fatty hepatosis , chronic cholecystitis , hypomotor biliary dyskinesia .

After meal

Many people note that they have a stabbing in their right side after eating, heaviness in the epigastrium, rumbling develops. Often, expectant mothers are also interested in why it pricks in the right side during pregnancy. After eating food in the body, the process of excretion and advancement of bile is accelerated, the liver is filled with blood, and peristalsis is activated. Therefore, at chronic diseases liver, intestines, gallbladder pain in the lower and upper abdomen is often manifested after eating. Such manifestations can be of a different nature: a person is nauseous, belching, diarrhea, and rumbling in the stomach.

Dull pain after eating is noted when cholecystitis , sharp - at colitis and dysbiosis , stabbing - at gallstone disease and biliary dyskinesia ... Often the soreness becomes more intense after hard drinking, heavy smoking.

After loading

Unpleasant sensations in the form of pulling or stabbing pain occur after physical exertion in people with hepatitis , cirrhosis , stagnant liver ... After shaking, physical exertion, an attack may appear calculous cholecystitis ... Also, periodic pain during exercise appears in patients myositis , intercostal neuralgia , osteochondrosis , broken ribs , vena cava thrombosis .

How to proceed?

You should ask a specialist about what to do if the gallbladder hurts, pricks the liver and other diseases appear that provoke soreness in the right side. In no case should you independently decide what to drink for pain in the liver, or seek advice on the forum. After all, even a slight pain requires the attention of a doctor. Self-treatment with pain relievers can help alleviate the overall picture of symptoms in an adult and a child. As a result, the doctor will not be able to make a correct diagnosis.

Pain under the right rib after exercise

Therefore, it should be remembered that it is not necessary to take medicines and folk remedies for pain in the liver before consulting a doctor. Do not give pain relievers to relieve pain.

The use of non-steroidal anti-inflammatory drugs, the use of a heating pad, is contraindicated, since these methods can provoke bleeding inside.

Do not give painkillers to children. In case of colic in infants, it is recommended to breastfeed the babies - sometimes this is enough for the baby to calm down.

If a person initially has a stab in the side, but later a sharp pain appears, you should immediately call " ambulance". After all, only a doctor can adequately assess the entire spectrum of symptoms in this case and make the right decision. It is important to immediately consult a doctor if a lump or lump appears under the ribs on the right.

In the clinic, initially with complaints about such a symptom, you should contact a therapist who will determine which specialists the patient needs to go to next.

If a person often has pain, heaviness, pulsates and bursts in the hypochondrium, gives to the scapula, forearm, back, then such a condition should not be tolerated in any case. Both men and women should be aware that a timely visit to a doctor will help prevent serious problems.

If such pain occurs unexpectedly, then many people immediately associate it with kidney problems. But, other diseases cannot be ruled out.

Moreover, discomfort localized in the indicated place can be a symptom of equally serious health problems.

Pain in the right hypochondrium radiating to the back, this is a signal that you need to see a specialist.

Liver disease

Any severe pain in the specified location may mean the presence of inflammatory processes in the internal organs(liver, gallbladder and pancreas). With such problems, it is imperative to make an appointment with a gastroenterologist and get advice from this specialist.

Ask your question to a neurologist for free

Irina Martynova. Graduated from Voronezh State Medical University. N.N. Burdenko. Clinical resident and neurologist BUZ VO \ "Moscow polyclinic \".

Long-lasting aching pains often indicate liver damage. This pain is especially pronounced immediately after physical exertion, the use of fatty or fried foods, as well as alcoholic beverages... Indirectly, liver problems are indicated by the presence of belching, nausea, a bitter taste in the mouth and fatigue. If the pain is accompanied by yellowing skin, then you need to immediately begin to treat the liver.

This problem should not be ignored. After all, the liver can hurt because of enough serious illnesses... Including hepatitis.

The earlier you begin to undergo a course of treatment, the more effectively you can cope with the disease.

