Flank pain on the right - what's behind it?

definition

Flank pain on the right side is a non-specific symptom that can indicate many different conditions. Flank pain is generally a pain that runs along the rear side of the trunk. It can sometimes be located above the hip or under the costal arch.

A distinction must be made between different forms of pain. They are also crucial in making the diagnosis. The pain can be very acute or even chronic. In this case one means a pain that persists for several months. The pain can run around the body parallel to the ribs and radiate to neighboring regions. Flank pain is very often one-sided. It can be found more on the right side, as there are various organs here that can hurt when there are changes.

Read more on the subject at: Flank pain

Causes of Right Flank Pain

The causes of flank pain on the right side are wide-ranging. The type of pain and when it occurs can greatly limit the possible causes.

After sporting activities that involve the use of force or rotation, the muscles of the abdominal wall and back can be strained, pulled and damaged. In this case, pain is often provoked by breathing and movement in particular.

Skin diseases at the level of the right flank can also be painful. A common disease in old age is shingles, which in most cases leads to pain along the flank in a horizontal line.

Read more about this at: Shingles

If these causes are out of the question, a disorder of the abdominal organs on the right side must be considered. This can affect the kidneys, urinary tract, intestines, liver, gallbladder, or pancreas. The kidney causes typical unilateral flank pain in inflammation of the kidneys, the renal pelvis or the upper urinary tract. Since the kidneys are laid out in pairs, the pain can occur on the right or left side. Such inflammations are often caused by untreated bladder infections and are more common in women than in men. A urinary stone can also form in the kidney pelvis, which blocks the urinary tract. This can also cause severe unilateral pain at the level of the flank.

You can find more information at: Urinary stone or kidney stone

The intestine must also be considered in the case of pain on the right side. Most of the pain is localized in the front part of the abdomen, but it can radiate into the flanks. A common condition that accompanies this pain is appendicitis.

For more information read: Appendicitis or signs of appendicitis

The liver is a very large organ in the upper right abdomen. It can be painfully changed by various processes. In rare cases, it can also become infected, for example from hepatitis viruses. In some diseases, it swells up and presses from the inside on the adjacent diaphragm and costal arch. This can lead to typical flank pain on the right. The gallbladder is closely anatomically related to the liver. As in the kidney, stones can develop here, which may block and clog the biliary tract. This is accompanied by severe pain on the right side.

Read more at: Gallstones

The pancreas can also be responsible for the blockage of the biliary tract. In the context of rare diseases this can be increased. In the case of long-standing flank pain, a doctor must clarify the possible organic causes. The potential underlying diseases range from harmless changes to serious diseases.

Liver disease as a possible cause

Liver pain is a rare cause of right side flank pain. The liver is the largest and heaviest organ in the upper abdomen and is mainly located on the right side just below the diaphragm. It is significantly involved in digestion and in many detoxification and metabolic processes in the body. With diseases that affect the liver, patients are often tired and have digestive problems. Diseases that can be behind liver pain are hepatitis, fatty liver, liver cirrhosis and also liver cancer. Liver problems can also occur during pregnancy, which must be clarified by a doctor.

Do gallstones trigger flank pain on the right?

The bile is an important digestive juice and is passed from the liver together with the secretions of the pancreas into the small intestine for digestion. In between, parts of the fluid can be stored in the gallbladder below the costal arch. If there is a high proportion of cholesterol in the fluid, stones can form which, depending on their size, block the biliary tract and cause a congestion. This is generally a very painful condition that often requires surgical treatment. Sudden, attack-like pain can arise in connection with eating and radiate into the flanks in a belt-shaped manner.

Further information on this topic can be found at: Gallstones and gallstones

Flatulence and flank pain

Flank pain on the right side associated with gas suggests a digestive tract problem. Gastrointestinal complaints are very common in the population. Accompanying symptoms can be diarrhea, bloating and general symptoms such as fever, body aches and fatigue. Viral pathogens can cause inflammation of the intestines and lead to nausea and upper abdominal pain that pull into the flanks.

