Right Upper Quadrant Pain Under Ribs: Causes and Treatments

Upper right abdominal pain under the ribs can be caused by a number of health issues ranging from mild to life-threatening. The right upper part of the abdomen is also known as the right upper quadrant, or RUQ. Organs in the upper right side of your body include your liver, gallbladder, right kidney, right lung, pancreas, and part of your colon and stomach. Right upper quadrant pain (RUQ) can feel sharp and stabbing if caused by trapped gas or a kidney stone. Or, you could have persistent gnawing or cramping pains if you have inflammation or infection in any of the organs in your upper right abdomen.

Although it’s rare that upper right abdominal pain is cardiac related, you should never ignore any kind of chest pain in your right or left side.

There are also muscles in between your ribs (intercostal muscles) that can cause agonizing pain that starts in your back and wrap around to the front of your chest. Relentless aches or burning pains can also radiate from other organs or muscles and feel as if the pain is coming from below your right ribs.

If you are wondering what it means to have upper right quadrant pain below your ribs, you will find the answer in this article. I will also examine how to treat various causes of right-sided abdominal pain.

Symptoms of Upper Right Abdominal Pain

Cramping aches or short sharp stabbing pains under your ribs on the right side could also be accompanied by other symptoms. Depending on the reason for your right-sided pain in your upper quadrant, you may also have:

• Burning sensation in your chest
• Feeling of something stuck in your throat
• Shortness of breath
• Sharp, jabbing chest pains when you cough, sneeze, or breathe deeply
• Changes in bowel habits like diarrhea or constipation
• Excruciating pain that starts in the middle of your back and spreads to your groin

Upper Right Abdominal Pain Caused by Internal Organs

Let’s look in more detail at what can be causing pain in your upper right side.

Gallstones

Stones in your gallbladder can cause a blockage in the bile duct that results in upper right abdominal pain that can last for a few hours. Gallstones are small hardened deposits of bile that can range in size from a grain of sand to a golf ball.

The Nigerian Journal of Surgery reports that the most typical symptom of gallstones is intense right upper quadrant pain just below the ribs. Sometimes, the abdominal pain can radiate and cause right-sided shoulder pain. The upper abdominal pain usually happens after a fatty meal and often in the evening.¹

Infections of the gallbladder could also cause sharp pains on the right side of your stomach because of inflammation. Other symptoms of gallbladder problems can include:

• Nausea and vomiting
• Right-sided pain that gradually gets worse
• Fever (if there is an infection in the gallbladder)
• Digestive problems like heartburn, gas, or bloating

Kidney stones

Kidney stones can cause agonizing right-sided abdominal pain and back pain if your right kidney is affected. Kidney stones appear when deposits of minerals form into small stone-like objects.

The book Endotext reports that kidney stones cause pain if they move in the urinary tract. This can cause flank pain on the side of the affected kidney. The sharp acute pain can also be felt just below the ribs and nearer the lower abdomen. This type of abdominal pain is usually referred to as renal colic.²

According to doctors from the Mayo Clinic, other symptoms of kidney stones can include any of the following:³

• Extreme pain when urinating
• Passing urine with an abnormal color – urine could be pink, red, brown, or cloudy urine
• An offensive smell from urine
• Pain radiating from your abdomen to groin area
• Sharp abdominal pains that come and go
• Signs of an infection

Drinking diluted apple cider vinegar is an effective home remedy for dissolving kidney stones. The acidic nature of apple cider vinegar also helps to flush out toxins from your kidneys and prevent kidney stones from forming.

Pancreatitis

Your pancreas is located in your upper abdomen to the right of the center of your chest. Inflammation of the pancreas can cause varying degrees of upper abdominal pain that can come and go or be persistent.

According to the journal The Annals of Royal College of Surgeons of England, pancreatitis can be a reason for recurring RUQ pain.⁴ However, Dr. Charles Patrick Davis on eMedicineHealth says that pancreatitis more often causes upper middle abdominal pain or upper left abdominal pain. The aching intense pain may be worse after eating and can last a few days.⁵

Apart from causing upper abdominal pain under your ribs, acute pancreatitis can also cause any of the following conditions:

• Severe pain that radiates to your back from your abdomen
• Abdominal pain that intensifies when you lie down
• Tenderness in the middle of your abdomen
• Nausea and possibly vomiting
• Passing oily, greasy stool

To help reduce symptoms of pancreatitis, doctors recommend avoiding all alcoholic drinks and consuming soups or broths to help reduce pancreatic inflammation.

Liver problems

The largest part of your liver is located in your upper right abdomen and can cause RUQ pain if inflammation or disease affects this vital organ.