Cholecystitis

At inflammation of the gallbladder discomfort can also appear in the back. At normal work organism through small intestine there is a withdrawal of bile. But, if its outflow is different reasons it is disturbed and its accumulation occurs, then this leads to severe attacks.

Cholecystitis can be acute or chronic. Pain in right side back often appears when there are stones in the affected organ. Its acute forms with this type of disease can be localized not only in the lower back, but even in the shoulder and neck area.

You can help a patient with cholecystitis with a course of antibiotics, drugs with an effect, as well as infusion therapy. Severe pain can be removed by applying cold to the area of ​​the affected organ.

If the pain is caused by a blockage of the duct by a large stone, then the treatment is reduced to the surgical removal of this formation.

Pancreatitis

Not uncommon, pain in the left or right hypochondrium, manifests itself in case of malfunctions of the pancreas... With pancreatitis, discomfort most often manifests itself in the upper abdomen, but can also shift to the indicated zones.

In acute pancreatitis, such sensations appear when eating fried, smoked and fatty foods. with such an ailment, it has a cutting and intense character. In chronic pancreatitis, muted pain sensations can accompany a person throughout his life.

With the onset of this disease, the patient needs to be laid down and helped to attach the knees to the chest.

You can relieve pain by applying a cold heating pad to the site of pain localization. Well helps to relieve pain "No-shpa", "", "Drotaverin" and other drugs.

Treatment for this disease is aimed at stopping the destructive processes in the pancreas. For this purpose, the doctor prescribes a special antienzyme therapy, as well as taking pancreatic enzymes.

With this disease, the patient is prescribed a special diet.

Duodenal ulcer

If the pain on the right under the ribs radiates to the back, appears with a long absence of food and passes immediately after saturation, this may indicate a duodenal ulcer. This disease develops against the background of intestinal damage. Helicobacter bacteria Pylori or due to acidity.

Pain with duodenal ulcer pain can be very sharp or aching. Other symptoms of this condition are nausea, bloating, and flatulence. Not infrequently, with such a lesion of the intestines, the feeling of hunger appears just a few hours after the last meal.

If you suspect such a disease, you should consult a gastroenterologist. It is possible to identify the presence of a disease with 100% certainty using endoscopy. Duodenal ulcers can be treated with therapy aimed at suppressing the bacteria that caused it.

Inflammation of the bowel

Another common bowel disease is appendicitis, can also cause pain in the hypochondrium and back. With inflammation of the intestinal process, the pain can be of a different nature. With this disease, pain is very often localized in the right side of the abdomen. As a rule, the sensations are tolerable, but due to the high risk of rupture of the appendix, you need to see a specialist as soon as possible.

Acute appendicitis can be treated surgically.

This is a fairly common operation in which the inflamed appendix is ​​removed. A few days after the operation, the patient must drink a course of antibiotics.

Treatment of an inflamed appendicitis alone is impossible. V mandatory you need to see a doctor who will quickly identify the problem and carry out the necessary procedures.

Heart failure

The described localization of pain may indicate the presence of problems in the cardiovascular system. One of these diseases is heart failure. This problem leads to blood stasis and girdle pain. Symptoms such as shortness of breath, frequent dizziness, chronic fatigue syndrome, edema in the area of ​​the steps and ankles, and irregular heartbeat indicate it.

You can help your heart to normalize its work by taking medications that lower blood pressure. In addition, a specialist can prescribe a course of glycosides. These drugs are prescribed for acute form heart failure. It is possible to remove such a symptom of this disease as edema with the help of diuretics.

If you have heart failure, you should increase your dietary intake of magnesium-rich foods or take a heart supplement that contains this nutrient.

Kidney disease

And yet, in the overwhelming majority of cases, pain in the hypochondrium in the zone, with a return to the back, signals kidney problems. Pain syndromes in the kidney area can be associated with a disease such as pyelonephritis. This disease has an acute and chronic form. The disease is accompanied by an increase in body temperature, the appearance of chills and a general deterioration in well-being.

