Abdominal pain consistently ranks in the top five reasons for hospital emergency room visits, says the August 2010 edition of "Annals of Emergency Medicine". The list of potential reasons for abdominal pain fills the pages of medical textbooks, but the more specific the symptoms, the easier it becomes to narrow the source. A description of pain in the upper right of the abdomen that occurs after eating gives important clues about the location of the pain and precipitating factors helping to narrow down the potential causes.
The Right Upper Quadrant of the Abdomen
Medical workers frequently talk about the abdomen as if it has four regions. Using the belly button as a reference point, the right and left upper quadrants sit above the belly button and the right and left lower quadrants sit below it. The most prominent structures in the right upper quadrant---the RUQ-- include the liver, gall bladder, the base of the lung, kidney, diaphragm, and segments of the intestines.
Abdominal Pain after Eating
Pain that occurs after eating indicates that those organs in the RUQ involved in digestion move to the front of the list of possible causes, called the "differential diagnosis" by doctors. Referred pain that originates elsewhere but manifests symptoms in the upper right area also deserve consideration.
The liver usually doesn't cause pain even with significant pathology. The gallbladder sits under the bottom of the liver. Classically, pain in the RUQ after eating points to the gallbladder, but other potential diagnoses exist.
Imaging and Diagnosis
The "Journal of the American Medical Association" explains in its January 2003 issue that a suspected diagnosis requires confirmation from specific medical tests. Ultrasound of the abdomen shows inflammation or the presence of gallstones in the gallbladder. Abnormalities of the liver and kidney stones show up on ultrasound as well. A CT scan provides a better picture of other structures, such as the intestine and base of the lung. Blood tests reveal problems with the pancreas or infections.
Endoscopy, or looking down the esophagus into the stomach, can rule out ulcers. Special testing follows to confirm the diagnosis and measure the extent of any damage.
The Gallbladder
When food is ingested, the gallbladder constricts to release bile into the intestine to aid in digestion of fats. If the gallbladder or its ducts become inflamed or blocked with stones, the process becomes painful. Patients classically relay a history of the onset of symptoms following a meal, especially one that is high in fat. Nausea and vomiting frequently accompany pain in gallbladder disease.
Warnings
There are other more rare but more serious conditions that can cause right upper abdominal pain that do or do not get worse after eating. These include conditions like a perforated ulcer, an aortic aneurysm and heart attacks. Because of this, it is absolutely necessary to seek medical attention for any new or severe symptom. Self-diagnosis using information on the internet is dangerous and not recommended. This article represents general information and is not intended to diagnose or treat symptoms or to take the place of a medical doctor in caring for these symptoms.
References
- "Annals of Emergency Medicine"; Emergency Department Care in the United States: A Profile of National Data Sources; Pamela L. Owens, PhDa Marguerite L. Barrett, MSb Teresa B. Gibson, PhD et al; August 2010
- "Journal of the American Medical Association"; Does This Patient Have Acute Cholecystitis?; R.L.Trowbridge, N.K. Rutkowski, K.G. Shojania ; January 2003
