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Avatar universal

RUQ pain - no diagnosis

Ok, maybe someone can give me a little insight into what to look for.  I have had pain under might right ribs extending into my back at times for three weeks. A little stomach upset, but only mild - no vomiting - a little loose stool which fiber helps.

34 years old - overweight (285)
Ultrasound - normal
Blood work - normal
CT scan - only indication is slightly enlarged spleen

Have been on Cipro for one week
Have taken flagyl for three days - just stopped because of side effects maybe from flagyl (headace, chills, stomach spasms).

Pain is not diminishing.

I'm thinking the gall bladder.  My doc is looking at diverticulitus, but my pain is in upper right quadrant, not the usual place for this.  I know he's going to try barium enema next.  Should I push for a hidascan?  Other things I should ask about?

I'm also concerned about potential for malignancies.  I smoked for 10 years and quit 5 years ago.  I haven't had any symptoms of lung cancer such as blood, or coughing - never the less, my body feels "funny".  It's hard to describe.  Not a good diagnostic description, I know.  It feels like a pressure - like a softball has been shoved inside my ribs and is pushing everything around.
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Avatar universal
Ann
More on the Costochondritis.  Since my last posting, where I mentioned the chronic Costochondritis I have, I had a bout of acute Costochondritis on my left side.  I had problems breathing, it really, really hurt to take a deep breath and when the doctor examined me, I just about fell off the examination table because my chest wall was so inflamed.  I got rid of that by taking 200mg of ibuprofen 3times a day with meals, using ice on the inflamed area and trying to get some rest for a few days.
The more chronic version on my right side sounds so much like what so many of you have.  It's not related to eating, but is made worse by sitting, wearing anything that presses on the bottom of my ribs (which are sore to the touch) or on my abdomen.  There are some Costochondritis support groups and forums - just search for "costochondritis support".  It's not the answer for everyone - clearly some people have gallbladder or other problems - but it is an interesting subject and explains a lot about how I feel most of the time.  It's made worse by stress and although I don't know what caused it, I can live with it, though it does get you down after a while.
Helpful - 1
Avatar universal
This is kinda long - sorry.  

I'm curious if I have 2 things going on at the same time or if everything is related.  My symptoms are many and I don't seem to fit into any category of illness.  I am just begining my testing - chest x-ray and blood work done & both normal.  My complaints are:

Chest pain in upper right chest (between top 2 ribs) close to the sternum.  Primarily a sharp stab if I inhale too deeply.  Sometimes radiates to my armpit or down my right arm.  Doctor diagnosed pleurisy and put me on anti-inflammatorys which have not helped.  Will be going back in 3 days for a follow up.  

Other symptoms are:
stomach contractions
adreanalin rush (or some other hormone - can feel the rush)
pain/pressure behind sternum (sometimes feels like I'm bruised)
bloated with gas (pants are too tight)
heartburn sometimes
belching
flatuence
shortness of breath
sometimes mucous in my throat that I can't swallow
my blood pressure was high at last dr visit (pain related?)
yes - stress makes things worse

I get back and neck pain in the upper right side but I'm not sure if that's just related to the way I sit at work???

Not sure if these are related - psoriosis and memory problems but I have these too.

Any ideas of what the heck is wrong with me?  Anyone else have similar symptoms?

PS - I'm 5'1", 130 lbs, and 32 year old female.
Helpful - 1
Avatar universal
Lori,

One theory I have for my ruq rib  pain is simply being overweight.  I feel that my weight (was 295, now 270) was putting undue strain on the ligaments in my lower rib cage.  Since losing 25 pounds, I have had very little ruq rib pain.  All my other pains are still there off and on, probaly due to the fibromyalgia.  I am trying to lose more in hopes my back pains will diminish.  I feel all this weight I'm carrying around puts strain on my muscles and ligaments.  If you can lose weight, do it!  I guarantee you will feel better, regardless if your pain goes away.  I have been eating "sensibly".  I have tried all the low fat diets, etc, without success.  I finally realized that I was eating way to much carbohydrates.  While I don't go off the deep end all the way to the Atkins diet plan, I have resrticed the sugars, fruits, pastas, rice, potatoes and filled up on vegies and proteins.  I usually eat some carbs, but not at the same time as fat and protein.  I don't bother with low fat, i just don't mix it with carbs.  I try to keep high carb foods in a different meal from protein/fats.   that is, I will eat carbs if everything is lowfat.  (carbs and vegies, or protein/fat and vegies but never carbs and fat/protein).  It seems to be working.  Increasing my fiber has also helped in my weight loss.

