Medically Verified By: Dr. Lalatendu Mahapatra
A dull aching or sharp shooting pain on the right side of the abdomen that is below the lower right ribs after meals is a common complaint seen in clinics and emergency rooms. Many people misdiagnose this as acidity or indigestion but it may be because of stone or an infection in gall bladder, liver or bile duct infection, or diseases of the kidney or pancreas and large intestine.
In an exclusive conversation with Dr Lalatendu Mahapatra, Senior Consultant General Surgeon, Manipal Hospital, Bhubaneshwar, "The normal function of gall bladder is to store bile which was released from liver. With each meal the gall bladder releases bile by contracting itself to small intestine which helps in digestion. Among all, the most common cause is stone in gall bladder or as we called it cholelithiasis. The commonest symptom of a patient having gall bladder stone is dyspepsia or upper abdominal fullness and discomfort or gas formation after meal or especially a fatty meal."
"Patient might also feel pain in right upper abdomen which may also be felt in the back. It may be associated with severe pain, vomiting or fever if stone in the gall bladder blocks the neck of gall bladder. If this was not treated in time, it may lead to pus formation inside gall bladder (known as empyma) or in sever case it may perforate inside abdomen leading to features of peritonitis," he added.
In complicated cases where stone passed down to the common bile duct (tube for bile flow to intestine), patient may present with jaundice with high grade fever. Another life threatening complication is pancreatitis (inflammation of pancreas) may result if small stones from gall bladder obstruct the pancreatic duct opening.
Inflammation of liver due to viral infection is the commonest cause of jaundice with fever and anorexia. So whenever you feel not eat with fever and yellow discoloration of urine or eyes, it may be due to hepatitis.
Not all right sided pain is from hepatobiliary pathology. Gastritis or peptic ulcer disease involving duodenum or stomach can cause pain after eating as well as pain on empty stomach and night pain. When ulcer present in pyloric part of stomach, pain is felt just after meal. Stones in right side kidney may also present with sever right upper and lower abdominal pain, vomiting, may be with fever or blood in the urine. Conditions like right sided pneumonia or pleurisy can also has a symptom of right abdominal pain.
Determining the patient's condition requires blood tests such as complete blood count, liver function test, renal function test, serum amylase, and serum lipase. Along with these, radiological investigations like ultrasound abdomen, CT scan, Upper GI endoscopy if need will help us to pinpoint pathology behind right sided pain after meal.
Treatment goal is to alleviate the symptoms and to eliminate the root cause of pain taking into account the nature of particular disease with concomitant pathology. In case of various pathology of gall bladder, complete removal of gall bladder is needed. That can be performed via surgical intervention by laparoscopy, robotics or open method.
Right-sided pain after meals is not something to ignore as far, we know the gall bladder is the main culprit, but many other conditions can present in similar way. Early evaluation of this symptom is required to prevent serious complications and managing the pathology behind this.
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