Right Flank Pain, Under the Ribcage, and in the Lower Back

Pain in the right flank may or may not indicate a more serious health problem.

It is important to note its character, intensity, direction, and other warning signs. These may precede it, provoke it, or are otherwise related to it. Right flank pain should not be underestimated if it persists for a long time.

In case of prolonged occurrence, professional examination is important.

Sharp pain on the right side during movement

If there is pain on the right side below the ribs, for example with greater physical exertion and when moving in running, it may be a reaction to excessive physical exercise and an increase in blood supply to the abdominal organs.

It occurs especially when the organism is not conditioned and accustomed to increased physical stress. After the interruption of activity, the pain subsides.

The cause is increased blood supply to the liver and spleen. A tension between these organs arises, which subsequently provokes an unpleasant stabbing pain. At rest, the engorgement is reduced, and hence the tension caused by the increased blood filling.

This pain is not a symptom of a disease.

Gallbladder and kidney

Pain in this part of the body can also be behind another problem.

To a large extent, it signals difficulties with the gallbladder or the liver.

Intense colicky or dull pain in the right flank is the most commonsymptom for gallstones. The onset of heaviness is often after a heavy and fatty meal, i.e. with inappropriate diet.

If it is associated with pain in the side, back, shins and lower back, it may be a kidney problem.

As with the gallbladder, here the pain can be triggered by a stone.

The cause can be a bladder stone or a kidney stone. In addition to urolithiasis it can also be an inflammation of the excretory system.

Additional complications besides pain:

• blood in the urine, first microscopically (not visible to the eye), then macroscopically (visible to the eye)
• urge to urinate
• frequent urination
  • small amounts of urine
• pain when urinating
• urinary restriction, urinary retention
• chills
• increased body temperature, fever
• nausea, vomiting

Pain can radiate from the right lumbar area to the lower back, flank, abdomen, lower abdomen, groin and testicles.

It can also be pain in the back of the left side and in the sacrum. It depends on which side is affected.

Given that on the sides can shoot pain in several organs, not only the abdominal cavity, it is always necessary to have a professional examination by a doctor. We do not recommend self-diagnosis.

A lot also depends on whether the pain is in the right side under the ribs, in the back, or if the pain is just shooting into the side from the inside, and also on whether the pain in the left side is not gradually going away.

Medicines and dietary supplements used in gallbladder and liver diseases:

• Rowachol gtt 10ml - it is recommended for the treatment of liver and gallbladder diseases and for the dissolution of gallstones (it increases bile secretion, relieves spasms of the bile ducts and increases the metabolic function of the liver by reducing the accumulation of bile).
  It is also suitable as an adjunct to the treatment of diabetes, but controls of the disease state are important. It is also available in the form of Rowachol cps 50 capsules.

• Cholagol gtt 10ml - this medicine is used in the treatment of gallstones, in chronic inflammation of the gallbladder, in conditions after biliary surgery with indigestion, and in case of indigestion in chronic liver diseases.

• Febichol- is used to treat digestive discomfort in chronic (long-term) diseases of the liver and bile ducts (gallbladder disorders, long-term inflammation of the gallbladder, long-term gallstone formation, long-term liver disease accompanied by a disorder or disease of the bile ducts), and conditions after surgical removal of the gallbladder or after inflammation of the liver (hepatitis).The drug will increase the secretion of bile from the liver into the small intestine, thereby eliminating or relieving digestive discomforts (such as feelings of pain or pressure under the right rib cage, belching, bloating, diarrhea, lack of appetite, and intolerance to certain, especially fatty or meaty foods) caused by disorders of bile secretion.

• Essentiale Forte N cps is a herbal medicine used to treat liver diseases.It contains so-called essential (basic) phospholipids, which are part of cell membranes. In liver diseases in which the metabolism of the liver cell is disturbed, the phospholipids thus administered are preferentially used by the liver cells and incorporated into their cell membrane. Essentiale forte N is used to improve subjective health complaints such as lack of appetite, a feeling of pressure in the right abdomen as a result of toxic-nutritional damage to the liver, and in hepatitis.

• Silymarín is a complex of active substances isolated from the seed of the fruit of the Milk Thistle plant (Silybum marianum), has a protective effect on liver cells, restores and improves the activity of damaged liver cells, helps liver regeneration.Dietary supplements containing silymarin are e.g. Livinorm cps, Silymarin Generica 140mg cps, SilymarinDuo cps, Silymarin Nefdesanté tbl, Silymarin+ cps 60.

Pain in the right side of the abdomen and under the ribs

As we mentioned, pain on the right side of the abdomen and under the ribs is a common symptom of a gallbladder problem.

If the intense pain is accompanied by nausea and vomiting, it is very likely to be gallbladder colic in case of a blockage the bile duct caused by a gallstone. If there is a high fever, it can be caused by inflammation of the gallbladder or the bile ducts.

Another example occurs in the case of ulcer disease. There is pain under the right rib arch marks a duodenal ulcer. Conversely, if there is pain under the left-side ribs, it may be a stomach ulcer.

Pain in the left side below the ribs is also a symptom of difficulty with the spleen.

In addition to the gallbladder, a liver problem also manifests in this way. For example, it can be inflammation of the liver in the form of viral hepatitis. Viral hepatitis is divided into Hepatitis A, B, C, D, E and G.

Learn more: An article on Hepatitis.

It's not just the virus that causes liver damage.

Pain also occurs due to the toxic effects of alcohol or medication, e.g. an overdose of paracetamol-containing meds. Paracetamol is an active substance administered against pain and fever.

Liver damage in mushroom poisoning is also common.

