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Right upper quadrant pain and pressure
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Right upper quadrant pain and pressure

I am currently seeing a GI doctor to try to figure out what is causing my right upper quadrant pain and pressure.  I'm a 30 yr.old healthy female that has had RUQ pain and pressure off and on for the past 3 years.  About 3 weeks ago, I had another "attack" which landed me in the ER.  They did an abdominal U/S which was negative, pelvic u/s which was negative, CT scan which was also negative, as well as blood work and urine.  They referred me to GI the next day.  The GI dr. has ordered an upper GI barium xray with small bowel follow through (to check for Crohn's, since I have RLQ tenderness).  She also ordered a HIDA scan to check the function of my gallbladder.  I haven't had any real changes in my bowel movements. I usually go every other day, and stools are formed and quite large.  I wouldn't say I have a "true" case of constipation, but anytime I've ever had a KUB xray, there is always a note that my colon is filled with excessive amounts of stool.  What could be causing this RUQ pain and pressure?  It's not constant, it can come and go during the day, but it has been a daily occurrence for the past 3 weeks.  Sometimes it radiates to my back, or underneath my right shoulder blade.  The pain and pressure can be right up underneath my right ribs (feels like something is swollen and pushing on something), or right below my right rib, kind of in the direct right side of my front abdomen.  This has been very frustrating.  Thanks for any ideas as to what this could be!
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There has been a pretty thorough examinination already.  The HIDA scan with CCK stimulation would be a reasonable next test since a low gallbladder function would cause similar symptoms.  

If negative, you can consider irritable bowel disease as well as the various causes for dyspepsia (i.e. GERD, inflammation of the upper digestive tract, as well as an ulcer).  If all the tests thus far are negative, an upper endoscopy can be considered as the next diagnostic test.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
16 Comments
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Avatar_n_tn
The description you give is highly suggestive of gallbladder pain; getting the HIDA scan may help to sort that out. There are other possibilities including irritable bowel, various inflammatory conditions of the bowel, pancreas problems, gastric disorders, etc.
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Avatar_n_tn
Hello,

I am sorry to break into the  thread but SUrgeon I have folowed many of your posts and view you as an extremely intelligent and compassionate person. I am hoping you can take a moment and read through my thread:

http://www.medhelp.org/perl6/Gastro/messages/C36489-8.html

Any input would be great as I have , Panic Disorder, OCD a little baby and a wife with a new home that I am trying to keep in order and I feel the OCD and Panic are winning the bulk of my time concerning this.

God Bless,
Stephen-k
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Avatar_n_tn
Dear abcsoup,
I ran across your post after doing several searches in an attempt to try to find the magic answer.  I am suffering from the same pain and when I saw your post - I thought this person is describing my pain.
I have RUQ pain, has been severe this past week.  I too have a negative U/S for gallstones.  My doctor performed a HIDA scan and that too was normal.  Yesterday I had an endoscopy and the only thing the doctor noted was some irritation in my dodendum (sp?).  He took a sample and ordered a test.

The way you described your pain is what I can relate to; I feel like I have a tennis ball lodged under my RUQ rib case.  The pain has been low grade for several years, but for the last week it has been awful.

Good luck with your tests - if I find anything out I will let you know since our symptoms seems similar.
Best of Luck
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Avatar_n_tn
The comments made by abcsoup and Ips66 describe my exact pain.  I am a 39 year old female and have been suffering from RUQ pain for a couple of years, although the pain comes and goes.  I also have pain under my right collar bone.  When I lay on my left side it feels as though my collar bone is broken and my shoulder falls forward causing a burning sensation.  The pain under my right rib cage feels exactly like a tennis ball is stuck.  I have no other medical problems during these "spells" that could be the cause, and I can't find any rhyme or reason as to why the pain comes and goes like it does.
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Avatar_n_tn
I happened upon this site by chance looking for a reason for my R.U.Q pain.
My G.P. is convinced it is  gastric related, and  the Gastroenterologist I wa referred to is convinced it is a Gallblladder problem, i.e. Gallstones.
I have had this problem on and off for the past ten years, and have had 3 ultrasound scans, plus an upper barium meal scan, plus endless blood tests.
I am now waiting for a Helico bactor pylori breath test , and have had to stop the medications I have been put on by my G.P. for the next 2 weeks.
Nobody seems to know the cause of my pain, but I have not had a HIDA test , or been offered it
I personally stongly suspect a Gallbladder problem, but not Gallstones., more a low grade infection, or just a poorly functioning Gallbladder or perhaps inflammation of the Gallbladder or Bile ducts.
I appreciate this an American site and tests available, are probably way ahead of us .
I do not know what a HIDA test is and it has not been offered .
Though the Gastroenterologist said he was 99% sure this was a gallbladder problem, the only thing I was offered was a Gastoscopy, and if I refused that he would not help me
What is the reason for this?
I am so glad that I am not alone in my pain, but would welcome any advice, and wish all those suffering too, an answer to there problem
Please can anybody help out there!
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Avatar_n_tn
Hi there,

