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Upper right abdominal pain is a common ailment seen in doctor’s offices and clinics everywhere. Unfortunately, there are many possible causes of pain in this region. As medical professionals run tests to determine what the issue is, patients are often left in a lot of pain and discomfort. Even when the cause is known, treatment may take some time to alleviate pain.

Luckily, there are options for managing upper right abdominal pain no matter the cause.

In this article, we will discuss 10 effective tips for dealing with abdominal pain as well as some of the potential causes.

Note: This article is not intended to replace diagnosis or treatment from a physician. If you are experiencing severe pain, pain that is worsening, and or fever, seek urgent medical treatment.

1. Over-the-Counter (OTC) Medications and Gas and Indigestion

One of the most common causes of upper right abdominal pain is gas and indigestion.

OTC medications for gas and indigestion include:

– Dietary enzymes including alpha-galactosidase and lactase.

  • Alpha galactosidase helps break down hard-to-digest carbohydrates found in beans and other vegetables. Lactase helps to digest the sugar lactose which is found in dairy products. Both of these enzymes have been well studied and proven to help digestion in people who do not easily stomach these foods. There are other dietary enzymes, like papain, available for purchase but they have not been studied as closely so their effectiveness is unknown.

– Simethicone. This anti-foaming agent breaks down gas bubbles that may be trapped in the intestines. This can be useful in relieving sensations of trapped gas that cause much discomfort. Babies are often given small amounts of simethicone to relieve gas associated with colic.

– Activated charcoal. Sometimes given as a preventative for “traveler’s diarrhea,” activated charcoal may help alleviate symptoms of gas and indigestion. Studies on the use and effectiveness of activated charcoal for gas and indigestion are limited so it is not clear how helpful this treatment may be. Note: activated charcoal may interfere with the absorption of medications. If you are taking prescription medications, consult with a medical professional before treating symptoms with activated charcoal.

In most cases, OTC medications for gas and indigestion should be enough to make you more comfortable. Other dietary and lifestyle changes can be made if this is a regular issue. It is advised that you consult with a physician to help identify potential causes of persistent gas and indigestion issues as you may have an underlying medical condition.

IBS and IBD

There can be several potential causes of persistent painful gas and indigestion. These include irritable bowel syndrome and irritable bowel disease.

Irritable bowel syndrome (IBS) is a common digestive disorder characterized by abdominal pain and discomfort. IBS affects about 10 percent of Americans. The cause of IBS is unknown, but some factors may be linked to the condition. These include stress, diet, hormones, medications, and genetics.

Irritable bowel disease (IBD) may present similarly to IBS but it is a distinctly different condition. IBD is characterized by inflammation in the intestines which can cause permanent damage to the lining. This damage can be seen in diagnostic imaging. IBD can also increase the risk of colon cancer.

Both IBS and IBD can cause significant, painful symptoms that can interfere with daily life. If you experience persistent painful gas, indigestion, and changes in bowel function, speak with your doctor.

2. Anatacids and Other Treatments for Gastritis

Upper right abdominal pain can also be caused by a condition called gastritis. Gastritis is inflammation of the stomach lining. The symptoms include nausea, vomiting, abdominal pain, diarrhea, weight loss, and fatigue.

These symptoms can range in severity between mild to severe. Gastritis may be caused by stress, poor diet, smoking, alcohol consumption, certain medications, or Helicobacter pylori infection.

The following treatments may provide relief from upper right abdominal pain due to gastritis:

– Antacids. An antacid works to neutralize acidity in the stomach. They work best when taken regularly throughout the day during periods of indigestion or gastritis. You may need to take them at bedtime because they tend to wear off during sleep. Some people find these products irritating to their esophagus.

– H 2 blockers. Histamine receptor antagonists block histamines, chemicals released by cells in response to injury or irritation. In addition to relieving symptoms associated with gastritis, H 2 blockers may reduce the likelihood of ulcers developing in the future. However, there is no evidence that they will relieve other types of gastrointestinal problems such as heartburn. Consult with your health care provider prior to starting therapy with H 2 blockers.

– Antibiotics. Some antibiotics such as amoxicillin/clavulanate potassium, clarithromycin, metronidazole, tetracycline, erythromycin, ciprofloxacin, levofloxacin, and azithromycin may reduce the number of bacteria causing gastric irritation. Antibiotics should only be taken under the direction of a physician.

Gastritis can be caused by a bacterial imbalance, in the case of food poisoning, or by viruses.

3. Treat Other Symptoms of Viral Gastritis

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Viral gastroenteritis, or the “stomach flu,” causes similar symptoms to those of gastritis including nausea, vomiting, bloating, cramping, abdominal pain, fever, chills, headache, muscle aches, and weakness. This condition usually lasts one week or less. There are many viral infections that can lead to this type of illness. Most often, children get rotavirus while adults typically contract noroviruses. Both of these illnesses are highly contagious and spread through contact with contaminated surfaces or objects.

People who come into close contact with someone infected with either virus may become ill themselves. Treatment includes rest, fluids, and medicines to relieve symptoms until the illness passes. Treatments for viral gastritis include:-Antiemetics. Antiemetic drugs are used to prevent motion sickness and relieve nausea and vomiting associated with viral gastritis. Examples include dimenhydrinate, scopolamine patches, prochlorperazine, and promethazine.

-Antidiarrheals. Used to control the symptoms of diarrhea, antidiarrheals are available over the counter. Antidiarrheals are not usually recommended in the first 1 to 2 days in cases of viral gastritis. This is because the body is eliminating infectious viral material and if it is prevented from doing so symptoms may be made worse. Consult with a doctor before taking antidiarrheal medications. Loperamide and Bismuth Subsalicylate are two of the most common OTC antidiarrheal medicines available.