Food intolerances also lead to these complaints. A common example of this is lactose intolerance, in which the body is not able to break down the milk sugar lactose. As a result, many gases develop in the intestine, which lead to flatulence and pain. Gluten intolerance can also trigger such symptoms.

Read more about this at: Lactose intolerance and gluten intolerance

Tension as a cause of flank pain

Muscular tension and injuries in particular can lead to flank pain on the right side. The abdominal wall consists, among other things, of several layers of muscles that enable the upper body to rotate and straighten up. These muscles can be tight, pulled, or torn, making them a primary cause of flank pain. On the other hand, the abdominal muscles can become painfully tense in the context of acute inflammatory diseases of the abdominal cavity. This often affects the intestine, which is inflamed to the touch, so that the muscles cramp painfully with every pressure on the abdominal wall.

Further information on the subject can be found at: Abdominal pain right

Diagnosis of flank pain

The diagnosis of flank pain on the right side depends on the organ area affected. In addition to inquiring about the type and timing of the pain, the accompanying symptoms are decisive here. As a rule, the causal organ area can already be determined on the basis of this survey. This is followed by invasive and non-invasive examinations. As a rule, the organ area can be narrowed down further with a blood test. The rough appearance of the upper abdominal organs can then be assessed simply and cost-effectively with an ultrasound examination. Inflammation, stones and major changes in the organ structure can often be recognized. In some cases, additional radiological procedures are necessary. The abdominal organs can be assessed well in a CT examination.

Endoscopic procedures have proven to be particularly effective in treating stomach, colon and biliary tract complaints. The hollow organ is examined from the inside with a camera and small interventions such as removing stones can already be carried out.

Where is the flank pain exactly?

The flank roughly describes the lateral part of the upper body and includes several anatomical regions and potential causes of pain. Typically, the right costal arch, the right area of ​​the abdomen and the lateral back up to the spine are referred to as the right flank.
Flank pain can occur diffusely in these areas and be localized precisely in one area, for example under the costal arch. Flank pain can affect the lateral gastrointestinal tract, the liver, and the right kidney and can therefore be traced back to numerous potential triggers.

When do I have to see a doctor with flank pain?

Many of the causes of flank pain are harmless and temporary. These are to be differentiated from serious causes and serious illnesses. The first criterion for a doctor to clarify the symptoms is the severity of the symptoms. If the pain is unbearably bad, has lasted for several days without interruption or keeps recurring, a medical diagnosis should be carried out. On the other hand, slight pain can recede within a few days and often do not give rise to a medical consultation.

Which doctor treats flank pain?

The ultimate treatment for flank pain depends on the underlying cause. However, an initial medical assessment and classification can be carried out by the family doctor or an internist. The possible causes can already be narrowed down on the basis of initial diagnostic measures.

An examination by a radiologist may be necessary for further diagnosis. Depending on the underlying diseases, the family doctor can then initiate further treatment by internists, orthopedists, hepatologists, nephrologists or other relevant specialist disciplines.

Concomitant symptoms

The symptoms that accompany the flank pain on the right side are crucial for the first diagnostic steps. Symptoms of the gastrointestinal tract can be accompanied by external pressure pain and defensive tension and cause flatulence, diarrhea, cramp-like pain, fever and vomiting.

The gallbladder and the biliary tract are also closely related to the digestive tract. This can lead to severe, colic-like pain in the upper abdomen, which radiate into the flank. The pain typically hits with a short delay after eating. In addition, yellowing of the eyes and skin may occur with prolonged biliary blockage. These symptoms could also indicate a problem with the liver or pancreas.

treatment

The treatment must be adapted to the individual disease. Flank pain itself does not necessarily have to be treated, unless it severely restricts everyday life. The pain itself can be treated on the basis of a graduated scheme, whereby drugs such as ibuprofen or diclofenac are initially prescribed. Opioids such as morphine can also be used for very severe pain.

