Pain in the right side when inhaling is a very common symptom. There are many reasons that lead to this unpleasant sensation: from the most harmless to the serious, requiring immediate medical attention. In this article, you will learn which diseases can lead to the appearance of pain on the right and what needs to be done with each of them.
What is in the right side?
To understand the pathology of which organs can be felt by pains on the right, it is worth figuring out what is within this anatomical site.
First, find out that in the right side under the ribs in front:
- the lower lobe of the right lung, covered with pleura (thin membrane). It is noteworthy that the lung itself does not cause pain, but pain in the right hypochondrium can cause damage to the pleura;
- capsule-coated liver. The same principle works here as with the lung: it is not the liver itself that hurts, but its capsule;
- gall bladder with bile ducts, which also extend from the liver, flowing into the duodenum;
- cecum with vermiform appendix.
If pain in the inspiration in the right side behind is disturbing, this may be a pathology of the following organs:
- kidneys with ureters moving down from them;
- in women, below the right are the uterine appendages: ovaries and fallopian tubes.
What diseases require emergency care?
Separately, it is necessary to highlight the diseases that cause pain in the right hypochondrium in front and requiring immediate medical attention:
- acute cholecystitis;
- acute appendicitis;
- injury;
- acute myocardial infarction;
- acute intestinal obstruction.
All of the above pathological conditions require emergency care and, often, surgical intervention.
Acute cholecystitis and appendicitis
These two pathologies belong to the group of diseases that cause a specific symptom in surgery called the “acute abdomen”. This means that they require immediate surgical examination followed by laparotomy. In this article, these two pathologies are combined into one group, because they have very similar clinical symptoms. Despite the fact that the appendix is located in most cases on the lower right abdomen, there are options when it is in the right hypochondrium, almost at the same level with the gallbladder. Then, cholecystitis and appendicitis can equally be the causes of pain in the right upper quadrant.
However, there are a number of symptoms that can help make the correct diagnosis. So, for cholecystitis, in addition to pain when inhaling in the right side, are characteristic:
- nausea and vomiting with an admixture of bile, which does not bring relief;
- yellowing of the skin that occurs when the bile duct is blocked ;
- temperature increase to high numbers;
- general weakness and chills.
Acute appendicitis, in turn, has a number of the following manifestations:
- pains begin, usually in the middle of the abdomen, and then go to the right side;
- muscle tension of the abdominal muscles;
- positive symptoms of peritoneal irritation (the most common is the Shchetkin-Blumberg symptom);
- the temperature is absent or rises to subfebrile;
- possible nausea and vomiting.
Acute intestinal obstruction
This is a dangerous surgical pathology, which can lead to death in the absence of timely assistance. There is a blockage of the intestinal cavity and a violation of the evacuation of feces. In the future, they can be absorbed into the blood and have a toxic effect on the whole body.
The presence of the following symptoms will help to suspect the development of intestinal obstruction when pricking in the right side during inhalation:
- the pain appears sharply, paroxysmally, has a pronounced intensity, accompanied by nausea and vomiting;
- lack of bowel movement for a long time - constipation;
- poor general health: lethargy and weakness.
Acute myocardial infarction
The most insidious pathology that can cause pain when you inhale in the right side is myocardial infarction. Many are aware of symptoms of a heart attack, such as pain on the left behind the sternum, which radiates to the left arm, lower jaw, left shoulder blade. And this is indeed the most common variant of the clinical course of a heart attack.
However, there is an abdominal form of heart attack that mimics other surgical pathologies (acute appendicitis, cholecystitis, intestinal obstruction). Therefore, with the appearance of pain in the right side, it is very important to make an electrocardiogram to exclude the presence of this dangerous pathology.
For pains with myocardial infarction, a very high intensity is characteristic, which can not be removed with any drugs. In this case, only narcotic analgesics ("Morphine") can help you feel better.
What is intercostal neuralgia?
