One of the most common causes of right-side pain in the torso is probably among the last things people would expect: Snoring. Any kind of obstructive sleep apnea, causing snoring, snorting, and most importantly, pauses in breathing, places a strain on the pulmonary vein, which brings oxygenated blood from the lungs back to the heart. This can cause chest pain that radiates either to the left, something like a heart attack, or to the right, like gallbladder pain, or even to the arms and legs. The solution, as you might guess, is to treat the sleep apnea or snoring, either with a BiPAP or CPAP machine, or, in some cases, simply by losing weight or by changing sleeping position.
There are many other unexpected causes of right-side pain. Here are just a few.
- Pancreatitis can cause intense pain on just one side of the abdomen. This pain will usually be accompanied by urgent diarrhea, floating stools, and especially unpleasant-smelling flatulence. Both pancreatic pain and gallbladder pain flare up after meals.
- Appendicitis also causes intense right-side pain, although appendicitis pain is in the lower abdomen. Vomiting that precedes pain is suggestive of either appendicitis or intestinal obstruction, but it's not unusual for appendicitis to cause no vomiting at all.
- Narrowing of the bile duct causes pain in almost exactly the same places as gallstones, but with symptoms of bile backing up, such as yellowing of the skin, painful bowel movements that pass floating stool, and itchiness. People who have this problem over a period of months or years also tend to develop small, raised patches at the inside corners of their eyes.
- Bile duct tumors cause milder pain in the upper right quadrant of the abdomen than gallstones, but they can cause jaundice (yellowing of the skin) similar to hepatitis or bile duct obstruction. Tumors in this location also cause floating, fatty stools and generalized itching.
- Cholangiocarcinoma, cancer of the bile duct, causes upper-right quadrant pain along with clay-colored stool and dark urine. It can also cause loss of appetite that leads to loss of weight, and generalized itching. Unlike gallstone attacks, the pain caused by cholangiocarcinoma is constant.
- Cholecystitis, gallbladder inflammation, differs from cholelithiasis, gallstones, by movement. When the problem is inflammation, not gallstones, the pain starts over the stomach and "moves" to the upper right abdomen.
- Gastroenteritis, or "stomach flu," tends to come on suddenly without warning, causing vomiting, diarrhea, and abdominal pain. About half of people who get viral stomach flu will develop fever and/or muscle aches. Gastroenteritis differs from gallstones in that it usually goes away in 12 to 60 hours.
- Gallbladder cancer causes symptoms that are more widely spread over the body than gallstones, and that last longer. As the cancer progresses, there will be loss of appetite and weight loss.
- Pancreatic cancer nearly always starts with unexplained weight gain. It progresses to cause pain in the middle of the abdomen that radiates down and to the back. There will be loss of appetite, nausea, and severe fatigue, sometimes with intense abdominal pain.
- Peptic ulcers (both gastric and duodenal) cause a burning, gnawing pain that usually starts two or three hours after meals. (Gallstone attacks usually occur an hour to 90 minutes after meals.) Food or antacids relieve duodenal (intestinal) ulcer pain but don't help with gastric (stomach) ulcer pain. As many as 80 percent of people who have duodenal ulcers have pain at night. Gallstone pain is not commonly worse at night.
Another tell that pain is due to gallstones is pain after eating fatty foods. More than other foods, fried foods, chips (crisps), and popcorn aggravate digestion to cause abdominal pain and urgent diarrhea.
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