This disease has several causes. Pyelonephritis can develop due to a disturbance in the normal flow of urine, impaired blood supply to the kidney, taking certain medications, and poor personal hygiene. With this disease, pain appears on the side of the affected kidney. The pains are dull and persistent. On palpation, the pain syndrome increases.

A simple form of pyelonephritis is treated with a course of antibacterial drugs that affect the cause of the disease.

At severe forms diseases, the intake of strong drugs that affect the microflora of urine is indicated.

How to relieve pain?

Most of the ailments described above require prompt professional help. And in order for the doctor to correctly diagnose the disease, taking painkillers is undesirable. In some cases, you can drink an antispasmodic. For instance, .

It is possible to reduce painful sensations by applying cold to the place of their localization.

But in such cases it is absolutely impossible to apply a heating pad. It can increase the discomfort and make it difficult to treat the disease.

Pain in the right and hypochondrium, radiating to the back, can cause serious disorders in the body. If you find such pain in yourself, you need to urgently go to the doctor. Only a specialist will be able to accurately diagnose and prescribe the correct course of treatment. The sooner you identify the problem, the faster and more effectively you will get rid of it.
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Almost every adult has felt pain in the right hypochondrium at least once in his life. Sometimes the discomfort goes away quickly enough without causing much discomfort. But there are times when such pains become systematic or permanent.

Such pain can be both aching and quite acute. In this case, it not only prevents a person from fully functioning, but can also serve as a signal that there are certain diseases in the body.

Safe pain in the right hypochondrium

Even completely healthy people, from time to time, may occur uncomfortable feeling of heaviness or aching pain in the region of the hypochondrium on the right. The most common conditions of the body that provoke such unpleasant sensations include:

As a rule, pain in the right hypochondrium arising for these reasons disappears immediately after the factor of their appearance is eliminated... They do not pose a particular threat to the health of the body and human life.

Pain in the right hypochondrium is a signal of a problem

Since the right hypochondrium is in contact with many internal organs, frequent pain or a feeling of discomfort can signal a problem in the work of organs such as:

• right kidney and adrenal gland;
• gallbladder;
• rectum;
• liver;
• heart;
• lungs.

Also in this area may be reflected bile duct pain, the inferior vena cava and sometimes, from the pancreas. This area can suffer from diseases of the spine, osteochondrosis, or inflammation of the intercostal muscles. Dislocation of pain in the right hypochondrium may indicate with which organ the problems are observed.

Pain in the right hypochondrium, radiating to the back

Such a dislocation of unpleasant sensations, when pain is felt behind, closer to the back, can signal existing renal diseases, problems with the spine, and pathological changes in the vena cava. The most frequent illnesses provoking acute or aching pain in the right hypochondrium are:

• Vena cava thrombosis - can manifest as pain in the right hypochondrium, lower back and in the area of ​​the right scapula.
• Intercostal neuralgia, which is characterized by the fact that, along with severe, shooting pain, limits the movement of a person with sharp bends and turns.
• Fractures or severe bruises of the ribs can manifest as severe, constant pain in the area of ​​the right hypochondrium. Such injuries are characterized by increased pain with a deep breath or cough.
• Osteochondrosis that affects lumbar... With this disease, pain in the area of ​​the right hypochondrium may be accompanied by pulling sensations along the spine and sharp sharp lumbago.
• Pyelonephritis is quite common kidney disease and most often it can be accompanied by fever, edema on the face, pain when urinating and, in addition to the right hypochondrium, the lower back in the kidney area can hurt.
• Acute upper paranephritis occurs as a result of inflammation of the fatty tissue in the kidney area. This disease is characterized by the fact that there is a strong increase in temperature, painful sensations arise in the lumbar region and only 2 or 3 days after the onset of the disease, they move to the area of ​​the right hypochondrium.
• Kidney cancer or adrenal gland tumor is characterized by mild and sluggish pain, which is most often localized in the lower lumbar region. But sometimes, this pain can manifest itself in the right hypochondrium.
• Urolithiasis disease, which affects the right kidney, can also manifest itself as pain in the hypochondrium from the corresponding side. The movement of stones and sand through the urinary canals can cause acute severe painful colic, which are localized in the area of ​​the right hypochondrium, lower back and lower abdomen.

