Causes of Upper Right Side Abdominal Pain

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Pain is not a pleasant experience no matter where it occurred in the body. Pain on the right side of the abdomen can be either in the upper part or lower part. Pain in the upper right abdominal region may be superficial or deep. Superficial causes may be attributed to the abdominal wall (skin and muscles), peritoneum, liver and gallbladder. Deeper pain may be due to the liver, bile ducts, stomach, duodenum and kidneys.

This is associated with the lung tissue itself (rare), lining of the lung (pleura) or space around the lung (pleural space). Lung and pleural diseases that may cause right sided abdominal pain include:
Pneumonia (bacterial or viral) of the lower lobe of the right lung.
Pleurisy or pleuritis (inflammation of the lung membrane) from infection, trauma and so on.


Breathing difficulty
Pain upon breathing/moving


The liver is an important consideration in upper right abdominal pain as it occupies most of this region. As a large organ with diverse functions, and the central processing unit of nutrients, the liver is prone to a variety of disorders. Liver conditions that may cause right sided abdominal pain include:
Enlarged liver due to heart failure, hepatitis, fatty liver, lymphoma, leukemia, etc.
Liver cancer or metastases of other cancer into the liver.

Changes in bowel movements
Consistency of stool
Nutrient deficiencies
Changes in appetite
Weight loss

Gallbladder/ Biliary Tract

The gallbladder stores bile that is produced in the liver. This fluid contains various compounds, particularly waste substances and fats, and can emulsify fats in the gut to allow for digestion and subsequent absorption. Bile is passed through the biliary tracts which communicate with the pancreatic duct before emptying into the duodenum, the first part of the small intestine. Conditions of the gallbladder and biliary tree that may cause right sided abdominal pain include:
Gallstones or bile duct stones
Gallbladder inflammation (cystitis), mostly due to gallstones.
Inflammation or blockage of the biliary tree (cholangitis) (cystic, or common bile duct)
Gallbladder and biliary cancer are rare


Fatty stools
The duodenum is the first part of the small intestine and an important site for digestion. It receives the partially digested food mixed with gastric acid and enzymes from the stomach and then bile and digestive enzymes from the pancreas. It is often affected with the same pathologies that afflict the stomach, often a combination of infection and the presence of gastric acid in the duodenum for prolonged periods. Some of the conditions of the duodenum that may cause right sided abdominal pain include:

Duodenal ulcer

Duodenitis – inflammation of the duodenum similar to gastritis (stomach).


Severe pain after eating,
Change in bowel movements
Excessive belching

The abdominal muscles comprise several groups of muscles that protect the abdominal contents, stabilize the trunk during movement and help with changes in position. Since the abdominal cavity lacks an extensive skeletal protection like the thoracic cavity, the abdominal muscles have to contend with significant impact in trauma. Some conditions affecting the abdominal muscles that may cause right sided abdominal pain includes:
Strained muscles
Blunt force trauma
Rectus sheath haematoma
Psoas abscess


Painting when moving
Tenderness on palpation of the affected area

The kidney is responsible for filtering the blood and forming urine. Electrolytes and water are reabsorbed as necessary and the urine is directed down the ureter to the bladder. The kidney is tucked behind and slightly below the liver on the right side of the abdomen to lie shielded by the back part of the ribcage. Some conditions affecting the kidney and ureter that may cause right side abdominal pain includes:
Kidney/urinary stones
Renal carcinoma


Changes in the urine color and composition
Alterations in urinary habits

The diaphragm is the large concave muscle that separates the thoracic and abdominal cavities. It is the major muscle of respiration and on the right side, it houses the liver immediately beneath it. When contracted, the diaphragm pushes down the abdominal contents to expand the chest cavity. Some of the conditions of the diaphragm that may cause right sided abdominal pain include abscess under diaphragm.

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