Male 51, have had chronic lower right rib pressure (under) for the last 23 years as a direct result of trauma, & of course 'unresolved' because all x-ray examinations were not capable of locating this symptom.  However, I went 'online' to try to obtain a surgeon for his help & he responded to my ad.  I have not seen him as yet, but intend to.  A Shunt Procedure has previously been discussed, which would entail drilling a tiny hole in-between the ribs/lower right rib cage, then inserting a drain tube to the back side of the pierced skin & holding it there while this pressure exits the body.  I highly believe this surgical procedure will terminate this chronic pressure, or I wouldn't bother to make the travel arrangements.  You'd better believe that I have previously 'struck out', thus throwing the entire 'kitchen sink' at this to no avail.  I welcome any replies here?

Scott T.
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Avatar_n_tn
Hi there,

Male 51, have had chronic lower right rib pressure (under) for the last 23 years as a direct result of trauma, & of course 'unresolved' because all x-ray examinations were not capable of locating this symptom.  However, I went 'online' to try to obtain a surgeon for his help & he responded to my ad.  I have not seen him as yet, but intend to.  A Shunt Procedure has previously been discussed, which would entail drilling a tiny hole in-between the ribs/lower right rib cage, then inserting a drain tube to the back side of the pierced skin & holding it there while this pressure exits the body.  I highly believe this surgical procedure will terminate this chronic pressure, or I wouldn't bother to make the travel arrangements.  You'd better believe that I have previously 'struck out', thus throwing the entire 'kitchen sink' at this to no avail.  I welcome any replies here?

