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.

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.

Gallstones can cause:

• sharp pain in the RUQ that lasts for hours
• fever and chills
• brown urine
• light-colored stools
• yellowing of the skin and eyes
• nausea
• vomiting

If a person experiences any of these symptoms, they should see a doctor right away. If left untreated, gallstones can block the bile ducts and cause complications.

One treatment for gallstones involves removing the gallbladder, which is not an essential organ.

Share on Pinterest A liver abscess may cause fever, chills, or nausea.

A liver abscess, which doctors also call a hepatic abscess or pyogenic liver abscess, is a collection of pus in the liver. The pus can result from infection with parasites, bacteria, or fungi.

A liver abscess can cause pain or tenderness in the RUQ, as well as:

• fever and chills
• unintentional weight loss
• nausea and vomiting
• yellow skin
• grey stools

Treatment typically involves a procedure to drain the pus. If the infection is bacterial, antibiotics can often help fight off the infection.

Pain in the RUQ can stem from other liver conditions, such as cirrhosis, fatty liver, and liver cancer.

Symptoms to look out for include:

• a sensation of fullness in the RUQ under the ribs
• a loss of appetite or feeling full quickly after eating
• unintentional weight loss
• a swollen abdomen
• yellowing of the skin and eyes
• fatigue
• itching
• blood vessels showing on the abdomen
• pain in the abdomen and right shoulder

If a person notices any of these symptoms, they should see a doctor.

Preeclampsia is a complication that develops in 5–8% of pregnancies. It tends to arise anytime between 20 weeks of gestation and 6 weeks after delivery.

Preeclampsia results from a sudden rise in blood pressure, and it causes swelling, mostly in the face, hands, and feet.

Other symptoms can include:

• pain in the RUQ that may spread to the shoulder and lower back
• headache
• weight gain of over 3–5 pounds in 1 week
• changes in vision
• shortness of breath
• nausea and vomiting

A doctor needs to monitor blood pressure with regular prenatal checkups. High blood pressure can indicate preeclampsia, even when no other symptoms are present.

A woman with any symptom of preeclampsia should receive immediate medical attention because the condition can become serious if it remains untreated. Treatment usually involves taking medication.

A pancreas condition can cause pain under the ribs in the middle of the abdomen, in the RUQ, or the left upper quadrant (LUQ).

Pancreatitis is inflammation of the pancreas, and it may result from gallstones or overuse of alcohol.

Symptoms of pancreatitis include:

• steady or sharp pain in the upper abdomen
• bloating
• nausea
• vomiting
• a loss of appetite

If a person has symptoms of pancreatitis, they should see a doctor right away because the condition can be severe.

Mild pancreatitis may go away within a few weeks. However, if pancreatitis becomes severe, a person may require medication and intravenous fluids in the hospital.

Lung conditions, such as pneumonia, can cause pain that spreads to the right side of the chest under the ribs.

Other conditions in surrounding areas can also cause pain in the RUQ. Some include:

• shingles
• a hernia
• bruising of the ribs
• inflamed cartilage of the ribs, known as costochondritis

Share on Pinterest A person should see a doctor if they experience unexplained weight loss, black stools, or yellowing of the skin or eyes.

People with mild or reoccurring RUQ pain should see a doctor and discuss any other symptoms.

If a person experiences any of the following symptoms, they should see a doctor right away:

• unexplained weight loss
• yellowing of the skin or eyes
• swelling of the abdomen
• black stools
• blood in the stools or urine
• severe pain in the right side
• coughing or vomiting blood
• coughing up a substance that looks like coffee grounds

Also, seek immediate medical attention for any symptoms of preeclampsia or a kidney infection. These conditions can be dangerous if a person does not receive treatment.

Pain under the ribs in the RUQ can result from various conditions that affect the organs or surrounding tissues in that area of the abdomen.

These conditions may relate to the liver or right kidney, for example, or they may be gastrointestinal.

Anyone with consistent or severe pain in the right side of the abdomen should seek immediate medical attention.

Last medically reviewed on July 25, 2019

• Body Aches
• GastroIntestinal / Gastroenterology
• Urology / Nephrology

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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• Kidney infection (pyelonephritis). (n.d.).
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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.”