A sudden, sharp pain under your right rib cage can stop you in your tracks — and send your mind racing. The good news is that, unlike the left side, the area under your right ribs sits away from the heart, so the cause is usually digestive or musculoskeletal. Most of the time it is not an emergency, but a few causes do need prompt attention. Here is what may be going on and when to seek help.
What sits under your right rib cage?
Several organs tuck beneath the lower right ribs: the liver, the gallbladder, part of the intestine, and — just behind — the right kidney, with the lower right lung above. Pain here can come from any of them, or simply from the ribs and muscles of the chest wall.
Common causes of sharp right-side rib pain
- Gallstones or a gallbladder attack. The most common culprit. Pain often starts after a fatty meal, sits in the upper right abdomen just under the ribs, and may radiate to the right shoulder blade — frequently with nausea.
- Muscle strain or a rib injury. Twisting, heavy lifting, a hard cough, or a blow to the ribs can strain muscle or bruise the rib, producing sharp pain that worsens with movement or deep breaths.
- Trapped gas. Gas caught at the bend of the colon under the liver (the “hepatic flexure”) can cause surprisingly sharp, stabbing pain that comes and goes.
- Liver conditions. Inflammation or a fatty, enlarged liver can create a dull-to-sharp ache under the right ribs.
- A kidney stone. A stone usually causes pain more toward the back and flank that can wrap around, sometimes with blood in the urine.
- Pleurisy or a lung problem. Inflammation of the lung lining causes sharp pain that is clearly worse when you breathe in.
Is right rib pain ever related to the heart?
Because the heart sits on the left and center of the chest, right-sided rib pain is rarely cardiac. That said, a heart problem occasionally causes diffuse or atypical discomfort — so if pain is accompanied by chest pressure, shortness of breath, or a cold sweat, do not assume it is your ribs. Get emergency care.
Emergency red flags — go to the ER or call 911
- Severe, unrelenting, or rapidly worsening pain
- Fever with yellowing of the skin or eyes (jaundice)
- Pain with shortness of breath, chest pressure, or a fast heartbeat
- Vomiting that will not stop, or vomiting blood
- Pain after a significant injury or fall
- A rigid, very tender abdomen
When to see a doctor
Make an appointment if the pain keeps returning (especially after meals), lasts more than a day or two, or comes with nausea, bloating, or changes in your stool or urine. A doctor can sort out the gallbladder, liver, and digestive causes with an exam, bloodwork, and often an ultrasound.
Frequently asked questions
What organ is under the right rib cage?
Mainly the liver and gallbladder, along with part of the intestine and, just behind, the right kidney. The lower right lung sits above them.
Is pain under the right rib cage related to the heart?
Usually not. The heart lies on the left and center of the chest, so right-sided rib pain is far more often digestive or musculoskeletal. Chest pressure or shortness of breath, however, always warrants emergency care.
When is sharp right rib pain an emergency?
Seek immediate care for severe or worsening pain, fever with jaundice, shortness of breath, persistent vomiting, or pain following an injury.
Can trapped gas cause sharp pain under the right rib?
Yes. Gas caught at the bend of the colon beneath the liver can cause sharp, stabbing pain that comes and goes and often eases after passing gas or a bowel movement.
How do I know if it is my gallbladder?
Gallbladder pain typically follows a fatty meal, sits in the upper right abdomen under the ribs, may spread to the right shoulder blade, and often comes with nausea. An ultrasound can confirm gallstones.