My motto is moderation in everything!  I hope you can find relief from your pain.
Helpful - 1
Avatar universal
Wow!  Kindred spirits unite!  I
Helpful - 1
Avatar universal
This all sounds familiar. I had this rt upper quadrant pain for 7 yrs and all gallbladder tests normal. Eventually had worse pain and had an open removal of galbladder( not recommended!), no stones but very immflammed. I still had pain and tests showed I had a narrowed bile duct.I had an ercp with many complications, it always happens to nurses!!I had further troubles with narrowing of the bile duct and had stents for 12 mnths. Even though blood tests ok the dr decided to operate and remove the scarred part of the bile duct and found chronic pancretitis. Unfortunatly I am getting pain again and wonder if the bile duct is narrowing again although blood tests ok. Also wonder if its pancreatitis again even though se amylase is ok. They say the amylase stops going up in chronic pancretitis. I also am getting indigestion which is what I got when the stent blocked up.The surgeon doesn't want to see me unless pain is excrutiating but the chronic pain is scary. I will probably see my gastroenterologist eventually but after so much illness its hard to start back on the dr trail again.
I wonder if alot of all your troubles are to do with the bile duct? They can do scans to see the passage of bile down the bile duct without having an ercp. Ercp doesn't hurt but the panreatitis afterwards can.
Helpful - 1
Avatar universal
Greg,
  Please let us know what the diagnosis was. I have been going through some of the same things you are, and was told by a gastro doctor he is at a loss, doesn't know what is wrong. When I had the scan, it also took about as long for the gall bladder to open up, had much pain and nausea when it did. Mine is emptying though at 85%. I have had all the other tests; ultrasound, upper GI of the stomach only (which showed irritated nerve endings), blood work and upper GI. Nothing else shows up. All the symptoms are there; pain in UPRQ,gets worse when I lay on my right side at night, pain up under ribcage, sometimes up behind the shoulder blades,orange colored stool, constipation and gas. I've been on Prevasid, Donnatal and nothing helps. I'm thinking of trying to get a referral to another gastro doctor. I'm tired of having all these test and then they find nothing. Any suggestions?
Helpful - 1
Avatar universal
Elaine,

Hang in there.  I don't have a firm diagnosis yet, but it sure seems like my gallbladder.  I had an upper GI last week.  It only showed that I have reflux.  I could have told them that without the barium swallow!  My doc suspects "chronic cholecystitis".  I have a consult with a surgeon next week (Thursday) and will let you all know what he says.  I have lots of questions for him.  I know what you mean about all the tests - I've had them all.  But at least I know I have nothing else wrong!  I actually had a MRI of my spine today to see if I have a pinched nerve.  I probably won't have the results until next week, but the technician said he saw a "bulge" which could be impinging on my nerves.  It was very small, so it may be nothing.    I want to make sure before I have anything cut out of me.  Did you have pain when your gallbladder contracted or when it started to show on the scan?  That might indicate that you have an inflamed gallbladder.  From what I can tell, it is possible to have gallbladder problems without necessarily gallstones.  But I'm going to ask the surgeon if it can be so inflamed and still contract normally.  

Oh, another thing I have seem pop up in the messages on this forum is problems with the "spinchter of odi" which may prevent the bile from flowing properly.  People who have the same pain after the gallbladder has been removed often have a problem with this.  It is diagnosed by a scope down the pipe.  There are complications with this procedure (~25% get pancreatitis).  You might want to ask your doc about this possibility.
Helpful - 1
Avatar universal
Randy, interesting you should mention the fatty liver - I also have a "slightly fatty liver" and the docs keep asking me if I drink a lot.  I don't - maybe two glasses of wine on Fridays.  I wonder if there's a connection.

Georgie, did you also have any acid reflux (heartburn)?  Now I feel this in my chest.  It has been there the last 4 or 5 days.
Helpful - 1
Avatar universal
A related discussion, same problems was started.
Helpful - 0
Avatar universal
Good God how I can relate to all of you. All test negative, still in pain. Crazy symptoms but I'm not crazy!  How can we all be having so many of the same symptoms and nobody know what's wrong?!
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Avatar universal
A related discussion, frustrated was started.
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Avatar universal
Hey, I'm having a hidascan tomorrow. I haven't felt good for about 3-4 weeks...I'm having pain and pressure in my chest that goes into my back between my shoulder blades and up my neck and have been running a low grade temp...I was told I have a sludgy gallbladder...the hidascan hopefully will show something I hope...I would push for a gallbladder ultrasound and hidascan...if nothing else it will rule it out. but it certainly sounds suspicious. Oh and the funny feeling you decribed, I know it well...good luck!
Helpful - 0
Avatar universal
28 years old.  I have had pain in my right side right under my ribs for about 2 weeks.  Vomiting and loose stool for about 3 weeks. I have lost 5 pounds since this has all started.  so my weight is down to 105.  I have had an ultrasound and blood work done and was all normal.  I am schuduled for a hidascan and do not know anything about it.  I am feeling the same as other people, that is very hard to descrip.
Helpful - 0
Avatar universal
Deb
Hpylori bacter  blood test first and formost I had same syptoms, took three attempts to get my doctor to listen. Came back positive.Floored him. Most sypmtoms went away after treatment and a healing time period. Had my gal bladder out to but also had second bout of hpylori same symptons, went away after antibiotics.
take the blood Test !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Watch your diet keep track and map it with symptoms. If you eat a fatty meal and later you have pain it is probably your gall bladder. My mother took one flax seed oil caplet and had the same pain.I am sure she has a gall bladder problem.
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Avatar universal
Do you have additional problems or increased pain when eating high fat ... or greasy foods? If so, then definitely push for the gallbladder screens first.  If your doctor won't do the test, then get a second opinion.  