Pain in the right hypochondrium, radiating to the side or into the abdominal cavity

In the case when the pain under the ribs on the right side radiates to the abdomen or to the side, with a high probability it can be argued that this is a symptom of a malfunction of the abdominal organs, or problems in the work of the cardiovascular system.

Quite often, diseases such as:

The liver is a common cause of these pains.

Since the liver is localized on the right side, very often, the problem in question can become a symptom of a malfunction of this organ. Exists a number of liver diseases which can cause constant heaviness or discomfort on the right side. The most common diseases in this group include:

Sharp, sharp pain on the right side under the ribs can be a signal that a serious problem has arisen in the body. This pain should not be ignored, since it can be a signal of myocardial infarction, or rather, his abdominal.

In this case, it is sharp, sharp and intense. It can give to the right shoulder blade and does not go away even after taking nitroglycerin. As a rule, it is accompanied by a sharp drop in pressure and pallor of the skin. With such manifestations, a person must be hospitalized without fail to exclude a heart attack.

Women should also not ignore detailed pains as they can signal the existence of such problems, how:

• torsion of the ovarian cyst;
• acute adnexid;
• ectopic pregnancy.

Required diagnostics

Systematic pain in the right hypochondrium, the causes of which can be quite varied, not worth ignoring... In order to diagnose in time possible diseases that can manifest themselves as pain or discomfort in this area, it is necessary to consult a doctor in a timely manner. As a rule, with such complaints, a specialist may prescribe the following studies:

• Ultrasound of the kidneys, pelvic organs or abdominal cavity;
• liver function tests;
• X-ray of the spine and lungs;
• ECG and ultrasound of the heart;
• hemogram.

The area located under the lower ribs on the back side can also be considered the left and right hypochondrium, although the more understandable name is the lower back. In front, speaking of the hypochondrium, we mean the area of ​​the liver adjacent to the lower edge of the costal arch.

If we consider this zone in the anteroposterior direction, then we will make sure that pain in the right hypochondrium, radiating to the back, can cause different pathology... Diagnosing the causes of pain is very difficult. Should be considered topographic features and anatomical structure all local structures and the possibility of irradiation.

Features of the "geography" of the zone of the right hypochondrium

The hypochondrium area is well protected by dense muscles of the abdomen and back, rib cage, peritoneal sheets, diaphragm. Here, important parenchymal organs fit tightly to each other.

The skeleton of the chest has special movable lower two pairs - XI and XII ribs. They are not "woven" on the right into the costal arch, but end with free ends in the muscles of the peritoneum.

The kidney is located retroperitoneally at the level from the III lumbar to the XI thoracic vertebra. The very last rib intersects along the back surface at the border of the upper and middle thirds. Supported by ligaments, special muscle bed and intra-abdominal pressure created by contraction of the abdominal press and diaphragm.

Further, the liver is adjacent to the anterior surface at the level of the upper 2/3, and the bend of the colon to the lower 1/3. The central zone is in contact with the duodenum. On the surface of the liver there are anatomical pits, where the right pole of the kidney, the head of the pancreas, the bend of the duodenum, and the gallbladder are compactly located.

The sheets of the peritoneum surround them in whole or in part. Powerful ligaments are attached to the diaphragm. We will consider the possible causes of pain depending on the localization of the source and taking into account the nature of the spread.

If the pain spreads along the hypochondrium from back to front

Most common reason are diseases of the kidneys and musculoskeletal system.

Inflammation in the renal pelvis is caused by an infection with blood from chronic foci (boils, palatine tonsils, maxillary sinus, osteomyelitis, internal genital organs) and from the urinary tract. The disease can be unilateral and bilateral, acute and chronic. In the chronic variant of the course, abscesses are formed in the tissues of the kidney.

In the acute form, the symptoms rapidly increase: the temperature rises to 39 degrees, the patient has chills, intense sweating, nausea, headache, severe weakness. Then, with a right-sided process, pain appears in the right hypochondrium from behind from the back.