Pain or uncomfortable pressure in the right lower abdomen is also felt in case of liver enlargement, i.e. in hepatomegaly. The condition is also part of a right ventricular heart failure. There are multiple causes behind liver enlargement.

We provide information in a separate article about this symptom - liver enlargement.

In the worst case, pain can also be a symptom of an already advanced oncological disease, e.g. a liver tumour or metastasis of another liver tumour. See also the article on liver cancer for more information.

However, this is usually also manifested by impaired function of the organ itself. The condition is associated with yellowish skin due to icterus. The white of the eye will also turn yellow.

Question: Does appendicitis cause pain on the right flank?

Yes, if the pain occurs first around the navel and later moves to the area of the right lower abdomen, it is necessary to get it looked at by a doctor.

It is often in this way that the symptoms of appendicitis, or inflammation of the appendix, begin. Along with the pain, there is a rise in body temperature. Inflammation can take place acutely - suddenly or chronically - prolonged, over a longer period.

In chronic appendicitis, the discomfort flares up, then subsides and returns again at a later time.

Apart from direct organ involvement, any muscular or nervous problems should also be taken into account.

An example is a stretch, muscle tear, or inflammation of muscle tissue. Neurological problems are also unpleasant, such as inflammation of a nerve, as is also the case with shingles. 

Unpleasant are the pain in the ribs as a result of an injury. Bruised or fractured ribs cause intense pain, which in both cases is unpleasant and is aggravated by a change in position and movement. Pain when inhaling is frequent.

Right flank and back pain

Right flank and back pain or when pain is radiating from the back to the flank is usually kidney or urinary tract related. The kidneys are part of the excretory system of a person and have a very important function within the filtration of the blood. Inflammation and infection in the kidneys present with pain and failure of function.

This can be seen, for example, in the discoloration of the urine. In addition to inflammation of the kidneys, inflammation of the urinary tract can also occur, which can also be manifested as referred pain from the right side to the back.

But not only inflammation, but also, for example, kidney and bladder stones are the cause of pain. Colicky pain is very intense because these stones erode the walls of the ureter or make it difficult for urine to flow.

In addition to organ pain, nerve pain can also affect the flank and the back, for example, due to a herniated disc or vertebrogenic pain. 

The vertebral disc pinches the nerve, which in turn causes pain. Of course, the pain is in the spine, but it is common for it to radiate to the side, under the ribs, but also into the abdomen.

This condition is commonly referred to as a lumbago attack or low back pain. Acute lumbago arises most often with sudden movement, when lifting a heavy object, but also as a result of cathcing a cold in this area.

Rest, medications and application of dry heat are important. Avoid wet forms of heat, such as a hot shower.

Excluding difficulties due to a displaced intervertebral disc, the cause of difficulties can be a bony outgrowth or a bone tumour. However, if the pain is sharp, it is most likely a pinched nerve.

Right-flank pain during pregnancy

Of course, pain also occurs during pregnancy.

It is important to observe the other symptoms as they can precede the pain or occur at the same time, or observe whether the pain in the right flank is caused not only by touch, but also preceded by bleeding, nausea and the like.

Also during pregnancy, a woman may be troubled by gallstones and bladder stones. If there is pain, it goes towards the lower back and the entire back, and there may be a problem with the kidneys and the urinary tract.

Pregnant women are more susceptible to infection and inflammation of the urinary tract. Alternatively, even to the extension of inflammation to the kidneys. Sometimes, especially in the first pregnancy, there may be a problem with the uterus that is expanding or pressure on the fetus. This can also cause pain on the left side.

If the pain is acute or even chronic, it is always better to see a doctor. There will be an ultrasound exam to find out if the baby is moving. Alternatively, he or she will also do laboratory tests, for example, blood and urine tests.

Pain on the sides and below the abdomen

This pain can be a symptom of an ectopic pregnancy, but this is detected at the first ultrasound examination.

It is necessary to consider other women's problems, for example, endometriosis or ovarian cysts. These generally present with pain. 

Various inflammatory diseases can occur, but also sexually transmitted diseases. The pain is mostly localized in the lower abdomen. However, it can also radiate to the right flank area.

Some women experience ovulatory or menstrual pain.

Summary

• if the pain in the right side is only with physical exertion, it is probably not a serious condition
• if you have pain under your ribs on the right, it is most often gallbladder or liver problems and a specialist medical examination is needed
• if the onset of pain is around the navel and gradually passes more intensely to the right side, namely the lower abdomen, it is a typical concomitant of appendicitis
• of course, it is always necessary to rule out non-organic problems of a muscular or nervous character
• pain in this area can also come from the abdominal cavity or from the back, so it is necessary to look for the cause there as well
• during pregnancy, pain on the right side of the hip is usually harmless and frequent, but it also depends on its intensity, time of occurrence and other associated symptoms and manifestations
• there are diseases that manifest themselves in this way and are statistically less likely causes, such as pulmonary embolism, right-sided heart failure and so on. However, they can only be ruled out by medical examination
• sometimes it can also be a manifestation of ordinary constipation, but then there is also pain in the left side in the area of the intestines and bloating

Other diseases that may be causing pain in the right side or radiating to that area:

• Inflammation of the stomach
• Crohn's disease
• Ulcerative colitis
• Irritable bowel syndrome
• Ileus, i.e. intestinal obstruction
• Diverticulitis
• Peritonitis
• Colon cancer
• Portal hypertension
• Intestinal infections
• Bloating, flatulence
• Diarrhoeal diseases
• Constipation
• Bleeding into the abdomen
• Adrenal tumour

The extraperitoneal area as a source of pain:

• Inflammation of the pleura
• Pneumonia
• Lung cancer
• Tietz syndrome
• Bleeding into the chest cavity
• Sexually transmitted diseases
• Dehydration