Helpful - 0
Avatar universal
I had pain in my URQ for about a year.  Finally went to the doctor who sent me to get an ultrasound (after scaring the hell out of me with a cancer talk).  I found out that I have 2 large gallstones that take up about half of my gallbladder.  Now I have the prospect of surgery at Christmas.  Great.  I'm hoping this is all that's wrong and the surgery has no complications.  Good luck to everyone on finding a cause for their pain.


Helpful - 0
Avatar universal
Comforting to read so many reports of swollen feeling just under ribs.  I first developed this 11 years ago after getting some kind of bug (undiagnosed) in India.  I went through 3 years of it coming and going along with mild digestive irregularities.  Recently I developed it again.  I had many of the tests listed by others.  Diet seems to have some impact, but not a lot.  It's unrelated to when I eat.  Recently I've had acupuncture and this is the only effective treatment I've found.  After two sessions and also some sessions of visualising a heathy 'flow' in my liver, the inflamed feeling went away for several weeks. It's now back following a business trip and much stress so I will return to acupuncturist.  The only thing I'd add is that it's worth finding a really good acupuncturist because if those needles don't produce a really deep ache when they put them in, they ain't working!
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Avatar universal
What is the answer to the above question please.
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Avatar universal
Leah ...I have had Bell's Palsy.  Not sure if there is a connection except poor immune system possibilities.  I have also had Lyme Disease, which may have brought on the BP.  I found this forum because of the pain I am having in the center of my chest right under the sternum (sp).  Sometimes mild and sometimes bad.  
I think my problem is GREATLY aggrivated by chocolate and coffee ... two of my favs!  (Throw in a little stress and I am up the wall) In fact I did a little experiment tonight with some Rocky Road Ice Cream.  The deep chocolate kind --Breyers.  Sure enough, about one hour later, I am in pain.  Same kind, same place, same intensity.  
One scary thing .... maybe some of you have had this too.  I get a "jolt" feeling that brings on moderate anxiety and a quick feeling of "let down"; like I took a punch on the inside.    
I had the upper GI, sonogram, ekg,  a few years ago with nothing remarkable except mild reflux.  Diagnosis was to lose some weight (which I finally did about three years ago and was symptom free.  I have gain it all back.  Go figure) and to use Gaviscon -- great stuff.
GREG
Helpful - 0
Avatar universal
Leah ...I have had Bell's Palsy.  Not sure if there is a connection except poor immune system possibilities.  I have also had Lyme Disease, which may have brought on the BP.  I found this forum because of the pain I am having in the center of my chest right under the sternum (sp).  Sometimes mild and sometimes bad.  
I think my problem is GREATLY aggrivated by chocolate and coffee ... two of my favs!  (Throw in a little stress and I am up the wall) In fact I did a little experiment tonight with some Rocky Road Ice Cream.  The deep chocolate kind --Breyers.  Sure enough, about one hour later, I am in pain.  Same kind, same place, same intensity.  
One scary thing .... maybe some of you have had this too.  I get a "jolt" feeling that brings on moderate anxiety and a quick feeling of "let down"; like I took a punch on the inside.    
I had the upper GI, sonogram, ekg,  a few years ago with nothing remarkable except mild reflux.  Diagnosis was to lose some weight (which I finally did about three years ago and was symptom free.  I have gain it all back.  Go figure) and to use Gaviscon -- great stuff.
GREG
Helpful - 0
18954 tn?1314298117
Pam
Well, I went to the Doctor and they set up the standard tests..Sonogram of total abdominal region and an Upper GI series and all came back normal.
The pain I have been having has all most gone completely.
The allergic reactions that I had to all of the meds I was on was my culprit, 4 antibiotics back to back and 3Prednazone count down packs and more! All in a matter of 2 months.
All of the meds messed up my system plus killed all of the bacteria that our bodies need.
I hope all of you can find the cause of your problems.
Remember some medications can cause this problem in the RUQ.
Best of luck to you all.
Pam
Helpful - 0
Avatar universal
Lee
When all has been ruled out and you still have RUQ Pain, RUQ fullness feeling, with delayed HIDA scan, pain radiating to the back PLUS Other symptoms like Bell's palsy or twitching facial or elsewhere, stiff neck are all fairly classic symptoms of Lyme disease. These are all caused by nerves or nerve roots that are infected.  Some people will even have elevated liver enzymes with Lyme.  Most doctors are still ignorant of this greatly underdiagnosed disease.  
***@****
Helpful - 0
18954 tn?1314298117
Pam
Thank you to all of you for being there.  I thought I was going crazy.  My story is long but here goes.

