The flanks are the sides of the abdomen, located between the ribs and the pelvis, or hipbone. Flank pain refers to any pain or discomfort in this area.
Flank pain usually only occurs on one side, and may be mild or severe. There are many possible causes, ranging from unimportant to serious.
When someone complains of flank pain, the healthcare professional may ask questions, such as: exactly where the pain is locatedwhen the pain startedthe type of pain, such as sharp, dull, or crampywhether the person has ever had this type of pain beforewhether the pain is constant or only occurs sometimeswhether there has been any injury to the painful areawhether anything makes the pain better or worse whether it is associated with an urge to urinate whether or not any other symptoms, such as swelling, rash, or fever are presentwhat other medical conditions a person has, if anywhat medications, drugs, or herbs a person takes, if any
There are many possible causes of flank pain. Common causes include: injury kidney stones pyelonephritis, a kidney infectionbladder infectionirritable bowel syndrome, a poorly understood condition which causes abdominal pain and irregular bowel movementsgallbladder pain due to gallstones or other gallbladder diseaseinflammation in the bowels, such as that caused by peptic ulcers or appendicitis hepatitis pancreatitis, an inflammation of the pancreasan enlarged or damaged spleenpneumonia a tumor or cancer inside the abdomen, such as colon cancer
Other causes are also possible. Sometimes a cause cannot be found.
Avoidance of alcohol abuse could prevent many cases of flank pain from hepatitis or pancreatitis. Vaccines are available to prevent hepatitis A and B. Drinking plenty of fluids every day can sometimes prevent kidney stones. Many of the causes of flank pain cannot be prevented.
The diagnosis of flank pain begins with a complete medical history and physical exam. The healthcare professional may then order tests, such as: a urinalysis an abdominal x-ray an intravenous pyelogram or IVPblood tests, including a complete blood count (CBC) and blood chemistry testsultrasound testsCT scans
Irritable bowel syndrome may make a person uncomfortable and even depressed, but poses no serious long-term health risks. A small kidney stone may pass by itself and have no long-term effects. A large kidney stone may require surgery or other procedure to remove. Appendicitis is cured by surgery if performed in time. Cancer may lead to death if treatments are not successful.
Flank pain is not contagious and usually poses no risk to others. If the cause is an infection, the infection may be contagious.
Pain medication can be given as needed for relief of the flank pain. Stronger medications for pain, such as morphine, may be needed in some cases. Those with a kidney stone may be able to pass the stone into their urine. If the stone passes, no other treatment is needed. If the stone doesn't pass, surgery may be needed to remove it.
Those with gallbladder disease or appendicitis usually need surgery.
Someone with irritable bowel syndrome may be given medication to help the bowel relax or prevent it from having spasms. Those with a urinary tract infection are usually given antibiotics. Those with a tumor or cancer may need surgery, chemotherapy, or radiation therapy.
Side effects depend on the treatments used. For instance, antibiotics can cause allergic reactions and stomach upset. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.
Someone who passes a kidney stone or has it removed may not need any further treatment. A person with irritable bowel syndrome may need long-term treatment for pain flare-ups. An individual with cancer may need long-term treatment for the cancer and may die if treatments are not successful.
Monitoring will depend on the cause of the flank pain. Any new or worsening symptoms should be reported to the healthcare professional.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.
