Right-Sided Abdominal Pain: Understanding Causes and Treatment Options

Introduction

Our abdomen is like a complex puzzle and contains many vital organs that help keep us healthy. It’s also common to experience pain in this area, especially on the right side. In this article, we’ll discuss what can cause such pain. We’ll also discuss ways to diagnose the cause, how to manage or relieve the pain, and when to visit the doctor. Lastly, we will answer some frequently asked questions regarding this topic. 

Causes of Right-Sided Abdominal Pain

Knowing the potential causes of right-sided abdominal pain is essential, as they lead to an accurate diagnosis and better management outcomes.

1. Acute Causes

Acute causes are conditions in which pain onset is rapid. These conditions also sometimes occur along with vomiting, fever, nausea, and abdominal distension that needs instant medical help¹. They include: 

• Appendicitis: This pain is caused by an inflamed appendix. It is often coupled with a high fever and nausea².
• Gallstones: Stones in the gallbladder or those moving towards the bile ducts, may sometimes lead to pain and also block the bile ducts³.  
• Kidney stones: Stones in the kidney lead to sudden intense pain. If the stones get stuck in the urinary tract, pain usually occurs with nausea⁴.  
• Ectopic pregnancy: This is a serious condition that may occur during the first trimester, where a fertilised egg implants outside the womb. It can cause vaginal bleeding and abdominal pain⁵.  
• Ovarian torsion: The ovary twists around the ligaments that hold it in place, cutting off its blood supply. The lack of blood flow to the ovary causes more intense pain⁶.

2. Chronic (Intermittent or Episodic) Causes

Chronic right-sided pain refers to pain that may come and go, may occur constantly, and last for more than 3 months. It often requires medical checkup and identifying the exact cause of the pain is challenging⁷. This type of pain may occur due to 

• Irritable Bowel Syndrome (IBS): This is a common disorder associated with abdominal pain that worsens during or after bowel movements. IBS may change the frequency and appearance of stools⁷.
• Inflammatory Bowel Disease (IBD): IBD refers to conditions that cause chronic inflammation of the digestive tract, like Crohn’s disease and ulcerative colitis. Common IBD symptoms include bloody and loose stools, an urgent need to pass stools, difficulty controlling bowel movements, weight loss, and fever⁷. 
• Endometriosis: This is a painful condition in which tissue similar to the lining of the uterus grows outside the uterus and sometimes on other organs in the abdomen. It can cause pain, often accompanied by nausea, vomiting, and loose stools⁸. 
• Pelvic Inflammatory Disease (PID): An infection in the female reproductive organs, it often presents as chronic pain in the pelvic region, abnormal vaginal discharge or bleeding and pain during intercourse⁹.

3. Progressive Causes

Progressive causes of the pain in your right side are often conditions that get worse over time. They will likely need a doctor’s help.

• Liver disorders: Liver issues like acute hepatitis, liver abscess, and perihepatitis that lead to right-sided pain¹.
• Kidney disorders: Conditions that affect the kidneys, like kidney infection or kidney cancer, can cause one-sided pain¹⁰.
• Gastrointestinal issues: Issues like ulcers, gastritis, and acid reflux disease (GERD) may be linked to ongoing abdominal pain¹. 

Diagnosis of Right-Sided Abdominal Pain

Diagnosing right-sided abdominal pain accurately is the first important step for choosing the right management option.  

1. Medical History

A detailed medical history can help doctors identify the possible causes of abdominal pain¹. This includes checking for parameters such as:

• Pain: Site, type, radiating or not, starting and ending time, and triggering and pain relieving factors such as food and/or position that relieves the pain¹.
• Other symptoms: Fever, nausea, vomiting, weight loss, cough, difficulty in breathing, chest pain, blood in urine and in stool, constipation, and loss of appetite¹.
• History of past disease or current health conditions: High blood pressure, heart disease, conditions related to the liver and gut, gastritis, and any past surgeries¹.
• Medications: Ongoing medication that may cause constipation, ulcer, or immunosuppression¹.
• Habits: Alcohol intake (it may lead to liver disease)¹.
• Travel history: To rule out infection or inflammation¹.
• Period and Pregnancy history: To rule out gynaecological or pregnancy causes in females of reproductive age¹¹.
• Other histories: Allergies, last food intake, and any trauma in the abdomen¹¹.

2. Physical Examination

Physical examination can help doctors find the cause of pain and help in treatment decisions¹². This may include:

• Abdominal examination: The abdomen will be visually examined by checking for any visible swelling, skin changes, distention of the abdomen, signs of trauma, any foreign objects, and entry and exit wounds¹¹.
• Palpation: The doctor will gently press on different parts of the abdomen to check for tender spots, hardness, or swelling¹¹.
• Auscultation: The abdomen will be checked to assess internal sounds¹¹.

