Right Upper Abdominal Pain: Causes and Concerns - Gastroenterology and Hepatology

Strange pain in the upper right abdomen?

Hello Doctor, yesterday afternoon I experienced some pain in my upper right abdomen.
The sensation is not very intense (I am very sensitive to pain, but this is within a tolerable range), with a slight pulling and cramping feeling that lasts less than a minute and occurs occasionally.
Sometimes it also happens when I laugh.
It occurs both before and after eating, and the intensity is similar.
The location of the pain is clear (just below the right nipple, towards the inner side of the ribs), and it hurts when pressed, but there is no rebound tenderness.
Once this sensation appears, it disappears as long as I remain still or ignore it.
My habits include low physical activity and staying up late (going to bed between 1-3 AM).
My water intake and eating habits are normal, but I tend to have brunch when I wake up late.
Bowel movements are normal, but not very substantial.
Yesterday at noon, I performed some abdominal exercises, and it was after that that I experienced this pain.
I would like to ask the doctor whether my condition is related to hepatobiliary or gastrointestinal issues, or if it might be a mild abdominal strain.
Thank you!

Qingqing, 20~29 year old female. Ask Date: 2020/04/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely a strain; apply local heat, rest, and when laughing or coughing, use your hand to press on the painful area to avoid worsening the condition.

Reply Date: 2020/04/06

More Info

Hello! Thank you for reaching out with your concerns about the right upper abdominal pain you are experiencing. Based on your description, there are several potential causes for the discomfort you are feeling, and it’s important to consider both gastrointestinal and musculoskeletal factors.

Possible Causes of Right Upper Abdominal Pain
1. Muscle Strain: Given that you mentioned performing a crunch exercise before the onset of pain, it’s possible that you may have strained a muscle in your abdominal wall. This can lead to localized pain that is exacerbated by movement or certain positions, such as laughing or bending.

2. Gallbladder Issues: Pain in the right upper quadrant can also be associated with gallbladder problems, such as gallstones or cholecystitis (inflammation of the gallbladder). This type of pain is often sharp and may be triggered by eating fatty foods. However, your description of the pain being mild and not associated with significant digestive issues (like nausea or vomiting) makes this less likely.

3. Liver Conditions: While less common, liver issues can also present as pain in the right upper abdomen. Given your history of chronic hepatitis B, it’s essential to monitor liver health closely. If you notice any changes in your symptoms, such as increased pain, jaundice (yellowing of the skin or eyes), or changes in your urine or stool color, you should seek medical attention promptly.

4. Gastrointestinal Issues: Conditions such as gastritis, peptic ulcers, or even gastroesophageal reflux disease (GERD) can cause discomfort in the upper abdomen. These conditions can lead to pain that may be aggravated by certain foods or positions.

5. Nerve Pain: Sometimes, nerve irritation or compression in the thoracic spine can manifest as abdominal pain. This could explain the intermittent nature of your pain and its association with certain movements or positions.

Recommendations
1. Observation: Since the pain is mild and transient, it may be beneficial to monitor your symptoms for a few days. Keep track of when the pain occurs, its intensity, and any activities that seem to trigger it.

2. Activity Modification: Avoid activities that seem to exacerbate the pain, such as crunches or heavy lifting, until you have a clearer understanding of the cause.

3. Hydration and Diet: Maintain a balanced diet and ensure you are drinking enough water. Eating smaller, more frequent meals may help if the pain is related to digestive issues.

4. Consult a Healthcare Provider: If the pain persists, worsens, or is accompanied by other symptoms (such as fever, significant changes in bowel habits, or jaundice), it is crucial to consult a healthcare professional. They may recommend imaging studies (like an ultrasound) or blood tests to rule out any serious conditions.

5. Stress Management: Given your mention of late-night habits and potentially high-stress levels, consider incorporating stress-reducing activities into your routine, such as yoga, meditation, or regular physical activity, which can also help with overall well-being.

Conclusion
While your symptoms may not indicate a severe issue at this moment, it’s essential to remain vigilant and proactive about your health. If you have any further questions or if your symptoms change, do not hesitate to seek medical advice. Your health is paramount, and understanding the underlying causes of your symptoms is the first step toward effective management.

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