Liver disease can include any type of inflammation or condition that affects the function of your liver. The journal Gastroenterology & Hepatology reports about a type of chronic liver disease that causes right upper abdominal pains. This can also cause itching in various parts of the body, yellowish skin (jaundice), and general feelings of fatigue.⁶

Because dull aches under the right rib cage caused by liver problems usually appear in advanced stages of liver disease, it’s important to recognize the early signs of liver damage. You can also avoid habits that damage your liver if you avoid drinking too much alcohol, get enough sleep, and eat healthily.

In fact, even just drinking plenty of water daily is a cheap and effective way to help cleanse your liver naturally.

Right Upper Quadrant (RUQ) Pain: Digestive Issues

Indigestion

Problems with your digestive system can cause a number of symptoms including cramping pain in your upper right side of the abdomen. Dr. Laurence Knott on Patient.info says that indigestion often causes abdominal pain just behind your breastbone^.18

For some helpful tips on relieving digestive problems, please see my article on natural ways to bring relief to your digestion problems.

Gas

A buildup of gas or flatulence in your intestines can cause sharp cramping pains just below your right ribs. Researchers from Johns Hopkins Medicine report that if gas builds up on the right side of the colon, you may experience stabbing pains that feel like gallstones or appendicitis.²¹

Irritable bowel syndrome (IBS)

Irritable bowel syndrome can cause many uncomfortable symptoms including sharp pains or dull aches in the right upper quadrant.

According to the journal Gut, one of the origins of chronic right upper abdominal pain is irritable bowel syndrome. For many IBS sufferers, this can mean episodes of gnawing abdominal pain along with bloating.⁷

However, Dr. Jenifer K. Lehrer, who is a gastroenterologist, says that pain below the ribs associated with IBS usually affects the left upper quadrant and can even cause chest pain.⁸

Other symptoms of IBS can include:

• Altered bowel habits with sometimes having diarrhea and other times constipation
• An urgent need to pass loose stringy poop
• Anal leakage
• Heartburn
• A hard, bloated stomach
• A need to pee frequently
• Strange stomach noises
• Diarrhea that gets worse under stress

To manage the symptoms of IBS naturally, try taking peppermint oil capsules to help relax your colon and soothe intestinal inflammation. Also, finding ways of dealing with stress better can also improve your IBS symptoms.

Right Upper Quadrant Pain: Rib Cage Related Issues

Some reasons for sharp pain in the upper right abdomen under the ribs can be due to muscle or joint issues in your chest.

Intercostal muscle strain

Strain to the muscles between your right-sided ribs can result in mild to very sharp agonizing pains depending on the extent of the injury.

Intercostal muscles help to support your rib cage and your upper body and assist in breathing. Throwing objects forcefully, having poor posture, or injuring your ribs can pull, sprain, or even tear your intercostal muscles.

For example, orthopedic surgeon, Dr. Jack McPhilemy says that baseball player Todd Hundley sprained muscles on the right side of his ribcage while playing sports. The injury happened while running at speed and twisting his body. He described the type of rib pain like being stabbed with a knife.⁹

Also, Dr. Michael Durtnall, a chiropractor from the Sayer Clinic in London, says that poor posture when sitting at a desk or standing incorrectly can put constant strain on your intercostal muscles. The result can be pain in the ribs, neck pain, or middle or lower back pain.¹⁰

If sprained muscles in your chest are causing right upper quadrant pain under your ribs that radiates to your back, please check out my article on relieving intercostal muscles strain for helpful advice.

Rib injury

Obviously, any kind of rib injury to your right upper chest will result in right quadrant pain under the ribs.

Doctors from the Victoria State Government say that falling, suffering a sports injury, or being in an accident can result in various degrees of rib injuries. This can cause bruising to your ribs, tearing your intercostal muscles, or even tearing a rib from your breastbone. This can cause severe pain when moving your arms, your upper body, or sneezing.¹¹

Injuries to your right rib cage can also cause excruciating under your ribs pain if it damages any of your vital organs. These injuries can even be life-threatening.

Right Upper Quadrant Pain Under Ribs: Lung Issues

Intense stabbing pains in your upper right quadrant could occur if you have any problems with your right lung.

Pneumonia

Pneumonia is often the result of a viral or bacterial upper respiratory infection and can cause sharp upper right chest pains if your right lung is infected.

