Why do I have pain under my right rib after eating?

There are many different causes of pain under the right rib. Pain that occurs in this location, especially after eating a fatty meal, may be caused by biliary colic. This condition occurs when a gallstone blocks the normal flow of bile from the gallbladder, leading to pain as the body attempts to move the stone. The pain is usually felt in the upper right abdomen or below the breastbone and may radiate to the right shoulder blade. It can also cause nausea and vomiting.

What causes biliary colic?

Gallstones are the most common cause of biliary colic. These are stone-like deposits made of cholesterol or bilirubin that can obstruct the bile ducts. This can cause the muscles in the bile duct to contract vigorously, leading to pain. Symptoms are worse after fatty meals when the gallbladder works to release bile to help with digestion.

Other causes of biliary colic include bile duct strictures or tumors that can also block bile flow and result in similar symptoms.

Symptoms of biliary colic

Someone experiencing biliary colic may experience the following symptoms:

• A steady or intermittent ache under the right rib cage
• Pain that radiates to the back or shoulder
• Nausea and vomiting

Symptoms are typically worse after meals, especially fatty meals. They may get better within a few hours after eating.

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Treatment of biliary colic

Treatment options for biliary colic may include lifestyle changes, medications, and surgery. Pain management and dietary changes (e.g., avoiding fatty foods) can help relieve symptoms. Antinausea medications may help with nausea and vomiting episodes.

In recurring cases or severe episodes, gallbladder removal surgery (cholecystectomy) may be recommended. Medications to dissolve gallstones are sometimes used, but they take time and are not always effective. In those who are not able to undergo surgery, extracorporeal shockwave lithotripsy may be an option.