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The right upper part of the abdomen, also known as the "right upper quadrant" (RUQ), contains some important organs. The liver and gallbladder are the most significant organs of the digestive system that are present in this part of abdomen. However, there are some other organs in the same region which play an important role in the body. These include:

  • Head of the pancreas

  • Duodenum

  • Part of the colon

Causes of heaviness in the right upper abdomen

Right-sided abdominal heaviness is, in the majority of cases, due to an abnormally enlarged liver. "Hepatomegaly" is the term doctors use for an enlarged liver. Hepatomegaly can result from several conditions including:

  • Fatty liver

  • Liver abscess

  • Hepatitis

  • Chronic liver disease - CLD

  • Liver cirrhosis

A feeling of heaviness can be normal after over-eating or drinking too much alcohol. However, feeling constant heaviness indicates something is wrong with digestive system.

Though the liver is the most common cause of heaviness under the rib cage, the gallbladder and intestines are also known to cause this symptom in rare cases.

Removal of the gallbladder (cholecystectomy) is a surgical procedure which may also result in right upper abdominal pain, heaviness, and rarely, tenderness. The majority of patients complain of heaviness after open gallbladder surgery. However, the symptoms are naturally fade within 5-7 days after the surgery.

Which examination and investigations are required to make the diagnosis?

It is not difficult to diagnose the exact cause of this disorder. The most important step in making a diagnosis is to rule out dangerous conditions such as liver cirrhosis, liver abscess, and gallstones. Once these causes are ruled out, there is nothing much to worry about.

Before doing any investigations, the doctor will physically examine your abdomen. The general physical examination is very important in making the correct diagnosis.

Here is a list of some investigations that help in making the correct diagnosis:

  • Complete blood count - CBC: To look for any infections in the body

  • Liver function tests - LFTs: To look for any disorders involving the liver

  • Ultrasound Abdomen: To look at the size of different organs

Do not forget that fatty liver is seen in most patients but it is not usually the cause of heaviness in right upper abdomen.

What is the treatment?

The treatment is totally dependent upon the cause. Abdominal heaviness fades away by simply treating the cause.

Remember: Heaviness, pain, or pressure in the right upper quadrant of abdomen is a symptom that should not be ignored, especially by patients who are known cases of liver or gallbladder disease. The reason is that some patients with similar presentation are diagnosed with chronic liver disease which is a silent killer. This disorder keeps on killing your liver cells without any symptoms. Patients may remain asymptomatic for years and then suddenly present with cirrhosis of the liver, which is an irreversible condition.

There is nothing be scared of, though -- this won't happen to you if you get regular checkups.

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