Pain In The Right Side : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 08/07/2022

Pain in the right side develops with damage to the digestive organs - appendicitis and mesadenitis, Crohn's disease, hernias and malignant neoplasms. Among other causes of the symptom, urolithiasis is distinguished, in women - pathologies of the internal genital organs. To diagnose diseases manifested by pain in the side, ultrasound, X-ray and endoscopic studies are performed. Be sure to prescribe a standard package of laboratory tests of blood, feces, urine. Treatment includes medications (analgesics, antibiotics, hormones and cytostatics), surgical interventions.

Why does it hurt in the right side

Physiological factors

Most often, the right side "pricks" during fast walking, running, physical activity. Painful sensations are due to the redistribution of blood flow, the deposition of blood in the liver. Pain occurs at the time of maximum load or immediately after exercise. Due to sharp stabbing sensations, a person stops, grabs his side. Discomfort disappears after a few minutes of rest.

Pain in the right side of the abdomen often appears in untrained people who begin to pump the press intensively. Myalgias develop, which last 2-3 days. Soreness becomes stronger with laughter, straining, turning the torso. Another common cause of myalgia and myositis is the effect of hypothermia or draft. In this case, the entire right side and lower back hurt, the pain is aggravated by awkward movements.

Appendicitis

With inflammation of the appendix, severe pain occurs in the right iliac. The pain syndrome develops suddenly, is not associated with typical provoking factors. Pain sensations are constant or cramping, in order to alleviate them, the patient lies on his side, pulling his legs up to his stomach. Abdominal pain on the right is accompanied by fever, weakness. Sometimes there are dysuric and dyspeptic disorders.

With appendicular infiltrate, a different nature of pain is specific. Patients experience aching pain that lasts up to several weeks. The pain syndrome is aggravated by bending the torso, physical activity. Sometimes patients themselves grope in the right side for a volumetric formation, with pressure on which a sharp pain is determined.

Mezadenitis

In the acute form of mesadenitis, pain in the right side begins suddenly. They disturb a person for several days, are cramping in nature. Sometimes soreness spreads throughout the abdomen, and a person cannot indicate its exact localization. Gradually, the pain becomes dull or aching, exacerbation is characteristic when coughing or changing position. The symptom is accompanied by fever, nausea and dry mouth, diarrhea.

salmonellosis

With this intestinal infection, there are sharp spastic pains in the upper abdomen and in the right side. In most cases, a "Salmonella triangle" is detected: patients complain of pain in the right iliac region, near the navel, in the epigastrium. The intensity of symptoms increases before defecation. Simultaneously with the pain syndrome, repeated diarrhea develops, the feces become greenish and acquire a fetid odor.

Helminthiases

With the invasion of intestinal parasites, a person feels periodic dull or cramping pains in the right side. Their strengthening in the evening and at night is characteristic. There are stool disorders, flatulence and rumbling in the abdomen. For helminthiases, a combination of abdominal manifestations with other syndromes is typical: asthenovegetative, hepatolienal, bronchopulmonary.

Crohn's disease

The most common localization of the lesion is terminal ileitis, so pain occurs on the right in the lower abdomen. During the period of exacerbation of pain, acute, paroxysmal, and when the inflammatory process subsides, periodic aching sensations and discomfort in the indicated area predominate. With the spread of the disease to other parts of the intestine, the localization of the pain syndrome changes. Pain in the right side is accompanied by diarrhea with impurities of blood in the feces, weight loss.

Pain in the right side

 

Hernias

Pain on the right lower abdomen is a sign of the right inguinal (more often in men) or femoral (more often in women) hernia. The intensity of pain depends on the size of the hernial protrusion, the presence of complications. At first, dull pains in the right side are disturbing, aggravated by physical exertion, straining. With strangulated hernias, the pain becomes severe, paroxysmal.

Intestinal tumors

Severe pain in the right flank of the abdomen is noted in cancer of the blind or ascending colon. Soreness as the first symptom of a tumor occurs in pseudo-inflammatory or enterocolitis form of oncopathology. The pain syndrome persists constantly, periodically it intensifies to excruciating spasms. Pain in the side is combined with a decrease in appetite, weight loss, the appearance of blood in the stool.

Damage to the female reproductive organs

In women, pain in the iliac zone on the right is often associated with gynecological diseases. Their intensity varies from dull or aching sensations to severe spasms. In most patients, there is a clear relationship between the nature and strength of the pain syndrome with the menstrual cycle. Typically increased pain during intercourse (dyspareunia). Most often, pain in the right side is manifested by:

  • Adnexitis. With an exacerbation of the process, women complain of sharp pains in the right side, which are given to the anus and perineum. Chronic inflammation is characterized by aching sensations that increase before menstruation, after overwork or hypothermia.
  • Endometriosis. Pain occurs when the right ovary or fallopian tube is damaged. With endometriosis, chronic pain on the right in the iliac and suprapubic zone is disturbing. During menstruation, pain intensifies, strong spasms join.
  • Ovarian cyst. With right-sided localization of a volumetric formation, constant aching pains occur in the corresponding half of the abdomen. Painful sensations are aggravated by physical exertion, torso bending, sexual intercourse.
  • Urgent conditions. With a rupture of an ovarian cyst, an interruption of an ectopic pregnancy, there is a strong cramping pain on the right in the iliac region. The pain syndrome radiates to the perineum, sacrum, anus.