Scott T.
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Avatar_n_tn
Four years ago I began having what I thought was severe heartburn. I went to countless doctors(not to mention countless meds that made the problem worse) and finally after many tests it was descovered that I had gallstones. I went through with having my gallbladder removed. It was the biggest mistake I have ever made. Shortly after having my gallbladder taken out I started to have diarrhea everytime I ate. The diarrhea eventually went on to be extremelly painful (as bad as labor contractions) and it alternated with constipation. A few months after the surgery I started to have pressure under the left side of my ribs. It felt like someone was blowing up a balloon under my ribs. I went to about three doctors. One said I had a lung infection (I was just getting over the flu as this started to occur) and put me on far to much medication. I went back to my surgeon and his attitude was it couldnt possibly be something he had done wrong. I went to one more doctor and she did an x-ray and found I had a 5 inch blockage in my bowel. She determined this was what was causing the pressure. Although I was still having diarrhea. She said I could still be having diarrhea and thats what caused the pain (because it was working so hard to get past the blockage). She also put me on an acid reducer for pain and told me to take stool softners.
It has been two years since my surgery and I am still having this pressure. After going to so many doctors and not getting a good outcome I started to see an M.D. who does alternative medicine. She ran some diagnostic tests and put me on herbal supplements. I cant tell you what a difference it has made. The day I started it I stopped having cramps. I now go to the bathroom almost everyday. Im still having the pressure (it seems to occur around the same time I get my period which leads me to believe that my intestines get sluggish due to hormones and it results in another blockage) but things are so much better now. I have tons more energy and my whole outlook on life has changed. When modern medicine has failed you its good to know you have a place to go. I plan on starting colon hydrotherapy once a month (a process that cleans out all 6 feet of your intestines) which I have heard works wonders. Here are a few sites if you think you may be interested http://colonhealth.net/colon_hydrotherapy/chthrapy.htm
http://www.i-act.org/iactsearch.htm
It may sound embarrasing and gross but if you feel bad and doctors cant do anything for you then you should do everything possible to change that for yourself. I wish you the best and hope things work out for you. If anyone would like to talk further here is my email: ***@****
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Avatar_n_tn
Four years ago I began having what I thought was severe heartburn. I went to countless doctors(not to mention countless meds that made the problem worse) and finally after many tests it was descovered that I had gallstones. I went through with having my gallbladder removed. It was the biggest mistake I have ever made. Shortly after having my gallbladder taken out I started to have diarrhea everytime I ate. The diarrhea eventually went on to be extremelly painful (as bad as labor contractions) and it alternated with constipation. A few months after the surgery I started to have pressure under the left side of my ribs. It felt like someone was blowing up a balloon under my ribs. I went to about three doctors. One said I had a lung infection (I was just getting over the flu as this started to occur) and put me on far to much medication. I went back to my surgeon and his attitude was it couldnt possibly be something he had done wrong. I went to one more doctor and she did an x-ray and found I had a 5 inch blockage in my bowel. She determined this was what was causing the pressure. Although I was still having diarrhea. She said I could still be having diarrhea and thats what caused the pain (because it was working so hard to get past the blockage). She also put me on an acid reducer for pain and told me to take stool softners.
It has been two years since my surgery and I am still having this pressure. After going to so many doctors and not getting a good outcome I started to see an M.D. who does alternative medicine. She ran some diagnostic tests and put me on herbal supplements. I cant tell you what a difference it has made. The day I started it I stopped having cramps. I now go to the bathroom almost everyday. Im still having the pressure (it seems to occur around the same time I get my period which leads me to believe that my intestines get sluggish due to hormones and it results in another blockage) but things are so much better now. I have tons more energy and my whole outlook on life has changed. When modern medicine has failed you its good to know you have a place to go. I plan on starting colon hydrotherapy once a month (a process that cleans out all 6 feet of your intestines) which I have heard works wonders. Here are a few sites if you think you may be interested http://colonhealth.net/colon_hydrotherapy/chthrapy.htm
http://www.i-act.org/iactsearch.htm
It may sound embarrasing and gross but if you feel bad and doctors cant do anything for you then you should do everything possible to change that for yourself. I wish you the best and hope things work out for you. If anyone would like to talk further here is my email: ***@****
Blank
Avatar_n_tn
Four years ago I began having what I thought was severe heartburn. I went to countless doctors(not to mention countless meds that made the problem worse) and finally after many tests it was descovered that I had gallstones. I went through with having my gallbladder removed. It was the biggest mistake I have ever made. Shortly after having my gallbladder taken out I started to have diarrhea everytime I ate. The diarrhea eventually went on to be extremelly painful (as bad as labor contractions) and it alternated with constipation. A few months after the surgery I started to have pressure under the left side of my ribs. It felt like someone was blowing up a balloon under my ribs. I went to about three doctors. One said I had a lung infection (I was just getting over the flu as this started to occur) and put me on far to much medication. I went back to my surgeon and his attitude was it couldnt possibly be something he had done wrong. I went to one more doctor and she did an x-ray and found I had a 5 inch blockage in my bowel. She determined this was what was causing the pressure. Although I was still having diarrhea. She said I could still be having diarrhea and thats what caused the pain (because it was working so hard to get past the blockage). She also put me on an acid reducer for pain and told me to take stool softners.
It has been two years since my surgery and I am still having this pressure. After going to so many doctors and not getting a good outcome I started to see an M.D. who does alternative medicine. She ran some diagnostic tests and put me on herbal supplements. I cant tell you what a difference it has made. The day I started it I stopped having cramps. I now go to the bathroom almost everyday. Im still having the pressure (it seems to occur around the same time I get my period which leads me to believe that my intestines get sluggish due to hormones and it results in another blockage) but things are so much better now. I have tons more energy and my whole outlook on life has changed. When modern medicine has failed you its good to know you have a place to go. I plan on starting colon hydrotherapy once a month (a process that cleans out all 6 feet of your intestines) which I have heard works wonders. Here are a few sites if you think you may be interested http://colonhealth.net/colon_hydrotherapy/chthrapy.htm
http://www.i-act.org/iactsearch.htm
It may sound embarrasing and gross but if you feel bad and doctors cant do anything for you then you should do everything possible to change that for yourself. I wish you the best and hope things work out for you. If anyone would like to talk further here is my email: ***@****
Blank
Avatar_n_tn
I am a 30-year old female from Long Island, NY, who until a year ago, was unaffected by medical problems and considered very healthy. I began suffering from RUQ and R-S abdominal pain, which landed me in the ER. Drs suspected gallstones. CT scans, ultrasounds and MRIs all came back neg for stones. Pain varied between dull and intense, and I eventually began suffering from other symptoms including body aches, chronic diarrhea, occasional rashes and iritis. Follow-up w/GI and rheumatologist. Colonoscopy results indicated Ulcerative Colitis and Rheumatology tests showed Fibromyalgia, Sjogren
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Avatar_n_tn
I am a 30-year old female from Long Island, NY, who until a year ago, was unaffected by medical problems and considered very healthy. I began suffering from RUQ and R-S abdominal pain, which landed me in the ER. Drs suspected gallstones. CT scans, ultrasounds and MRIs all came back neg for stones. Pain varied between dull and intense, and I eventually began suffering from other symptoms including body aches, chronic diarrhea, occasional rashes and iritis. Follow-up w/GI and rheumatologist. Colonoscopy results indicated Ulcerative Colitis and Rheumatology tests showed Fibromyalgia, Sjogren
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Avatar_n_tn
Hi all,

