What Causes the Right Upper Quadrant Pain Under My Ribs?

Kidney problems such as kidney stones, a urinary tract infection (UTI), a kidney infection, or kidney cancer can lead to RUQ pain.

Symptoms that can accompany RUQ pain due to a kidney problem include:

• pain that radiates to the lower back or groin
• painful urination
• foul-smelling urine
• frequent urination
• blood in your urine
• fever
• nausea or vomiting

If you have RUQ pain due to a kidney problem, you may need to schedule an appointment with a doctor or visit an urgent care center.

Liver conditions can also lead to RUQ pain. Examples include hepatitis, liver abscess, or liver cancer.

In addition to RUQ pain, other symptoms of a liver condition can include:

• yellowish skin (jaundice)
• abdominal tenderness
• nausea or vomiting
• darkened urine
• fever
• fatigue
• unexplained weight loss

You likely need to see a doctor if you have RUQ pain and symptoms consistent with a liver condition.

Preeclampsia is a condition that typically occurs in people who are at least 20 weeks into their pregnancy. It can also develop earlier in pregnancy or, in some cases, postpartum.

The hallmark of preeclampsia is a rise in blood pressure, but RUQ pain often occurs as well.

Additional symptoms and signs can include:

• severe headache
• nausea or vomiting
• decreased urination
• protein in urine
• kidney or liver problems
• blurred vision or sensitivity to light
• shortness of breath

A doctor typically monitors your blood pressure during prenatal care visits. However, if you experience preeclampsia symptoms such as RUQ pain, blurred vision, or shortness of breath, you should seek immediate medical care. Preeclampsia can be life threatening for you and your baby if untreated.

Gallbladder problems, such as gallstones or choledocholithiasis, can cause RUQ pain. Choledocholithiasis is the presence of gallstones within your bile ducts.

RUQ pain due to gallstones may last several hours, often after a large meal or in the evening. Additional symptoms to look out for can include:

• nausea and vomiting
• fever
• chills
• darkened urine or light-colored stools
• yellowish skin (jaundice)

If you’re experiencing symptoms consistent with gallstones or choledocholithiasis, you may need to make an appointment with a doctor or visit an emergency room. Stones in the bile ducts can lead to serious complications.

A variety of gastrointestinal issues can cause RUQ pain. These can include:

• Indigestion: Indigestion or an upset stomach refers to discomfort in your abdomen.
• Gastritis: Gastritis is the inflammation of your stomach lining and is often caused by infection.
• Peptic ulcers: Peptic ulcers or gastric ulcers are sores on the stomach lining.

Typically, the pain caused by these conditions is a dull, burning type of pain. Other symptoms can include:

• a feeling of uncomfortable fullness
• abdominal bloating
• burping or gas
• nausea or vomiting

While most cases of indigestion and gastritis are mild and resolve on their own, consider meeting with a doctor if your symptoms last longer than 2 weeks. If you suspect that you have a peptic ulcer, a doctor can conduct tests to confirm it and recommend treatment.

You can feel RUQ pain if your pancreas is inflamed, known as pancreatitis. The pain that you experience from pancreatitis slowly worsens over time. Additional symptoms can include:

• nausea or vomiting
• fever
• increase in heart rate

Most cases of pancreatitis require hospitalization for treatment.

In addition to the conditions discussed above, other underlying conditions can trigger pain in your RUQ.

These can include:

• injury or trauma
• pneumonia
• shingles

Inflammation of the gallbladder (cholecystitis) is the most common diagnosable cause of pain in the right upper quadrant.

Cholecystitis usually occurs when the main opening to the gallbladder becomes blocked, either by a gallstone or biliary sludge. Though less common, it may also happen if your gallbladder becomes damaged.

Upper quadrant pain may occur with other symptoms. These symptoms may include:

• bloating
• gas
• food intolerances
• nausea
• vomiting

If you experience sudden severe RUQ pain, seeking medical attention as soon as possible is essential, especially if the pain lasts longer than a few hours or you have any of the symptoms listed above.