In early Sept. I was bit by a brown recluse spider was put on Cipro and a prednizone count down pack and Hydroxyzine. Got off of that and two weeks later had an abcessed tooth and was put on Penicillin for 10 days. Got off that on Thursday and was coming down with flu and Brochitis and on Friday was put on Keflex, cough med. and of course another count down pack. Next day was itching like crazy and was taken off keflex and was put on a new drug, Avelox..SEVERE allergic reaction and ended up in the ER for an IV treatment for rash etc. The ER DR. put me on more Prednizone (stronger dosage), Zantac, he said he liked to use that as a histimine blocker, and something else Radi..something.
Then had to go back to my regular Dr. and they put me on Augmentin and was told to finish up the rest of the other meds.
Next to the last day of the Augmentin, started having itching of the palms, inner ears and throat.  Told not to take the last couple of augmentin, but to take Hydroxyzine for the itching.
(It has been 2 weeks since I got off antibiotics and I am still having the itching off an on.)
The same day I had a funny feeling in the top of my stomach, just under the breast area like a full feeling. Then a burning feeling went to my ribs and my back on the right side. It keeps coming back everyday now for 2 weeks. I am afraid to eat anything because after 30 mins. to 4 hours it hits.
I tried mylanta and it seemed to make it worse. I was told the gallbladder bothers you mostly during the night. Mine seems to be anytime, but worse from about 9 to 11pm. I don't have nausea or vomiting. It feels like a burning or slight pinching. I feel like I need to burp and when I do it feels better. I don't have a feeling of a tight band yet.
I go back to the Dr. today at 3:30 just for a check up because on the allergic reactions that I had. I am going to mention this pain to Dr.
I'm really scared. I will tell you what they say and do for me.
Again, thank you for being there and listening to my story.
Pam


Helpful - 0
18954 tn?1314298117
Pam
Thank you to all of you for being there.  I thought I was going crazy.  My story is long but here goes.

In early Sept. I was bit by a brown recluse spider was put on Cipro and a prednizone count down pack and Hydroxyzine. Got off of that and two weeks later had an abcessed tooth and was put on Penicillin for 10 days. Got off that on Thursday and was coming down with flu and Brochitis and on Friday was put on Keflex, cough med. and of course another count down pack. Next day was itching like crazy and was taken off keflex and was put on a new drug, Avelox..SEVERE allergic reaction and ended up in the ER for an IV treatment for rash etc. The ER DR. put me on more Prednizone (stronger dosage), Zantac, he said he liked to use that as a histimine blocker, and something else Radi..something.
Then had to go back to my regular Dr. and they put me on Augmentin and was told to finish up the rest of the other meds.
Next to the last day of the Augmentin, started having itching of the palms, inner ears and throat.  Told not to take the last couple of augmentin, but to take Hydroxyzine for the itching.
(It has been 2 weeks since I got off antibiotics and I am still having the itching off an on.)
The same day I had a funny feeling in the top of my stomach, just under the breast area like a full feeling. Then a burning feeling went to my ribs and my back on the right side. It keeps coming back everyday now for 2 weeks. I am afraid to eat anything because after 30 mins. to 4 hours it hits.
I tried mylanta and it seemed to make it worse. I was told the gallbladder bothers you mostly during the night. Mine seems to be anytime, but worse from about 9 to 11pm. I don't have nausea or vomiting. It feels like a burning or slight pinching. I feel like I need to burp and when I do it feels better. I don't have a feeling of a tight band yet.
I go back to the Dr. today at 3:30 just for a check up because on the allergic reactions that I had. I am going to mention this pain to Dr.
I'm really scared. I will tell you what they say and do for me.
Again, thank you for being there and listening to my story.
Pam


Helpful - 0

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