Cramp in the Upper Right Abdomen: Causes and When to Worry

What causes a cramp in the upper right abdomen?

The most common causes of a cramp or pain in the upper right abdomen are gallstones and gallbladder inflammation, trapped gas in the colon near the liver, a strained muscle, liver inflammation such as hepatitis or fatty liver disease, a duodenal ulcer, and kidney stones or infection on the right side. Less often, pneumonia at the base of the right lung or shingles causes pain in this area.

Is upper right abdominal pain my gallbladder?

It often is. Gallbladder pain, called biliary colic, is usually a steady, severe ache under the right ribs or in the upper middle abdomen that starts 30 minutes to a few hours after a fatty or large meal, lasts from about 30 minutes to several hours, and may spread to the right shoulder blade or back with nausea or vomiting. Pain that lasts longer with fever or yellow skin may mean the gallbladder is inflamed or infected.

Can the liver cause upper right abdominal pain?

Yes, the liver can cause a dull ache or fullness in the upper right abdomen when it is inflamed or enlarged, as in hepatitis, fatty liver disease or alcohol-related liver disease. Liver problems often cause few symptoms early on, so tiredness, dark urine, pale stools, itching or yellow skin or eyes are important clues. Abnormal liver blood tests and imaging help confirm the cause.

Learn about fatty liver disease symptoms and liver care in Katy and Cypress.

When is upper right abdominal pain an emergency?

Get emergency care for upper right abdominal pain that is severe or lasts more than a few hours, comes with fever or chills, yellow skin or eyes, persistent vomiting, dark urine with pale stools, a rigid belly, or shortness of breath or chest pain. These can signal gallbladder infection, a blocked bile duct, pancreatitis, pneumonia or a heart problem.

How can I ease mild upper right abdominal cramps?

For mild cramps that seem to be gas or a muscle strain, try a short walk, a warm compress, gentle stretching and smaller, lower-fat meals. Avoid large fatty meals if gallbladder pain is suspected. If cramps keep returning after meals, see a doctor for an abdominal ultrasound rather than waiting, since gallstone attacks often recur.

How is the cause diagnosed?

Diagnosis usually starts with an exam and blood tests, including liver tests, a blood count and lipase, and an abdominal ultrasound to look for gallstones, gallbladder inflammation and liver changes. Depending on the findings, a CT scan, MRI of the bile ducts, a FibroScan for the liver, or an upper endoscopy for ulcers may follow. Treatment depends on the cause; symptomatic gallstones are often treated with gallbladder removal by a surgeon.

See diet after gallbladder removal and abdominal pain by location.

Key takeaways

• Upper right abdominal cramps often come from the gallbladder, liver, trapped gas or a strained muscle.
• Gallbladder pain typically follows fatty meals, lasts hours and may spread to the right shoulder.
• Liver problems may cause a dull ache with fatigue, dark urine or yellow eyes.
• Fever, yellow skin, severe or long-lasting pain needs emergency care.
• An ultrasound and blood tests usually find the cause.

Frequently asked questions

Sources

1. NIDDK — Gallstones
2. MedlinePlus — Gallbladder diseases
3. MedlinePlus — Liver diseases
4. MedlinePlus — Abdominal pain
5. MedlinePlus — Hepatitis

Where to be seen in Katy and Cypress

United Gastroenterology Associates has two offices: Katy, at 23920 Katy Freeway, Suite 555, next to Memorial Hermann Katy Hospital, and Cypress, at 21216 Northwest Freeway, Suite 640, on US-290. Both are open Monday through Friday, 8:30 AM to 5:00 PM, closed for lunch from 12:00 to 1:30 PM, and serve patients from Fulshear, Richmond and across Greater Houston. Call (346) 340-4414 for either office.

If you have severe pain, vomit blood, pass black stools or have chest pain, call 911 or go to the nearest emergency room.