What to Know About Right Upper Quadrant Pain

Gastrointestinal problems, such as indigestion, can cause RUQ pain.

What causes pain in the right upper quadrant of the ribs?

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Healthcare professionals consider the abdomen to have four sections, which they call quadrants. This classification helps them better identify symptoms.

The right upper quadrant (RUQ) includes the pancreas, right kidney, gallbladder, liver, and intestines.

Pain under the ribs in this area can indicate a health problem affecting one of these organs or the surrounding tissues.

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Below, we describe nine causes of pain in the RUQ, their treatments, and when to see a doctor.

Gastrointestinal problems, such as indigestion, can cause RUQ pain.

RUQ pain can result from gastrointestinal issues, such as indigestion or gastroesophageal reflux disease (GERD).

Symptoms of GERD can include:

frequent heartburn
chest pain
nausea
vomiting
a sore or burning sensation in the throat

Maintaining a healthful lifestyle, avoiding trigger foods, and taking antacid medications can often help with managing GERD.

An infection in the right kidney can cause pain in the RUQ. Other symptoms of a kidney infection can include:

pain in the groin and back
fever and chills
a frequent need to urinate
pain when urinating
blood in the urine
dark or cloudy urine that may smell foul
nausea
vomiting

Bacteria or a virus may be responsible for this infection, and it can spread from the bladder.

Anyone who suspects that they have a kidney infection should see a doctor right away. They may receive a prescription for antibiotics.

If the infection is severe, a person may need to stay in the hospital to receive intravenous fluids and, possibly, further treatment.

When a kidney stone forms in the right kidney, it can cause pain in the RUQ. Other symptoms of kidney stones can include:

blood in the urine, which may appear red, pink, or brown
fever and chills
painful urination
a frequent need to urinate
low levels of urine
an inability to urinate

If a person suspects that pain results from kidney stones, or if they have other symptoms of the condition, they should see a doctor right away.

Treatment may involve removing the stone or breaking it into pieces that the body can pass easily.

The gallbladder sits in the RUQ underneath the liver. Gallstones are small and made up of cholesterol or bilirubin, which is a substance that forms when red blood cells break down.

The primary risk factor for gallstones is being overweight, particularly if the weight is around the waist.

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Medically reviewed by Saurabh Sethi, M.D., MPH — By Beth Sissons on July 25, 2019

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What to Know About Right Upper Quadrant Pain

Several health conditions can cause pain in the right upper quadrant (RUQ) of your abdomen.

What Is RUQ Pain?

Pain in your abdomen can be hard to diagnose because it holds so many organs. Doctors describe your abdomen in sections or quadrants to help find the organs that might be the cause of any health problems.

The right upper quadrant, or the RUQ, has many important organs that affect your health. It’s important to pay attention to pain in this area. These include:

Liver
Gallbladder
Large intestine
Small intestine
Stomach
Pancreas
Right kidney

To find this section, look down at your belly and imagine a vertical line through the center. Then imagine a second horizontal line across your belly. This divides your abdomen into four sections. The upper right section near your ribs is the right upper quadrant.

Symptoms of Right Upper Quadrant Pain

Depending on the organ involved, you might have many different symptoms along with the pain in your abdomen. These might include:

Fever
Nausea
Vomiting
Diarrhea
Swelling in your abdomen
Yellow skin
Blood in your stool
Tenderness in your abdomen
Pain when you take a breath

You might experience different kinds of pain. Most of the time, pain in your abdomen is minor and simply a discomfort. Depending on the organ and the condition, sometimes these can be serious.

Severe abdominal pain. Acute and severe pain comes on very quickly. This kind of sudden pain usually means something serious is happening.

‌Visceral pain. This pain comes from your organs, which are called the viscera. Visceral pain is a response to your organs stretching or the surrounding muscles contracting. Visceral pain is usually:

Dull
Vague
Nauseating
Hard to pinpoint

Referred pain. Sometimes problems with organs in your abdomen might cause pain in a different part of your body. For example, a problem with your gallbladder might cause pain in your abdomen but also in your right shoulder. This is called referred pain.

Somatic pain. This kind of pain comes from nerves responding to a problem in the abdominal cavity. You have a membrane that lines your abdomen called the peritoneum. The nerves here can respond to irritation or cutting. This usually gives you very sharp pain that’s easy to pinpoint.

This kind of pain is usually caused by infections in your organs. Liquids leak out and irritate the lining, causing pain and a condition called peritonitis.

Causes of Right Upper Quadrant Pain

There can be several causes for right upper quadrant pain. The most common causes include:

Gallbladder problems
Gallstones
Cholecystitis
Kidney problems
Infection
Kidney stones
Urinary tract infection
Cancer
Pancreas problems
Pancreatitis
Peritonitis
Stomach problems
Peptic ulcers
Indigestion
Gastritis
Liver problems
Infection
Abscess
Inflammation

In some cases like indigestion and gastritis, this might cause mild symptoms like burping, gas, bloating, and pain. This can be caused by eating certain foods and may be minor.

Other conditions like sudden pancreatitis and peritonitis are serious and might cause sudden and severe symptoms.

Treatment for Right Upper Quadrant Pain

The cause of your pain will determine the kind of treatment you get.

Your doctor will do different tests to determine the cause. This might include a physical examination where they feel and tap your abdomen. This is called palpating.

They will feel your abdomen for masses, if you involuntarily contract your muscles during touch, if the muscles stay tight even when they’re not being touched, or if you flinch with pain. They will also look for how sensitive you are to touch. If you have these signs, you might have peritonitis.

Your doctor might also do other tests, including:

Computed tomography (CT) scan
Ultrasound
Blood test
Urine tests

These tests can help look for inflammation and swelling in your organs. Urine tests will help identify kidney stones or infections.

Your doctor will treat you depending on what these tests show. You might receive:

Antibiotics for infections
Antacids for indigestion
Surgery to remove stones
Hospitalization for surgery and to receive fluids
Pancreatic enzymes for pancreas support
Pain relievers

It’s a good idea not to take pain relievers, though, until you figure out what’s causing the problem. Pain relievers can sometimes mask a more serious condition, which could harm your health.

Emergency Signs of Right Upper Quadrant Pain

Pain in the right upper quadrant can be a sign of a serious health condition. If you have the following symptoms, you should go to the hospital right away:

Severe pain
Fast heartbeat
Sweating
Confusion
Low blood pressure
Swelling in your abdomen
Pain that makes you double over
Pain that gets worse when you touch your abdomen
Throwing up blood
Throwing up what looks like coffee grounds

If you don’t have emergency signs but have pain and other symptoms, you should see your doctor within a day.

Show Sources

American Family Physician: “Evaluation of Acute Abdominal Pain in Adults.”

Merck Manual Consumer Version: “Acute Abdominal Pain,” “Acute Pancreatitis.”

What to Know About Right Upper Quadrant Pain

What causes pain in the right upper quadrant of the ribs?