pain locator - where does it hurt

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Pain Locator: Where Does it Hurt?

Abdominal pain can have a wide range of causes. Understanding the nine regions and four quadrants of your abdomen can help pinpoint possible origins and identify associated ailments. Here's a helpful guide.

May 10, 2018 5 minute read

Abdominal pain could be indicative of many ailments, ranging from gas and constipation to gallstones or pancreatitis. Understanding the type of pain you're experiencing, where it's originating from, and the severity of your ailment, could help you get the correct treatment before symptoms worsen.

It's important to become acquainted with the nine regions of the abdomen, so you can better understand how your digestive organs function and are susceptible to a variety of medical issues.

9 Regions of the Abdomen

Envision the sections of your abdomen as a Tic-Tac-Toe board. To simplify this even further, let's number each region of your abdomen: Regions 1 to 3 are the top row (right, middle, left), regions 4 through 6 encompass the middle boxes, and regions 7 to 9 comprise the bottom row. 

9 Regions of The Abdomen 

Region 1: Right Hypochondriac Region (upper, right)

Liver, Gallbladder, Right Kidney, Small Intestine

Region 2: Epigastric Region (upper, middle)

Stomach, Liver, Pancreas, Duodenum (first part of small intestine), Spleen, Adrenal Glands

Region 3: Left Hypochondriac Region (upper, left)

Spleen, Colon, Left Kidney, Pancreas

Region 4: Right Lumbar Region (middle, right)

Gallbladder, Liver, Right Colon

Region 5: Umbilical Region (center)

Umbilicus (navel), Jejunum (the part of the small intestine between the duodenum and ileum), Ileum (the third portion of the small intestine, between the jejunum and the cecum), Duodenum

Region 6: Left Lumbar Region (middle, left)

Descending Colon (the part of the large intestine that passes downward on the left side of the abdomen toward the rectum), Left Kidney

Region 7: Right Iliac Fossa (lower, right)

Appendix, Cecum (a pouch connected to the junction of the small and large intestines)

Region 8: Hypogastric Region (lower, middle)

Urinary Bladder, Sigmoid Colon (the S-shaped last part of the large intestine, leading into the rectum), Female Reproductive Organs

Region 9: Left Iliac Fossa

Descending Colon, Sigmoid Colon.


 

Quadrants

Exact origins of abdominal pain can be tricky to pinpoint. You may have noticed, for instance, that the liver is listed under several regions: the right hypochondriac, epigastric, and right lumbar. For our purposes, these nine regions will be reduced to four quadrants, as explained below, when discussing pain points.

Right Upper Quadrant

Organs found in this quadrant include: the liver, the gallbladder, duodenum, the upper portion of the pancreas, and the hepatic flexure of the colon.

Pain in the right upper quadrant may be indicative of hepatitis, cholecystitis, or the formation of a peptic ulcer.

Cholecystitis

Cholecystitis occurs if a gallstone finds its way into a bile duct preventing bile from flowing out and causing your gallbladder to become inflamed. 

Symptoms of Cholecystitis include:

  • Nausea
  • Vomiting
  • Belly pain (may worsen when taking deep breaths)
  • Possible aches in back or right shoulder blade

Note: Bacteria also can cause Cholecystitis.

Hepatitis

Regardless of cause, inflammation of the liver is referred to as hepatitis. Most instances of hepatitis are viral, but the disease may also be caused by drugs or alcohol.

The most common types of viral hepatitis include:

  • Hepatitis A - This virus causes an acute inflammation and will usually heal on its own. It's easily spread in food and water, and often infects many people at once.
  • Hepatitis B - This virus can be both acute (short-term illness) and chronic (ongoing illness), and is spread through blood or other body fluids in various ways.
  • Hepatitis C - The Hepatitis C Virus (HCV) is almost always chronic and spreads usually by blood. Hepatitis A and B can be prevented by vaccination, but not hepatitis C. However, certain strains of Hepatitis C may be cured by a regimen of direct-acting antiviral medication.

Peptic Ulcer

A hole in the lining of the digestive tract is called a peptic ulcer. Peptic ulcers are created by erosive digestive action of pepsin and stomach acid, which may be linked to any of the following root causes:

  • Helicobacter pylori (H. pylori), a type of stomach infection and inflammation causing bacteria
  • Excessive use of NSAIDs (non-steroidal anti-inflammatory drugs) like aspirin (Bayer), ibuprofen (Advil), and other anti-inflammatory drugs
  • Smoking and drinking
  • Radiation therapy
  • Stomach cancer

Right Lower Quadrant

Organs found in the right lower quadrant include the appendix, the upper portion of the colon, and the right ovary and the Fallopian tube in women.

The right lower quadrant may be assessed when diagnosing appendicitis, in which case, this quadrant would be tender and painful.

Appendicitis

Appendicitis is a condition in which the appendix becomes inflamed and filled with pus, causing pain.

If left untreated, appendicitis may cause your appendix to rupture and cause infection, which can be serious and even fatal.

Left Upper Quadrant

Organs in the left upper quadrant include the stomach, spleen, left portion of the liver, main body of the pancreas, the left portion of the kidney, adrenal glands, splenix flexure of the colon, and bottom part of the colon.

This quadrant may feel tender in cases of appendicitis and abnormalities of the intestines, such as malrotation.

 

Left Lower Quadrant

Organs found in this quadrant include the sigmoid colon, and the left ovary and Fallopian tube in women.

Pain in this quadrant may be symptomatic of colitis, diverticulitis, or kidney stones. Ovarian cysts (in women) or pelvic inflammation may also be at the root of pain in this quadrant.

Diverticulitis

Diverticula are small, bulging pouches that can form in the lining of your digestive system. Sometimes, however, one or more of the pouches become inflamed or infected. That condition is known as diverticulitis.

Ureteral Colic

This is most commonly caused by the obstruction of the urinary tract by kidney stones.

Colitis

Colitis, simply put, is inflammation of the colon. The three most common forms of colitis are: ulcerative colitis, Crohn's disease, and infection. 

Ulcerative Colitis

This is a chronic IBD that causes sores (ulcers) in the lining of your colon, as well as inflammation.

Crohn's Disease

This is a chronic inflammatory bowel disease that affects the lining of the digestive tract. Inflammation can appear anywhere in the digestive tract, from the mouth to the anus, and it generally affects all the layers of the bowel walls, not just the inner lining.

C. Diff. Colitis

This is inflammation of the colon caused by the bacteria Clostridium difficile which can occur after treatment with antibiotics.

Gastroenterology Associates specializes in helping restore you and your family to optimal digestive health. We are conveniently located adjacent to Long Island Center for Digestive Health (LICDH), a New York State-licensed non-hospital outpatient facility dedicated to providing high-quality endoscopic and colonoscopic services in a comfortable, welcoming environment. For more information or to schedule an appointment, contact us today!  

Topics: gastroenterology associates