Chronic pyelonephritis leads to scarring of part of the parenchyma

First, it is local, then spreads along the hypochondrium anteriorly into the abdomen. With inflammation of both kidneys, they become encircling. The patient is disturbed by cramps during urination and increased urge.

Purulent complications develop as small multiple abscesses (apostematous pyelonephritis) or carbuncles, boils. Renal stone disease is associated with pyelonephritis, which provides favorable conditions for infection of the parenchyma.

The diagnosis is made on the basis of indicators of urine analysis (leukocytes, pus, mucus, erythrocytes), a test according to Nechiporenko, confirmation of the presence of an infection with a seeding tank. Hardware techniques (ultrasound, excretory urography). If necessary, cystoscopy and angiography of the renal vessels are performed. Consultation of a gynecologist is obligatory for women; in men, a urologist examines the prostate.

In the treatment, diet, antibacterial agents, anti-inflammatory and diuretic herbs are used. In the absence of a result and the threat of sepsis, the abscess in the kidney is surgically removed along with the affected area of ​​the organ. If the kidney is not viable, then a nephrectomy is performed.

Urolithiasis disease

Formed due to the precipitation of salts, their adhesion to insoluble calculus (stones). The cause is impaired metabolism, local chronic inflammatory process, conditions accompanied by a significant loss of fluid (diarrhea, vomiting, lack of sufficient drinking in the heat, uncontrolled use of diuretics).

The most commonly found stones are crystals of oxalate, phosphate and urate.

The main symptom of the disease is an attack renal colic: acute pain in the lower back and in the side with irradiation in the hypochondrium in front, down the abdomen, groin and external genitals. It is caused by a stone blocking the urine outflow tract, spastic contraction of the muscle layer of the ureter.

It is often provoked by the experienced shaking in transport, jogging or jumping in the gym, heavy physical exertion. At the height of pain, patients are agitated, vomiting, headache, bloating, constipation is possible. The attack lasts from a few minutes to 5-6 hours. At the end, fresh blood is excreted in the urine.

In the interictal period, the patient feels dull pain in the lower back

For diagnostics, in addition to urinalysis, contrast methods of X-ray examination of the urinary tract, ultrasound, cystoscopy are needed. In the treatment, a diet is used depending on the type of salt sediment of urine, diuretic herbs, uroantiseptics, vitamins to restore the correct metabolism, special mineral water... Lack of effect and frequent attacks- indications for prompt stone removal.

Bruises and fractures of the ribs

With the received closed injury the right side of the chest and lumbar region are most often affected by the ribs. The ribs account for up to 15% of all fractures. Important feature- the possibility of injury to internal organs.

The neurovascular bundle supplying the muscles is necessarily damaged. Ribs from pairs V to VIII break more often. From IX and below, fractures are rare, since these ribs have sufficient mobility.

Pain is one of the main signs of a fracture. It is maximal in the area of ​​injury, given along the intercostal space anteriorly. Typically, increased breathing, movement, coughing. Decreases when seated.

At the same time, the victim is observed:

• shallow rapid breathing;
• lag of the injured part of the chest;
• bruising and swelling at the fracture site.

With several fragments, the doctor feels a crunch on palpation, the sound of bone rubbing. In case of complications develop:

• subcutaneous emphysema - due to rib damage to the lung tissue, air escapes under the skin;
• hemoptysis - complements the picture of a damaged lung;
• pneumothorax - drawing the air stream into the pleural cavity, can displace the lung into the mediastinum and cause cardiac arrest, pleuropulmonary shock;
• hemothorax - an accumulation of blood in pleural cavity.
• inflammation of the lung.

Diagnosis begins with an examination, the doctor pays attention to bruising, the patient's inability to breathe deeply, soreness and local signs on palpation

In doubtful cases, tests are used to compress the chest, tilt the body to the healthy side. With a fracture of the ribs, the soreness increases sharply. X-rays confirm the presence of bone fragments. Treatment is reduced to anesthesia with injection blockade alcohol solution Procaine applied with a circular bandage to create immobility.