However, if possible, the underlying condition should be addressed. Bacterial infections, for example of the kidneys, often require antibiotics. Infections of the gastrointestinal tract, the gall bladder and other organs can also be treated in this way. If possible, therapy must always be geared towards combating the causes of the disease instead of just treating the pain symptomatically. If the urinary tract is blocked, for example, the stones must be removed first.

How long do flank pain last?

The duration of the flank pain cannot generally be stated. Often times, the symptoms go away on their own with treatment of the underlying disease. If ureteral stones or gallstones are removed, the pain usually subsides immediately after the final treatment. Antibiotic therapy usually works within 2-7 days, which also improves the pain. Diseases that cannot be cured immediately sometimes cause chronic pain that persists for months to years. In these cases, long-term pain medication can be used for right side flank pain.

forecast

The prognosis of flank pain must be made dependent on the underlying disease. As a rule, the flank pain occurs due to an underlying inflammation or pressure of the affected organ on surrounding structures in the abdomen. When this condition is treated, the flank pain on the right side also subsides.

Only in very rare cases can no improvement or cure be sought. This is due, for example, to tumor diseases or incurable viral diseases. The prognosis for these diseases is very different. However, pain in the flank alone can also be relieved in the long term with suitable pain therapy.

Right flank pain when lying down

If the right side flank pain is aggravated by lying on a certain side, this can provide concrete clues as to the location and cause of the pain. If you lie on your back, painful inflammation symptoms of the kidneys can be exacerbated. The kidneys are located far back in the upper abdomen and experience increased pressure from the organs in front of them when lying down.

Even during pregnancy, flank pain can arise from lying on your back. In an advanced pregnancy, the uterus can press on the stomach and upper abdominal organs while lying down, causing pain.

You can find more information at: Abdominal pain in pregnancy

Pain on the left too

Bilateral flank pain is very rare. As a rule, both sides are not equally affected by superficial or organic diseases. A potential disease of bilateral flank pain is direct kidney inflammation, better known as "glomerulonephritis". This is a dangerous inflammation of the kidney corpuscles, whereby the filter function of the kidney is damaged and restricted.

Read more about this at: Glomerulonephritis

Front right pain

If the pain in the flanks is felt further forward, a disease of the anterior abdominal organs is more likely. The ascending large intestine, the small intestine, but also the liver and gall bladder come into consideration here. If the complaints are deep and above the groin, a problem with the large intestine or appendix is ​​likely. On the other hand, on the right front under the costal arch are the liver and gall bladder. The latter often causes attack-like pain that radiates into the right flank. The organs located on the front can be subjected to an initial examination by means of an ultrasound examination.

Pain under the right costal arch

Immediately below the costal arch on the right are the lower edge of the liver and the gallbladder. The general examination of the doctor includes palpation of the costal arch. A bulging gallbladder can be felt under the costal arch without great effort. This is the case, for example, with biliary congestion and gallbladder inflammation. The pain can be belt-shaped along the right costal arch.

The kidneys are also at about the level of the costal arch in the back of the upper abdomen. If the renal pelvis is inflamed, the pain also occurs under the costal arch and can in turn pull forward in a belt-like manner.

More about this at:

• Pain under the right costal arch
• Inflammation of the gallbladder
• Pelvic inflammation

Flank pain in pregnancy

Flank and upper abdominal pain can become more common in late pregnancy. This is primarily due to the ever-growing uterus, which grows upward in the abdominal cavity. This mainly affects parts of the intestine, stomach and other upper abdominal organs, which react painfully to the pressure. In addition to organs, the uterus can also hit blood vessels and nerves and press them off. A dangerous complication is pressing the inferior vena cava by lying on your back. In the case of complaints, the pregnant woman should definitely clarify the causes, since infectious diseases and other diseases can have different effects in pregnancy than in a non-pregnant person.

Pain after eating

If the flank pain always occurs depending on the time of eating, a cause in the digestive tract is obvious. Colic pain in the upper abdomen strongly suggests biliary congestion. Spasmodic pain, on the other hand, can often be localized in the stomach or small intestine. This is where harmless food intolerance but also gastrointestinal infections and other diseases can be behind.