Pneumonia can be contagious and can cause mild to severe pain depending on the extent of the infection. The journal Common Surgical Diseases lists pneumonia as one of the common causes of abdominal pain in the upper right quadrant.¹²

Dr. Melissa Conrad Stöppler on MedicineNet says that other symptoms of pneumonia can include:¹³

• Sharp chest pains when coughing or sneezing
• Shortness of breath
• Fatigue
• Shaking chills
• A cough that produces colored phlegm

Although treatment for the symptoms of pneumonia depends on what kind of infection you have, there are many foods that can improve the health of your lungs. These include consuming green leafy vegetables, taking omega-3 supplements, or enjoying the many benefits of having more garlic in your diet.

Collapsed lung

A collapsed lung (pneumothorax) can cause sudden chest pain in your right upper quadrant if your right lung is affected.

Doctors from the Mayo Clinic say that chest injuries, lung disease, or small air blisters in your lungs can cause a collapsed lung. The most common symptom is severe chest pain that comes on suddenly. Other symptoms of a collapsed lung include:¹⁴

• Shortness of breath accompanied by rapid breathing
• Intense chest pain when breathing deeply
• Fatigue

A collapsed lung can quickly become a medical emergency, so, it’s essential to get prompt medical care if you have any kind of intense sudden pains in your chest.

Pulmonary embolism

A blockage or clot in an artery in your right lung can cause a pulmonary embolism and can sometimes cause right upper quadrant pain that can feel like a heart attack.

According to the journal Case Reports in Emergency Medicine, abdominal pain can accompany pulmonary embolism. Although uncommon, doctors say that it’s important not to ignore right upper quadrant pain that gradually gets worse.¹⁵

Other, more common, symptoms of pulmonary embolism include:¹⁶

• Coughing up blood
• Sore legs or leg swelling
• Sweating excessively
• Irregular or racing heartbeat

Other Reasons for Upper Right Abdominal Pain Under Ribs

Some health issues can cause general upper abdominal pain or pain on just one side of your abdomen, depending on how the condition affects you.

Shingles

Shingles is a viral infection that causes a painful rash on one side of your body. Dr. Mary Harding on Patient.info says that a blistery, sore rash on your right upper quadrant is very common. The pain on the right side of your chest may continue after the rash has disappeared.¹⁷

Dab a little Manuka honey onto the tender rash to help treat the symptoms of shingles quickly.

Peptic ulcer

Gastroenterologist Dr. Jay W. Marks says that a peptic ulcer usually causes a dull gnawing pain in your right upper quadrant. This may be associated with acid reflux, intestinal bleeding, or digestive problems.²²

Appendicitis

Although appendicitis usually starts off as pain around your belly button that spreads to your right lower quadrant, it can also cause upper abdominal pain. The World Journal of Gastroenterology reports that sometimes, appendicitis pain can feel like gallstone pain in the right upper abdomen.¹⁹

Can a Heart Attack Cause Right Upper Quadrant Pain?

A heart attack can cause pressing persistent pain in your right upper quadrant. Dr. Melissa Conrad Stöppler on MedicineNet says that chest pains caused by a heart attack can affect the right side of the chest. The common signs of a heart attack are:

• Squeezing pains in the left chest that spread to the left arm, jaw, and neck.
• Chest pains that spread to the upper back
• Sweating
• Indigestion and a sensation of burning in the chest

With a few simple lifestyle changes, you can improve the health of your heart and significantly lower your risk of a heart attack.

Upper Right Abdominal Pain During Pregnancy

Dr. Mary Harding on Patient.info says that many of the causes of right upper quadrant pain in pregnancy are similar to those in women who aren’t pregnant.

However, RUQ pain may be more common among pregnant women because of extra pressure pressing on organs. Also, other health conditions like indigestion and urinary tract infections which are common during pregnancy can also cause upper abdominal pain.¹⁷

When to See a Doctor about Right Upper Quadrant (RUQ) Pain

The occasional twinge, ache, or spasm in your right upper abdomen is usually nothing to worry about and may just be gas or indigestion. However, if you have severe RUQ pains, aches, or discomfort, you may need to see a doctor for a checkup.

Doctors from the Mayo Clinic advise that you should see a doctor for right upper quadrant pain in the following circumstances:²⁰

• Passing bloody stools – either black tarry stool or stools that streaks of blood
• Persistent abdominal bloating
• Yellowish skin
• Tenderness when pressing on your abdomen
• Persistent pressure in your chest that feels as if a heavy weight is pressing on it (call the emergency services in this case)

Read my other related articles:

• Causes of Right Side Chest Pain and When You Must See a Doctor
• Pain on Right Side: Causes, Treatments and When to See a Doctor
• Lower Right Back Pain: Causes, Treatments, and When to See a Doctor

Medical Sources