25 y/o male

I'm in pretty much the same boat as everyone else on this string, but I haven't had the misfortune of having severe problems.

I started out the same, bad heartburn like pain that kept me from sleeping for almost three straight weeks.  Since then I've developed the same RUQ pain and "tennis ball".  I have had every test that i have heard of and have ruled out as much as I can.  Even though I strongly believe I'm having some sort of Gall Bladder problems since eating pizza, or burgers or anything too exciting causes my problems to worsen.

The docs have had zero luck finding something and the only abnormal test I have is one mildly high Lypase level when I was bad sick.

It's hard not having any answers, since this problem has cost me a chance to fly fighter jets for the navy.  I try to take comfort in believing that if it was something as serious as cancer, they would have found it by now.

One thing to note for you that are getting a HIDA scan.  My GI has told me infactly that it is the worst test he can do for predicting gall bladder dysfunction.  That even abnormal scans only give patients a 50% prediction that gall bladder surgery will be effective at all.

Be careful with surgery and do it only as a last resort or in an emergency.

Also, eventhough I curiously surf the web on other patients stories about this problems.  I've found that endless searches for the magic answer on the web can cause me to consume my thoughts in my own health, can be unhealthy.  Good luck all.
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Avatar_n_tn
Does anyone here try a laparoscopic exploration of the abdoment ? The surgeon would be able to see what the "tennis ball" is.
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Avatar_n_tn
I have been suffering exactly the same pain. I'm female, 44 years old, it started about four months ago. Sensation of pressure under the ribs, a bit like last trimester of pregnancy when the uterus was pushing up. Sometimes it's more like a dull ache, that can radiate to the side and front. Also bouts of heartburn for the first time in my life. And constant burping.

My GP was convinced it was gallstones, but an ultrasound shows my gallbladder to be in 'pristine' condition. No sign of liver inflammation either. Only other possibly related symptoms are very fleeting bouts of jaundice - wake up with very yellow skin under my eyes which clears up after a few hours - and slight elevated bilrubin levels. Liver tests are otherwise fine, as are kidneys.

GP has now put me on Zantac for a month, suspecting an ulcer. One week on and it seems to be making no difference.

The pain/discomfort is not so bad as the anxiety that it is a symptom of something more sinister.
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A related discussion, upper right quadrant abdominal pain was started.
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