Urolithiasis disease

Occasionally, unbearable pain in the right side is a symptom of renal colic. With ICD, the pain syndrome begins suddenly, quickly reaches its maximum intensity. At the time of the attack, the patients are restless, rushing around the room, moaning in pain. Pain usually radiates to the lower back, thigh, external genitalia. The symptom is accompanied by dysuric disorders, excretion of pink or reddish-brown urine.

Diagnostics

The examination of patients with complaints of pain in the right side is carried out by a gastroenterologist, if necessary, other specialists are involved - a surgeon, gynecologist, nephrologist. Physical examination checks for peritoneal symptoms, specific signs of appendicitis, and deep palpation of the abdomen. To establish the diagnosis, laboratory and instrumental methods are recommended:

  • Sonography. Ultrasound of the abdominal organs is a screening method. With the help of ultrasound, inflammatory processes, volumetric formations, an increase in mesenteric lymph nodes are detected. Dopplerography visualizes blood flow in the large vessels of the abdominal cavity.
  • Radiography. The survey radiograph is uninformative, a detailed visualization of the intestine is provided by irrigoscopy with double contrast. The method is suitable for detecting tumors, ulcerative defects, local narrowing or expansion of the intestine. Abdominal CT is widely used.
  • Colonoscopy. With the help of endoscopic instruments, the mucous membrane of the colon is examined, a biopsy is taken in case of chronic inflammation or suspicion of cellular atypia. If the symptoms indicate damage to the small intestine, a modern method is used - video capsule endoscopy.
  • Gynecological examination. Women undergo a standard bimanual examination, vaginal examination in the mirrors. To exclude the pathology of the appendages, ultrasound of the pelvic organs is performed. For a more detailed examination, hysteroscopy, transvaginal sonography, hysterography are prescribed.
  • Laboratory methods. The list of mandatory studies includes clinical blood and urine tests, a coprogram, and a fecal test for helminth eggs. An extended diagnostic complex includes biochemical blood tests with an assessment of the content of acute phase proteins, stool culture.

Treatment

Help before diagnosis

Non-intense pain in the right side, associated with hypothermia or physical exertion, does not require medical treatment. Mostly they pass on their own after 1-3 days. If the pain syndrome bothers you for a long time or the intensity of pain increases rapidly, you should immediately seek medical help. With excruciating pain, the doctor at the prehospital stage uses analgesics.

Conservative therapy

To relieve pain, non-steroidal anti-inflammatory drugs, narcotic analgesics, antispasmodics are used in practical medicine. For quick anesthesia, blockades are made with local anesthetics. These measures give a temporary effect, therefore, in the future, to eliminate pain in the right side, etiotropic therapy is prescribed, which affects the underlying disease. In surgery and gastroenterology, the following groups of medicines are used:

  • Anti-inflammatory drugs. Inflammation is stopped not only by classical NSAIDs, but also by derivatives of 5-aminosalicylic acid, corticosteroid hormones.
  • Probiotics. Medicines are needed to restore the microflora and normal functioning of the intestine, which helps to reduce pain, the disappearance of dyspeptic disorders.
  • infusion solutions. Necessary to correct dehydration of the body, remove toxic decay products from the blood, maintain normal hemodynamic parameters.
  • Antibiotics. The drugs are prescribed for generalized forms of salmonellosis, for the prevention of purulent complications of inflammatory diseases of the digestive organs.
  • Cytostatics. They are taken in severe forms of Crohn's disease, when hormonal therapy is ineffective. They are also part of the chemotherapy regimens used for malignant neoplasia of the colon.

To improve the patient's condition, symptomatic therapy is carried out. Antidiarrheal or laxative drugs, drugs with pancreatic enzymes, prokinetics are selected. In order to correct metabolic processes, vitamin-mineral complexes with iron content are shown. In the recovery period of chronic diseases, courses of physiotherapy, the use of mineral waters, and spa treatment are recommended.

Surgery

Urgent surgery is performed for acute appendicitis (laparoscopic or classical appendectomy), strangulated hernia (revision of abdominal organs and hernioplasty). In the formation of fistulas and abscesses in those suffering from Crohn's disease, their opening and sanitation is shown. If a total lesion of all layers of the intestinal wall develops, the operation of choice is resection of the intestine.

With an interrupted ectopic pregnancy, urgent surgical care is needed. The type of operation is selected taking into account the severity of complications and the desire of the woman to have children in the future. Organ-preserving tubotomy or radical tubectomy is performed. When the ovarian cyst is ruptured, a wedge resection or oophorectomy is performed. Some forms of endometriosis require elective surgical treatment.

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