Retroperitoneal hematoma

It is formed by the accumulation of blood as a result of rupture of blood vessels, damage to organs, fractures of the pelvic bones, ribs, and spine. Possible reason- a strong blow in case of an accident, falling from a height. The hematoma can hold up to 3 liters of blood. In the area of ​​the right hypochondrium, parenchymal organs (liver, kidneys, pancreas) are subject to injury.

Depending on the depth and nature of organ damage, breaks are distinguished:

• superficial - their depth is up to 3 cm;
• deep - penetrate deeper than 3 cm;
• central - localized in the area of ​​the gate of the organ;
• subcapsular - lesions are superficial or central in nature with a preserved capsule;
• separation and crushing of part or all of the organ.

The hollow organs of the right hypochondrium (gallbladder, duodenum) are damaged in the form of injury in the form of: tearing of the membrane, complete rupture, separation or crushing. The nature of the pain is determined by the severity of the injury.

Patients complain of a sharp pain in the abdomen, under the ribs, on the lateral surface, in the lower back, with movements it becomes unbearable, dizziness, weakness due to blood loss, in a shock state, intestinal paresis is possible with the cessation of peristalsis.

With a small hematoma, the symptoms are scanty: dull or aching pains that are caused by compression of the surrounding organs. In the diagnosis, the experience of the doctor is important, the ability to palpate the abdomen, and find out the accompanying signs of pain. Ultrasound, magnetic resonance imaging helps.

Treatment is needed as early as possible. Shock fighting is underway therapeutic agents, the introduction of hemostatic drugs. In cases of severe injury, surgery to stop the bleeding is necessary.

If it hurts in the hypochondrium in front with radiation to the back

There are enough reverse options pain syndrome in the hypochondrium. Consider diseases that cause pain in the right hypochondrium radiating to the back.

Cholelithiasis and cholecystitis

The formation of stones and inflammation in the gallbladder are associated with common aggravating circumstances. It is difficult to find out what comes first - an infection or stagnation of bile. One pathology complicates and provokes another. There is calculous cholecystitis, which combines both nosologies.

Inflammatory edema or stones in the bladder cause stretching of the organ and pain in the right hypochondrium. Exacerbation of cholecystitis is accompanied by sharp pain radiating to the back, high fever, nausea, vomiting, bitterness, belching.

Provoke the condition: violation of the diet (fatty, spicy and fried foods), long hungry days, breaks in eating, drinking alcohol, stressful situations, physical labor, infectious diseases.

Outside of exacerbation, the pains are dull, aching in nature. An attack of gallstone disease is characterized by the absence of an increase in temperature, sudden cutting pain in the hypochondrium on the right and irradiation along the right side of the abdomen to the side and back, right shoulder, collarbone, scapula.

Due to the release of bilirubin into the blood, the sclera, then the skin, turn yellow in the patient. There is a gray color of feces, dark urine.

The attack stops if the stone passes into the intestines. With prolonged blockage of the gallbladder, the appearance of pulsating pain, an urgent operation is necessary, since a gangrenous or phlegmonous gallbladder can rupture at any time. Content hitting abdominal cavity will cause severe peritonitis.

In diagnostics, biochemical tests, determination of bilirubin in the blood and urine, ultrasound of the liver area are used. Patients are advised to follow a strict diet and diet for therapeutic and prophylactic purposes.

One of the causes of inflammation of the pancreas is a violation of the outflow of secretion

Pancreatitis

Inflammation of the pancreas is triggered by cholelithiasis, cholecystitis and duodenitis, alcohol intake, organ trauma, addiction to fatty and spicy foods. It proceeds in an acute and chronic form. They differ in intensity clinical manifestations, the ability of tissues to restore functions and structure.

Chronic pancreatitis is accompanied by irreversible replacement of the parenchyma with scar tissue. Pain in the right hypochondrium of the girdle type is characteristic of lesions of the head of the pancreas. At the same time, there are:

• nausea with vomiting;
• the temperature rises;
• weakness is growing;
• bloating;
• diarrhea with a greasy film covering the stool;
• decreased appetite.