The term "intercostal neuralgia" is widely heard. And not surprising, because this is really one of the most common causes of pain in the right hypochondrium when inhaling from the front. But not everyone, however, correctly understands the meaning of this term. After all, even doctors are actively discussing this topic. Many consider intercostal neuralgia an independent diagnosis, while others say that this is only one of the symptoms of a number of diseases. Therefore, we will try to figure out what this pathology is all about.
Neuralgia is a pain in the nerves. It can occur both with direct damage to the nerve (with trauma or inflammation - neuritis), and with compression of the nerve by other organs located close to it. For example, the cause of trigeminal neuralgia (providing facial sensitivity) may be inflammation of the sinuses.
Intercostal neuralgia: the main causes
The causes of pain in the right hypochondrium during inspiration from the front, caused by neuralgia, are really diverse:
- injuries
- intoxication: from the outside (bacterial toxins, drugs), internal (associated with pathology of internal organs);
- multiple sclerosis - a chronic autoimmune disease of the nervous system, manifested by the destruction of the membranes of nerve fibers (myelin);
- polyradiculoneuropathy;
- herpes zoster - herpes is an infection that affects the nerve ganglia; intercostal nerves and the trigeminal nerve are most often involved in the process;
- allergic reactions;
- pathology of the spine - hernias and protrusions of the intervertebral discs, which lead to compression of the roots of the spinal cord;
- compression of the nerve with tumors of the right lung or mediastinal organs.
It is also worth noting separately the conditions that increase the likelihood of tingling when inhaling in the right side:
- diabetes mellitus, which leads to peripheral polyneuropathies;
- violation of the exchange of vitamin B12, since it is necessary for the formation of nerve membranes;
- alcohol abuse, which can lead to alcoholic polyneuropathy;
- cardiovascular diseases (atherosclerosis, coronary heart disease), which lead to a decrease in the supply of oxygen to the nerves;
- endocrine diseases (thyrotoxicosis, adrenal gland pathology, prolonged use of hormonal drugs).
Intercostal neuralgia: symptoms
The leading clinical manifestation of neuralgia of the intercostal nerves is the appearance of pain in the right side with a deep breath, coughing, sneezing, sudden movements. On palpation, the gaps between the ribs are sharply painful. A feature of these pains is that the patient in most cases can accurately indicate their location. This feature will help distinguish neuralgia from diseases of the cardiovascular system, for example, from angina pectoris.
So, heart pains do not have a specific location, the patient cannot point a finger to a specific place. More often he will characterize the pain as pressing, putting his fist to the sternum, while with neuralgia the pain is stitching. In addition, pain with angina pectoris begins quickly and passes quickly (3-5 minutes). It is also not characteristic of its increase with sneezing or coughing.
Hepatic or biliary colic
Some of the most common causes of pain in the right side should be considered separately, since almost everyone knows these terms, while not completely understanding what they mean by themselves.
Hepatic (or biliary) colic is not a disease, but a separate symptom. Despite the presence of the word “hepatic” in its name, colic is not due to pain in the kidney, but because of the stretching of the capsule around it. Almost everyone at least once experienced hepatic colic by running a cross at school or simply by walking a long distance. The mechanism of this symptom is that with increased physical exertion, the blood supply to the liver increases, its edema occurs. Upon reaching a certain size, the liver stretches the capsule surrounding it, about which information is transmitted through the nerve endings to the brain. Then the same pain sensations arise in the right side, called hepatic colic.
Most often, no specific treatment is required. When physical activity stops, the swelling subsides and the pain goes away.
However, colic may occur with pathology of the gallbladder and biliary tract. So, gallbladder inflammation (cholecystitis) or gallstone disease can lead to blockage of the biliary tract. This, in turn, causes the same swelling of the liver tissue and stretching of the capsule.
Therefore, if a person experiences prolonged and severe pain in the right side, which is in no way associated with physical activity, it is urgent to seek medical help. After all, the only possible treatment for cholelithiasis is cholecystectomy (removal of the gallbladder).