4. Analgesics and Surgery for Appendicitis

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In some cases, appendicitis may cause upper right abdominal pain but in most cases, it begins with pain near the navel and moves to the lower right abdomen. Pregnant women are most likely to experience pain in the upper right quadrant of the abdomen.

Appendicitis is most common in people between the ages of 10 and 30 although anyone may become affected. Surgical removal of the appendix is the most common treatment for appendicitis.

Symptoms of appendicitis include:

• Pain localized below the navel and above the pubic bone on both sides of the midline. The pain may radiate down the side toward the hip joint. It may also move up along the spine toward the neck.

• Abdominal tenderness upon deep palpation. A hard mass may feel like an enlarged lymph node.

• A fever greater than 100 degrees Fahrenheit.

Appendicitis can have an acute onset and runs the risk of complications. So, if you are experiencing any of these symptoms seek urgent medical attention.

When patients are admitted to the hospital with appendicitis and are awaiting surgery, they will often be treated with intravenous pain medications.

Following an appendectomy, patients should avoid heavy lifting, strenuous exercise, and sexual activity for at least 3 weeks. They must take antibiotics as prescribed by their physician. If they do not follow instructions properly, there could be serious consequences such as infection.

5. NSAIDs and Other Medications for Gallstones

Gallstones are a common cause of upper right abdominal pain. This is because the gallbladder is located in this region of the abdomen.

Gallstones occur when cholesterol crystals form inside bile ducts that lead to the liver. These stones then travel back out of the liver and into the small intestine where they block the flow of food through the intestines causing discomfort. In addition, the presence of large amounts of calcium salts within the gall bladder causes inflammation which leads to more frequent episodes of painful attacks.

The best way to treat gallstone disease is to remove them surgically. However, many times doctors recommend medication instead of surgical intervention. There are several types of drugs used to dissolve or prevent the formation of gallstones including:

1) Cholecystokinin. CCK stimulates the secretion of pancreatic enzymes that help break down fats and proteins found in foods. By stimulating the pancreas, CCK helps reduce levels of cholesterol in the bloodstream.

2) Proton pump inhibitors. PPIs inhibit the production of stomach acid.

For treating the pain associated with gallstones and gallbladder attacks, these medications are recommended:

– NSAIDs. Nonsteroidal anti-inflammatory drugs are the usually the first-line pain medications recommended. Examples include ibuprofen, naproxen, ketoprofen, indomethacin.

– Opioids. Narcotic analgesics work well for severe pain. But, they carry risks of addiction and overdose. Therefore, they are only considered after other treatments fail.

– Anticholinergics. These drugs block the neurotransmitter acetylcholine. This transmitter is associated with muscle contractions in the bile ducts of the gallbladder. So taking anticholinergics might prevent gallbladder attacks. For some patients, these drugs are a better option than NSAIDs.

Surgery is an option for some patients who experience gallbladder attacks and gallstones.

6. Celiac Plexus Block for Chronic Pancreatitis

Chronic pancreatitis occurs when chronic damage to the pancreas results in scarring and fibrosis. The result is the reduced ability of the gland to produce digestive juices needed for digestion. As a consequence, people suffering from chronic pancreatitis may develop nausea, vomiting, diarrhea, weight loss, fatigue, and jaundice in addition to chronic pain in the abdomen.

Celiac plexus blocks involve injecting local anesthesia around the celiac trunk. It’s done under ultrasound guidance using fluoroscopy by a professional who has received extensive training.

The celiac plexus is a bundle of nerves that sits in front of the diaphragm behind the stomach. These nerves carry sensory signals, including pain signals, throughout the abdomen. When a celiac plex block is performed, these nerves will be numb for an extended period of time offering pain relief.

This procedure is not permanent. For some patients the pain-relieving effects can last for weeks for others it may last for years.

7. Splanchnic Nerve Block For Abdominal Cancer

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Abdominal cancers can result in pain throughout the abdomen.

These cancers include:

– Liver cancer

– Pancreatic cancer

– Colorectal cancer

– Stomach cancer

– Kidney cancer

Splanchnic nerve blocks involve an injection of local anesthetic into the abdominal wall near where the splanchnic nerves enter the body. The splanchnic nerve starts in the thoracic vertebrae and runs along both sides of the spine where it eventually joins with the celiac plexus.

Like with a celiac plexus block, a splanchnic nerve block numbs the nerves responsible for transmitting pain signals.

The risks associated with this procedure are low making it a good choice for individuals living with pain caused by abdominal cancer.

8. Sympathetic Block for Chronic Abdominal Pain

Sympathetic blocks target the ganglion nerve bundles that are a part of the sympathetic nervous system.

Depending on where the patient is experiencing abdominal pain, the trained physician who is performing the procedure will inject an anesthetic into the responsible ganglion nerve bundles.

The effectiveness of this procedure varies based on the patient and the specific condition they are experiencing. To determine if this type of nerve block will help treat chronic abdominal pain, patients should speak with a qualified pain management practitioner.

Conclusion

Upper abdominal pain can have many different causes and can vary widely in intensity. OTC medicines help in cases of mild to moderate upper abdominal pain caused by gastrointestinal upsets.

In cases of persistent pain due to chronic conditions or more serious illnesses, there are treatment options that can be provided by pain management experts including nerve blocks.

To learn more about these pain solutions contact the experts at MidSouth Pain.

You don’t have to live in pain.