Pain under the right ribs

Category: Digestive & Abdomen · All digestive symptoms

What it can feel like

Pain under the right ribs sits over the liver and gallbladder. It ranges from a dull ache after fatty meals to the intense, wave-like pain of a gallstone attack that can spread to the right shoulder blade and last for hours.

Possible causes

A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.

Common causes

Pain here can be associated with gallstones (biliary colic), indigestion and reflux, muscle strain of the abdominal wall, and inflammation of the liver capsule after viral illness.

Other possible causes

Persistent or severe pain can be associated with an inflamed gallbladder, infection ascending the bile ducts, liver inflammation, or occasionally problems of the right kidney, lung base or pancreas.

Red flags — when to seek help promptly

Pain under the right ribs with fever, shivering or yellowing of the eyes — urgent
Severe pain lasting more than a few hours or steadily worsening
Pain with vomiting that will not settle
Pain with dark urine and pale stools

What a clinician may do

A clinician will examine the abdomen — tenderness under the right ribs when breathing in is a classic gallbladder sign — and arrange blood tests for liver function and inflammation, plus an ultrasound scan of the gallbladder and bile ducts.

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Frequently asked questions

What does a gallstone attack feel like?

Typically a strong, steady or wave-like pain under the right ribs or in the centre of the upper abdomen, often starting after a fatty meal or at night, sometimes spreading to the back or right shoulder, and lasting from half an hour to several hours.

Can gallstones be silent?

Yes — many people have gallstones found on scans that have never caused symptoms, and those usually need no treatment. It is symptoms — attacks of pain, inflammation or jaundice — that drive decisions about surgery.

Related symptoms — Digestive & Abdomen

Abdominal pain Black stools Bloating Blood in the stool Change in bowel habit Constipation

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Please note: This page is educational information about a symptom. A symptom alone cannot diagnose any condition, and the causes listed here are possibilities, not a diagnosis. If you are worried about a symptom — especially one that is new, severe, getting worse or not going away — please see your own clinician, who can examine you and arrange tests. In an emergency, call your local emergency number.