3. Imaging Studies

Imaging studies provide detailed information about the internal structures of the abdomen and include: 

• Ultrasound: Useful for detecting blockages, and other abnormalities. Ultrasounds are considered the first line of investigation by doctors¹¹.
• Transvaginal sonography: This may help detect abnormalities in the female reproductive system¹¹.
• CT scan: Provides a slice-by-slice view of abdominal organs, allowing a detailed study of their structure and function. It is widely used for accurate diagnosis¹¹.
• MRI: It is used when additional investigation is required along with ultrasound to determine the cause of pain¹.

4. Laboratory Tests

Laboratory tests may also be used to help diagnose the cause of right-sided pain. These include:  

• Complete blood count (CBC): This test evaluates blood cell levels to check for infection, inflammation, or other abnormalities¹¹.
• Urinalysis: This test checks for infections or other issues in the urinary tract or kidneys¹¹.  
• Liver function tests: This set of tests helps rule out hepatitis, infections and any obstructions that affect the liver¹¹.

Management Options for Right-sided Abdominal Pain

The management of pain depends on its root cause. Some individuals might get better with simple home remedies, while others need medical or surgical help. 

1. Home Remedies

In minor cases of abdominal pain, the following home remedies may help:

• Apply heat: Using a heating pad or warm compress on the affected area may help relax muscles and ease the pain.
• Rest and relaxation: Adequate rest and calming practices like deep breathing exercises or meditation may help reduce stress and ease discomfort.
• Hydration: Drink plenty of water to stay hydrated.
• Modify food intake: Restrict solid foods temporarily if needed.
• For vomiting: Avoid eating for at least 6 hours and then consume a very light diet.
• After meals: Take antacids to help reduce the pain.
• Avoid trigger foods: Limit the intake of foods like caffeine, citrus fruits, high-fat foods, tomato products, fried or greasy foods, alcohol, and carbonated beverages¹³.

2. Medical Interventions

More serious or persistent abdominal pain may need medical therapy, as follows.  

• Pain management: The doctor may prescribe medicines like ibuprofen, acetaminophen, or fentany depending on the intensity of pain¹.
• Antibiotic therapy: For abdominal pain due to infections, you may be prescribed antibiotics¹¹. 
• Antacids and Antiemetic: To relieve pain related to gas or for vomiting, antacids and antiemetics may be prescribed¹¹.
• Hormonal therapy for endometriosis: For people with endometriosis, hormonal therapies (along with painkillers) can help balance hormone levels and reduce the pain⁸.

Remember to refrain from self-medication and always take medication only when and as prescribed by your doctor. 

Hormonal imbalance may also contribute to abdominal pain. Hormones like serotonin and cholecystokinin can affect how food moves through your intestine and can influence symptoms of pain, fullness or nausea. If you’re experiencing abdominal pain, it’s helpful to consider how hormonal changes might play a role.

Dr. Nayana Shetty, MBBS, MD

3. Surgical Interventions

In situations where the right-sided pain doesn’t respond to conservative therapy, the doctor may recommend surgery.

• Appendectomy: If appendicitis is causing the pain, surgery may be recommended to remove the appendix².
• Cholecystectomy (gallbladder removal): Gallstones or an infected gallbladder may need surgery to remove the gallbladder in some cases³.
• Kidney stone removal: If a kidney stone is too large to pass naturally or is causing severe pain or complications, your doctor may recommend surgical intervention to remove it⁴. 

When to Seek Medical Advice?

You must know when to get medical advice for right-sided abdominal pain. You should book an appointment with your doctor in the following cases.

• Pain: When you have severe and sudden onset of pain, you should consult a doctor immediately¹.
• Associated Symptoms: When you have fever, vomiting, distention, and nausea along with pain, or unexplained weight loss, it is essential to seek a doctor for proper management of your condition¹.

Management of Right-Sided Abdominal Pain and Strategies to Reduce Its Risk

Taking steps towards a healthy lifestyle may help avoid certain causes of right-sided pain. 

Lifestyle Modifications

• Diet and nutrition: Eating a balanced diet that includes fruits, adequate fibre, and vegetables may help reduce the risk of acute abdominal pain¹³.
• Exercise and physical activity: Regular exercise has many health benefits. It helps maintain good digestion and may also help in reducing inflammation¹⁴.
• Stress management: Studies suggest a link between stress and abdominal pain¹⁵. Stress reduction techniques like deep breathing exercises, yoga, and meditation may help with stress management and support overall mental well-being¹⁶.

Routine Health Screenings

• Annual check-ups: Regular check-ups with your healthcare professional can help in the early detection and management of many health conditions¹⁷.

Conclusion

Right-sided abdominal pain can have multiple causes and may vary in severity. Understanding the causes, symptoms, and management options can help you make informed decisions about your healthcare. Moreover, maintaining a healthy lifestyle, reducing stress, and getting regular health check-ups may help avoid many health conditions.

Frequently Asked Questions (FAQs)

References

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