To diagnose the cause of your RUQ pain, a doctor will request your medical history and perform a physical examination.

They typically order tests to help them reach a diagnosis. These tests may include:

• a basic or comprehensive metabolic panel (BMP or CMP) to evaluate your liver function, blood cell counts, and electrolyte levels
• urinalysis to assess your kidney function or to check for a UTI or kidney stones
• stool culture to check for pathogens present in your stool
• endoscopy to check for the presence of ulcers
• imaging tests, such as ultrasound, X-ray, or CT scan, to help see the inside of your abdomen or to check for the presence of stones

Treatment for RUQ pain depends on its cause. Examples can include:

• pain relievers such as acetaminophen (Tylenol) or ibuprofen to relieve discomfort
• antacids to help neutralize stomach acid
• medications such as proton pump inhibitors or acid blockers to reduce the amount of acid in your stomach or intestines
• antibiotics to kill bacteria causing an infection
• surgical procedures, such as those to remove stones or a tumor
• cancer treatments, such as chemotherapy, radiation therapy, or immunotherapy

Typically, a doctor will try to avoid performing surgery if possible. But it may be necessary for some conditions to avoid complications or the disease worsening.

For example, if gallstones that block a bile duct (choledocholithiasis) are not removed, there can be life threatening complications. In some cases, a doctor may remove your gallbladder completely.

If your kidney stones are too large to be passed naturally, a doctor may use sound waves to break the stones into smaller pieces that can be passed. They may also use a scope to remove the stones.

If you are diagnosed with kidney or liver cancer, surgery may be necessary to remove a tumor, depending on the cancer stage and severity.

Since your RUQ contains many vital organs, monitoring RUQ pain and any additional symptoms and seeking treatment promptly can help avoid complications.

Examples of potential complications include:

• kidney infection caused by an untreated UTI
• high blood pressure, kidney failure, or kidney scarring due to an untreated kidney infection
• low birth weight, preterm birth, organ damage, or death caused by unaddressed preeclampsia
• inflammation or infection of the gallbladder or pancreas due to untreated gallstones
• increased risk of ulcers or stomach cancer from untreated gastritis
• progression of cancers that are not caught early

You can help prevent some causes of RUQ pain with habit changes. These may include:

• eating a nutritious, well-rounded diet, which involves:
  • foods rich in fiber, such as whole grains, fruits, veggies, and legumes
  • foods with healthy fats, such as olive oil, while limiting fried foods
  • limiting foods that contain refined carbohydrates, added sugar, and high amounts of sodium
• staying hydrated, as drinking lots of liquids can help flush bacteria from your urinary tract
• using calcium supplements only as directed to avoid kidney stones
• avoiding indigestion by limiting foods or drinks that are spicy, greasy, or contain a lot of acid or caffeine
• avoiding smoking, if you smoke, or considering quitting
• reducing your alcohol intake, if you drink alcohol
• maintaining a moderate weight

The following includes common questions about pain in your upper right quadrant.

When should I worry about upper right quadrant pain?

If your upper right quadrant pain is severe, occurs with other concerning symptoms like fever or jaundice, or doesn’t go away, you may need urgent medical attention.

What organ is on your upper right side under the rib cage?

You have multiple organs on the upper right side under the rib cage. These can include:

• parts of the liver
• right kidney
• gallbladder
• pancreas
• intestines

Can the liver cause pain just under the right ribcage?

You can experience pain under the right ribcage due to problems affecting the liver and other organs. If you have a liver condition, you may also have other symptoms, such as darkened urine, jaundice, abdominal tenderness, or unexplained weight loss.

The possible causes of RUQ pain can vary. Some of them, such as indigestion, are common and will often go away on their own. Others, such as preeclampsia or pancreatitis, need to be addressed right away.

Since your RUQ contains a variety of essential organs, it’s important to monitor RUQ pain.

If you’ve had RUQ pain for a week or longer, you should make an appointment to see a doctor. If you experience signs of a medical emergency, like severe pain that lasts longer than a few hours or fever, in addition to RUQ pain, you may need emergency medical attention.