To make a diagnosis, the enzyme composition of blood, urine, scatological analysis... With the help of ultrasound, computed tomography, it is possible to reveal the swelling of the organ, the violation of the patency of the ducts. The treatment uses: strict diet with hunger in the early days, anti-inflammatory drugs, enzymes, antispasmodics, vitamins.

Subhepatic abscess

The disease is most often a complication of cholecystitis, purulent appendicitis, acute necrosis of the pancreas, sepsis. An enclosed abscess forms under the lower surface of the liver between the intestinal loops.

Symptoms differ depending on the underlying disease. Most often, among the signs:

• intense constant pain under the ribs on the right, aggravated by breathing, radiating to the back, collarbone, scapula, shoulder;
• heat with chills;
• palpitations and a tendency to hypotension;
• severe intoxication (nausea, headache).

Perhaps a less pronounced course with moderate pain, low temperature. The pain syndrome is characterized by an increase in pressure on the liver area.

In diagnostics, ultrasound is used, CT scan, blood counts. Necessary hospital treatment antibiotics, detoxification against the background of an operation to drain the abscess.

Inflammation appendix does not always proceed classically. The disease is provoked by fecal masses that have blocked the lumen, impaired blood supply, and decreased motility of the colon.

The free edge of the appendix can extend into the subhepatic space and beyond the peritoneum

Atypical pain during an attack may occur in the right hypochondrium. It is enhanced by breathing, coughing, movement, position on the left side. It may at first be aching in nature, give in the back, be accompanied by malaise, nausea.

Then the temperature rises to high numbers, vomiting appears, unstable stool, the pain becomes more intense. Suppuration is characterized by pulsation in the right iliac zone. Diagnostic signs are difficult to distinguish from other diseases of the right hypochondrium.

Therefore, doctors observe the dynamics of the disease, conduct repeated blood tests. It is very important to operate the patient in a timely manner and remove the inflamed process. The risk of rupture and peritonitis increases with each passing hour. Antibiotics are prescribed before and after surgery.

When does pain in the hypochondrium cause respiratory diseases?

General border zone(diaphragm) and participation in the act of breathing contribute to the reflected pain manifestations in the right hypochondrium with diseases of the lung and pleura with right-sided localization.

• tide - causes the filling of the pulmonary vessels with blood and the release of fibrin into the alveoli;
• red hepatization - the tissue becomes denser, its structure becomes similar to the liver, the number of erythrocytes increases;
• gray hepacy - erythrocytes disintegrate, leukocytes accumulate in the alveoli;
• resolution - reverse development of the process and restoration of lung tissue.

Acute pain occurs in the area of ​​the scapula, in other parts of the chest. It is capable of radiating to the right hypochondrium, belly. The pain increases with coughing, sudden movements, physical activity... Patients have fever, shortness of breath, and cough up sputum streaked with blood.

The diagnosis is confirmed by percussion and auscultation of the lung, on the roentgenogram. There are characteristic changes in the blood, in the analysis of sputum. Pneumonia is treated antibacterial agents or, depending on the cause, antifungal and antiviral drugs.

Judging by the picture, the whole lobe of the right lung is affected, it is completely switched off from breathing

Right-sided pleurisy

Inflammation of the pleural sheets accompanies pneumonia, tuberculosis, chest trauma, acute pancreatitis, and allergic manifestations. Characterized by intense cutting pain in chest, the area of ​​the scapula, in the lower back, under the ribs. The patient is worried about shortness of breath, painful cough, high fever, severe intoxication.

The diagnosis is confirmed by x-ray. Treat pleurisy antibacterial drugs, anti-tuberculosis and antihistamines... With a significant accumulation of fluid, a puncture is performed with pumping out and washing of the pleural cavity, antibiotics are injected into it. Pain in the back and under the ribs cannot be considered in isolation without other manifestations and diagnosed based on them. The symptom is assessed only after examination and identification of the cause.