Pain felt in the subcostal region called 'hypochondrium' after eating, breathing... should not be taken lightly. They can signal liver, pancreas, kidney, or bile duct disease. It is recommended to consult a doctor.

Definition of hypochondrium

Right subcostal pain appears in the right hypochondrium, the upper part of the abdomen. Left subcostal pain refers to the pain felt on the upper part of the abdomen also but on the left side (left hypochondrium).

Causes of hypochondrium pain
Gas in the intestines. "One of the main causes of pain in this area of the abdomen is the presence of gas bubbles in the large intestine. This causes digestive discomfort, attacks of colitis. It's quite banal', describes in the preamble Professor Jean-Marie Péron, head of the hepato-gastroenterology department of the Purpan Hospital (Toulouse University Hospital) and secretary-general of the French National Society of Gastroenterology (SNFGE).

Gallstones. Pain felt under the right ribs can also be a sign of damage to the bile ducts called cholelithiasis. It occurs when stones, which form in the gallbladder, put tension on the bile ducts. It is a common disorder in Western countries where at least 20% of the adult population suffers from it. "In the vast majority of cases, cholelithiasis does not cause any symptoms and does not require special treatment," says Professor Jean-Marie Péron. But sometimes the stone migrates into the bile ducts, resulting in pain called hepatic colic. The elderly, women, and obese people are most at risk. People who suffer from hepatic colic complain of severe pain lasting several minutes or even hours, which can radiate into the back and right shoulder. Pains are so violent that breathing is difficult and limited. Another complication of vesicular stones is acute cholecystitis. It is an infection of the gallbladder that combines pain in the right hypochondrium and moderate fever. This clinical picture can worsen further if the stone comes out of the cystic duct and joins the main bile duct. Patients with this complication, called angiocholitis, suffer from severe pain associated with high fever, chills, and jaundice (jaundice). This disorder is rare, but it is a vital emergency. Patients must be treated very quickly otherwise they risk sepsis," insists Professor Péron.

Liver disease. Chronic pain of the right hypochondrium can be a sign of liver disease. Patients then complain of gravity in the abdomen on the right under the ribs. The cause: an increase in the volume of the liver (hepatomegaly). This is particularly the case of the heart, liver, a liver disorder observed in patients with heart failure.' In the latter, there is an accumulation of blood in the liver because the veins can not make it go up to the heart," explains the specialist. Right subcostal pain can also signal a benign or malignant liver tumor (cancer). In the case of malignant tumor, it can be primary cancer or metastases.

Other miscellaneous causes. Left subcostal pain can be a telltale sign of several conditions such as colitis (inflammation of the colon), pancreatitis (inflammation of the pancreas), hydronephrosis and tuberculosis. They can also result from high pressure on the kidney and urinary tract due to a stone (renal colic), the presence of cysts, or kidney cancer.

Diagnosis: ultrasound, blood test

The first examination to be performed systematically is an abdominal ultrasound to identify possible stones in the gallbladder or bile ducts or a liver tumor. In parallel, it is also essential to take a blood test to perform a liver test. This analysis makes it possible to detect any liver abnormality. ' It is necessary to check the level of transaminases, gamma GT, alkaline phosphatases, total bilirubin. If the pain is due to a liver disorder, the rates will increase," says Professor Jean-Marie Péron, who adds that "if the results of the ultrasound and blood test are negative, it is reassuring".

When should I consult?

"In general, any pain of the right hypochondrium deserves a consultation with the doctor," judges the specialist. The latter is reassuring and recalls that in a large number of cases, the pains of the right hypochondrium are actually pains of the large intestines induced by gas or constipation.

Treatments

In the event that stones located in the gallbladder or bile ducts are found by chance in a patient who does not suffer from no treatment is necessary.
On the other hand, in patients who have hepatic colic, it is recommended to perform surgery to remove the gallbladder (cholecystectomy) since it is the cause of the stones.
In the case of an infection of the vesicle, or acute cholecystitis, the patient should be hospitalized to receive antibiotic therapy and benefit in the following days from a cholecystectomy.