While it’s important to rule out serious conditions involving any organs that may cause pain in that area, says Dr. Iloabachie, the most common causes tend to heal on their own with proper care. That starts with injuries to the ribs.

The musculoskeletal system

Rib cage injury

The digestive system

Many of the organs that help the body process food can be a potential cause of pain under the right rib cage. Certain conditions interrupt how food is broken down through the gastrointestinal (GI) tract, which is part of the digestive system.

Biliary colic

The body digests fatty foods by releasing a liquid called bile from the liver, gallbladder and pancreas to the small intestine via a tube called the bile duct. When that tube gets blocked, often by gallstones, it results in abdominal pain under the right rib cage. This is a condition called biliary colic.

“When that bile builds up in the gallbladder, it can lead to significant inflammation or infection,” Dr. Iloabachie says.

Other signs of a bile duct obstruction include:

• Stomach pain
• Fever
• Nausea
• Vomiting
• Unintentional weight loss
• Anemia
• Jaundice (yellowing of the skin or eyes)

What to do

Sometimes the pain associated with biliary colic will ease when the obstruction passes, and you won’t need to see a doctor. If the blockage doesn’t clear, the complications can be serious, potentially even leading to a ruptured gallbladder. “To prevent that, biliary colic often needs to be treated surgically, which involves removing the gallbladder.”

If you have signs of a bile duct obstruction, seek immediate medical attention.

Dyspepsia

Dyspepsia is a chronic form of indigestion, meaning it happens over a long period of time. Approximately one-third of cases are caused by a stomach ulcer, but for the majority the exact physical cause is unknown — this is common among GI conditions.

In both types, dyspepsia occurs during or after eating and has a long list of causes and symptoms. “This is a more benign condition, which most may know better as indigestion or heartburn, and is caused by something you ate, something you did not eat, or something you ate too quickly,” Dr. Iloabachie says.

Symptoms come and go in the upper abdomen — a region called the epigastrium — on either the right or left side. They include:

• Burning or bloating
• Nausea
• Sharp pain right after, or while eating
• Loss of appetite
• Feeling “full,” despite a small portion
• Acid reflux

‌What to do

Dyspepsia does not typically require medical attention. To control symptoms, Dr. Iloabachie recommends lifestyle changes, such as eliminating fatty foods from your diet and reducing portion sizes. Antacids and other over-the-counter medications for indigestion, as well as reducing stress and anxiety can also help.

But, he cautions, if symptoms persist beyond one to two weeks, consult a doctor.

Hepatitis

Hepatitis is an inflammation of the liver, which can damage the organ — the largest in the body. Hepatitis can be acute or chronic — meaning symptoms last six months or longer. It is often caused by one of five viruses (hepatitis A, B, C, D and E), all of which are distinct but cause similar conditions. There are vaccines to prevent hepatitis A and hepatitis B, as well as a combination vaccine that guards against both. (These are typically given in the first two years of life.)

The inflammation caused by hepatitis can lead to liver damage, but progression is usually slow. Some have no symptoms, while others may experience upper abdominal pain or any of the following:

• Loss of appetite
• Fatigue
• Low-grade fever
• Jaundice
• Symptoms of chronic liver disease

What to do 

Depending on the type of hepatitis, you may need to see a doctor, who can prescribe medication to prevent additional damage to the liver.

• Hepatitis A and B — Thanks to effective vaccines, both are rare in the U.S. For those not vaccinated who contract either strain, the virus is often mild and may resolve on its own without treatment. If the initial infection is severe, it can cause liver damage. Those patients should consult a hematologist for monitoring and possible treatment.
• Hepatitis C — About four in five cases progress from acute to chronic hepatitis C. At that point, close monitoring and antiviral treatments are used to slow or eliminate the virus.
• Hepatitis D — This is only found in those also infected with hepatitis B, this virus is structurally different than hepatitis A, B and C. Treatment includes antivirals for hepatitis B, as well as an antiviral therapy called pegylated interferon alpha, which is taken for at least a year.
• Hepatitis E — More prevalent in Asia and Africa, this form doesn’t typically require treatment. If symptoms persist longer than two months, see a specialist.

If diagnosed with pulmonary embolism, treatment may involve blood thinners, clot-dissolving medications or, for those who meet the criteria, a procedure called thrombectomy to remove the clot. Doctors may also prescribe compression stockings to help prevent future clotting.

Pneumonia

The human body is very good at preventing lung infections caused by germs, but if the immune system gets overwhelmed by bacteria or viruses it can lead to an infection, which is called pneumonia. Depending on the type and severity, pneumonia can cause serious lung issues and can even be deadly.

Symptoms include confusion, especially in older people, cough, fever and shortness of breath. It can also cause sharp or stabbing chest pain that gets worse when you breathe deeply or cough.

What to do

There are two types of pneumonia: bacterial and viral.

Viral pneumonias most often clear up on their own and there is no specific treatment. Dr. Iloabachie recommends getting plenty of fluids and rest, as well as making use of over-the-counter medications to alleviate any pain, cough or fever.

Bacterial pneumonia is an infection and requires antibiotics to treat. Call your primary care doctor or visit an urgent care center near you. If symptoms worsen, call 911 or visit your nearest emergency department.