Diagnosis of pain in the side
To find out the true cause of pain in the right side during inhalation, modern diagnostic methods will help:
- electrocardiogram - to exclude angina pectoris and myocardial infarction;
- chest x-ray - to diagnose lung disease and mediastinal organs, as well as some heart diseases;
- computed tomography and magnetic resonance imaging are the most effective diagnostic methods that can detect tumors of the chest and spinal cord, vascular and inflammatory pathologies, diseases of the spine.
The rapid development of modern medicine and the increasing improvement of laboratory and instrumental diagnostic methods allow us to determine in time the cause of pain in the right side when inhaling to prescribe an effective treatment.
The main methods of treatment
All methods of treating pain in the right side can be divided into three main groups:
- etiotropic - aimed at eliminating the cause of the disease;
- symptomatic - designed to alleviate the symptoms of the disease;
- pathogenetic - affects individual stages in the development of a specific disease.
In addition, treatment can be medication and non-medication. The latter includes physiotherapy exercises, breathing exercises, treatment with folk remedies.
Etiotropic and pathogenetic treatment should be carried out strictly according to the prescription of the attending physician after carrying out all additional diagnostic methods and ascertaining the cause of the disease. Symptomatic therapy can be performed independently at home. Therefore, further we will focus on this particular type of treatment.
Non-drug treatment
How to treat pain in the right side when inhaling? What folk methods and medicines will help relieve pain in the right side?
Treatment of symptoms of intercostal neuralgia at home should primarily include strict bed rest in the acute period, which usually lasts 1-3 days. The patient is recommended to lie on a solid, level surface. Dry heat also alleviates pain: a heating pad, warm salt in bags, mustard plasters. This tool should be discarded if there are rashes, redness, abrasions on the skin.
Wearing a special corset for several days helps a lot. In addition, you need to spare the body: do not lift weights, avoid sudden movements and turns, prolonged sitting position.
Drug treatment
The following groups of medicines are used to treat symptoms of intercostal neuralgia at home:
- analgesics;
- antispasmodics;
- non-steroidal anti-inflammatory drugs.
The group of analgesics includes such drugs as Analgin, Baralgin, Sedalgin.
The following non-steroidal anti-inflammatory drugs are allocated: "Ibuprofen", "Diclofenac", "Voltaren", "Indomethacin".
Another effective group of drugs that will help reduce pain in the right side are antispasmodics. The principle of their therapeutic effect is based on the elimination of skeletal muscle spasm. The following is a list of antispasmodics most commonly used to treat side pain:
- atropine sulfate;
- platyphyllin hydrotartrate;
- mebeverin - "Duspatalin", "Niaspam", "Meverin";
- Pinaweria bromide - "Dicetel";
- otilonium bromide - "Spasmomen";
- drotaverin - "No-shpa", "Spazmol", "No-shpalgin";
- papaverine - "Papazol";
- Nitroglycerin - Nitro-Mick, Nit-Ret, Sustak.
In this list of antispasmodics, international names are on the left, and trade names on the right, with which you can find these drugs in Russian pharmacies.
In addition to antispasmodics, analgesics and anti-inflammatory drugs, vitamin therapy is effective for relieving symptoms. Especially effective are preparations containing vitamins B1, B6, B12.
If the pain is too strong, novocaine blockade is indicated. Physiotherapy and reflexology are also widely used.
Preventive actions
To reduce the likelihood of pain in the right side when inhaling, it is worth following these rules:
- adhere to proper and balanced nutrition, which includes the rejection of fatty and fried foods, the use of vegetables and fruits. This will reduce the risk of developing acute surgical pathology;
- avoid stress and mental overload;
- streamline sleep and rest;
- provide daily moderate physical activity (15-20 minute exercise, walk in the fresh air);
- avoid excessive physical exertion;
- get rid of bad habits: quit smoking and limit alcohol intake.
Particular attention should be paid to observing these rules for those who have already had episodes of pain in the right side, people with previous surgical interventions, and diseases of the cardiovascular system. However, healthy people should try to adhere to the above rules, because they will help not only prevent the appearance of an unpleasant symptom, but also strengthen health in general.