Right Upper Quadrant Pain

Authored by Dr Mary Harding, 08 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 08 Jul 2017

This leaflet looks at pains which can develop in the upper part of the tummy (abdomen) on your right-hand side. It deals with possible causes, how a diagnosis might be made, and what the treatment might be.

The right upper quadrant (RUQ) is a section of your tummy (abdomen). Look down at your tummy, and mentally divide the area from the bottom of your ribs down to your pubes into four quarters. The quarter on your right side closest to your ribs is your RUQ.

Right and Left Upper Quadrants

By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Right and Left Upper Quadrant Organs

By Mariana Ruiz Villarreal, modified by Madhero88 [Public domain], via Wikimedia Commons

The organs within your RUQ are your:

  • Liver.
  • Gallbladder.
  • Part of the pancreas.
  • Duodenum and some other parts of your large and small bowel.
  • Right kidney (at the back behind the other organs).

And don't forget the skin and nerves of that section.

Pain can come from any of the organs mentioned above, and indeed these are the source for the most common causes. But the human body is never simple, so pain can also come from other areas of your body. This is called "referred" pain. So this rather widens the possible options.

In adults, gallstones are a common cause of pain in this area. Other possibilities are kidney infections, shingles and ulcers in the upper part of the guts. Learn about the most common causes of RUQ pain in adults, in children and in pregnancy. You can also read about other, less common causes.

Yes, if you have a pain which doesn't settle, you will probably need to see a health professional to help you figure out the cause. See a doctor urgently if:

  • Your skin has turned yellow (this is called jaundice).
  • Your wee has gone darker and your poo lighter (this suggests a blockage in the tubes around your liver and gallbladder).
  • Your pain is very severe.
  • You have recently lost weight without trying to do so.
  • You are bringing up (vomiting) blood, or have blood in your poo (including a very dark coloured poo which can be caused by old blood from high up in the guts).
  • You have a high temperature (fever) with shaking (rigors).
  • You feel out of breath.

The doctor will be able to get a reasonable idea of the reason for the pain by asking you some questions and examining you. They may want to test a sample of your urine. You may then have to have further tests, depending on their suspicions at this stage. These may be done urgently or in due course, again depending on their suspicions and how much pain you are in. Possible tests might include blood tests, an ultrasound scan, a look into your stomach and upper bowel with a camera (endoscopy) and other scans and "scopes".

Learn more about diagnosis of RUQ pain.

This will entirely depend on the cause. Once this has been established, your doctor will be able to advise. Learn about treatments for some of the common causes of RUQ pain.

Further reading and references

  • Kim JS; Acute Abdominal Pain in Children. Pediatr Gastroenterol Hepatol Nutr. 2013 Dec16(4):219-224. Epub 2013 Dec 31.

  • Wilcox CM; Sphincter of Oddi dysfunction Type III: New studies suggest new approaches are needed. World J Gastroenterol. 2015 May 2121(19):5755-61. doi: 10.3748/wjg.v21.i19.5755.

  • Cholecystitis - acute; NICE CKS, January 2017 (UK access only)

  • Gallstones; NICE CKS, February 2015 (UK access only)

  • Ahmed F, Fogel EL; Right upper quadrant pain and a normal abdominal ultrasound. Clin Gastroenterol Hepatol. 2008 Nov6(11):1198-201. doi: 10.1016/j.cgh.2008.06.020.

  • Cartwright SL, Knudson MP; Diagnostic imaging of acute abdominal pain in adults. Am Fam Physician. 2015 Apr 191(7):452-9.

Every morning I wake up with left abdominal and back pain, it's located between my spine around to my navel. The pain is in the exact same place every morning and wakes me from my sleep, iv had it...

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