Pleurisy

Pleurisy is an inflammation of the lining of the lungs, often caused by a viral infection like influenza. It can also occur after a bacterial infection like pneumonia. This can cause chest pain that gets worse when you try to breathe deeply and may be the reason for pain under the right rib cage.

What to do

When caused by a viral infection, pleurisy often resolves itself and you can avoid the doctor’s office. But if the cause is bacterial, antibiotics may be necessary. “Most of the time it is not dangerous, but it can be very uncomfortable,” Dr. Iloabachie says.

The cardiovascular system (heart)

Heart-related conditions don’t typically impact the right side, more often causing pain under the left rib cage. However, says Dr. Iloabachie: “Because the inside of the body does not have specific nerve endings for specific locations, you can still have heart pain and experience that as pain under the right rib cage.”

Heart attack

When blood flow to the heart suddenly becomes blocked, it’s called a heart attack. Most heart attacks develop slowly as a result of plaque buildup inside the coronary arteries. The most common symptom is chest pain. It can occur on the center or left side. The pain can also spread to the jaw, back, and left or right arms. Still others experience a prolonged, burning sensation in the upper abdomen near the breastbone.

“Diseases do not read textbooks,” stresses Dr. Iloabachie. “You will not always get classic symptoms and pain under the right rib cage or in the right chest could potentially mean that you are having a heart attack, especially if it is associated with some of the more common symptoms. This is particularly true of women, elderly patients and those with diabetes.”

Atypical symptoms of a heart attack also include:

• Extreme fatigue
• Indigestion/heartburn
• Pain in the abdomen
• Pain or discomfort in the center of the back or in the jaw

What to do

A heart attack is a medical emergency and requires immediate treatment. Anyone experiencing symptoms should call 911. “One of the ways I might look for a heart attack is by getting an EKG as soon as you come to me in the emergency department.”

Treatments may include medicines to dissolve the blood clot blocking the coronary arteries, or aspirin to prevent further blood clotting. Surgery may be an option and include coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

Pericarditis

Pericarditis is another reason for heart-related pain on the right side under the rib cage. It causes inflammation of the heart lining, known as the pericardium. Potential causes include autoimmune conditions, viral infections and medication.

Pericarditis can last two to six weeks. Symptoms include sharp chest pain felt behind the breastbone, beneath the clavicle (collarbone), neck or left shoulder. Other symptoms include:

• Fever
• Pain when swallowing
• Palpitations (irregular heartbeats)

What to do

Anyone with this condition should consult a health care provider, Dr. Iloabachie says. A doctor will conduct a full history and evaluation, as well as order an EKG. Treatment may include medication, aspiration or removal of excess fluid, or surgery.

If you suspect you have kidney stones, particularly if you experience lasting pain or blood in the urine, schedule an appointment with a urologist; if the pain’s excruciating, go to your local urgent care or hospital. Patients may receive medication to relax the muscle responsible for transporting urine from the kidney to the bladder — known as the ureter. If that doesn’t work, more targeted treatments are available.

To help lower your risk of kidney stones, Dr. Iloabachie strongly recommends making these changes to your diet.

Urinary tract infection

One of the risks of untreated kidney stones is a urinary tract infection (UTI). The buildup of urine in the kidneys leads to excess bacteria, which is known to cause UTIs. The most common type of UTI-causing bacteria is E. coli, which is typically passed from the GI tract. UTIs can affect any part of the urinary system, but there are three main types:

• Urethritis — infection of the urethra
• Pyelonephritis — infection of the kidneys
• Cystitis — infection of the bladder

“We tend to think of them as being lower urinary problems, but when UTIs get to be as bad as they can be, an infection in the bladder or urethra can spread up to the kidneys and that can certainly cause pain under the right rib cage.”

What to do

If you suspect you have a UTI, talk to your doctor — especially if you’re prone to recurring UTIs. Antibiotics are the main treatment.

The cutaneous layer (skin)

The skin, hair, nails and glands make up the outer layer of the body, called the integumentary system. Some skin conditions can cause significant pain and could potentially be responsible for that pain under — in this case on top of — the right rib cage.

Shingles

Shingles is a painful rash caused by the same virus — known as herpes zoster or varicella-zoster virus — that causes chicken pox in childhood. It can resurface decades later as shingles. “This can happen during times of stress as a rash typically around the waist and on just one side of the body,” Dr. Iloabachie says. “The pain of shingles can be excruciating despite covering a very small area of the body.”

What to do

If you think you have shingles, see a dermatologist. Medications can help manage pain and potentially reduce the severity and duration of symptoms. Long-lasting nerve pain is one potential complication of shingles, but starting treatment within three days can potentially prevent that, according to the American Academy of Dermatology Association.

What should I do if I have pain under my right rib cage?

If you’re still not sure whether it’s safe to heal at home, or if your symptoms are a sign that you need medical attention, Dr. Iloabachie stresses that pain is subjective.

“If the pain is minor and goes away on its own, there is usually no reason to panic. If that pain seems to worsen with certain movements, with exertion or with breathing, this is often a sign that there is something more dangerous going on. If the pain is unbearable to you, that's when you should go to the emergency department.”