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upper area below right side of rib cage
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upper area below right side of rib cage

My upper area of my digestive system has been constantly having a spasm off and on when I am awake. It is right under my right bra line area.  Don't think it is a pepic ulcer-isn't that more in the middle of the stomach area.  It comes and goes all day. Something is constantly going on and the"spasms" are coming more frequently. Wasn't sure if it was aliver situation or gall bladder situation.  Is this the area of the eshophagus entering the stomach?  When I put pressure on it it feels better so I am constantly pushing on it. It doesn't hurt just keeps spasiming-almost like a baby feels when it is kicking in my stomach.I first felt it about a week or to ago
Thank-you
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Hello - thanks for asking your question.

You always have to consider gall bladder and liver disease with right upper quadrant pain.  Peptic ulcer, and other causes of dyspepsia (gastritis, or esophagitis) can also cause right upper quadrant pain.

I would first obtain an abdominal ultrasound to evaluate the gall bladder and liver.  This will also see whether there are gallstones present or not.  Other tests to consider would be an upper endoscopy to evaluate for dyspepsia (i.e. gastritis or peptic ulcer disease).  If both these tests are negative, the next step would be an abdominal CT (looking for pancreatitis - although on the left side, can also cause right upper quadrant pain) or a HIDA scan evaluating for gall bladder ejection fraction.  

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.
6 Comments
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Avatar_n_tn
the location is suggestive of gallbladder; no one can say without further testing. Liver problems don't usually cause pain like you describe, but that's where the liver is. The junction of stomach and esophagus is more in the center, below the breastbone.
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Sherie:
I am not a doctor, but I have had my gall bladder removed and the upper right quadrant pain you speak of, that is somewhat relieved by applying pressure sounds familiar.

When my gall bladder started to go south on me, I would have similar discomfort that felt better with pressure, however, if I would apply pressure with my hand, then abruptly let go; the release would cause pain.

I hope the input helps.
Good Luck,
Raider
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Avatar_n_tn
hi, the letter from sherrie sounds so familiar, it feels like a baby moving sometimes, it is so weird. what has your dr. suggested?
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Avatar_n_tn
I'm 32 yours old and usually don't have medical problems. I've been having some non-specific abdominal pain just
about every night. It's pretty weird. It comes on after I've been asleep for 5 or 6 hours, so I wake up around 4 or 5 am. It sort of moves around depending on how I'm laying, so if I'm on my back it feels like back/kidney pain or if I'm on my sides it mostly shifts to right below my rib cage on both sides. Once I get up and get moving for 10 minutes or so it pretty much
goes away. So far I've had an ultrasound on my gall bladder and liver, some X-rays and blood work at the ER, and just Weds. they did a scope. So far they haven't found anything except for a bit of esophagitis. They took some biopsies when they did the scope, but no results yet. I don't think I've had a chest X-ray - although I didn't see them, I think they were pretty much from the ribs down.Deep breaths can hurt during the time that I'm having the pain, but typically not. The pain is mostly dull. I'm almost always sort of aware of my organs. Sort of like they don't quite fit inside of me and want to bust out. When I lay
on my side I can't stand not to have a pillow or something pulled against my belly to sort of hold everything in.
The only other symptom is that I've felt pretty fatigued lately. It seems like I'm always tired. I've felt a little sick to my stomach off and on, but I have a feeling that 80 - 90% of the time it's just me worrying that I'm going to drop dead or something.The ER Dr. mentioned that my Dr. should check for Porphyria, but that it's pretty rare. The only significant medical problem I have had is psoriasis for several years.
Can you give me any advice


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Avatar_n_tn
I'm now 27 and haven't had a gallbladder for 4 years.  It took 7 years for someone to finally correctly diagnose my gallbladder.  I had pretty much every test you can have, and finally an ultrasound tech turned me on my side and looked across, rather than through, the wall of my gallbladder.  They found gallbladder diverticuli with little stones in them.  When the gallbladder finally came out, the surgeon said it looked pretty bad.  But I feel so much better since it came out.  Your pain sounds very familiar to me.  It's worth having the gallbladder checked out.  Although I will say that I now have biliary reflux, but that's easier to deal with than a diseased gallbladder.
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Avatar_n_tn
Hello,

Let me share my story with you.  In late summer 02, I began having pain in the upper right quadrant of my abdominal cavity.  It felt like a gremlin was inside of me pinching something.  My AST and ALT's were slightly elevated.

I told my doctor I was very concerned and he began ordering tests.  First I had an ultrasound, which came back with a dilated bile duct.  This test referred me to a CT Scan, which again noticed the bile duct.  This test referred me to an ERCP.  I had this test done, and it was the most UNCOMFORTABLE thing I have yet to go through.  I remember them yelling at me to "be still," yet I could not control the gagging instinct.  After it was completed, my doctor said everything looked just "fine."  I went back to my doctor and he sent me for a surgical consult.  The surgeon had me get a Hidascan, and my return visit to him revealed that it was not my gallbladder, and he wanted the ERCP repeated, but with a different doctor.  

So off I go to see a different GI doc.  He too was concerned, and wanted to repeat the test.  I explained to him how bad the previous test was, and he agreed to put me out w/ general anesthesia.

Well, low and behold, he found a stone blocking the bile duct and performed a sphinteroty (sp?) then wanted me to have the gall bladder removed before it created more problems.  Now why didn't the first doctor find this problem and fix it?

I went home after his procedure but ended back in the hospital at 10:00 that night with the worst pain one can imagine.  It was pancreatitis!  My amalaze was 9100 and my Liapase was 3200! They gave me Demerol every 2 hrs for pain.  4 days later I went home, having nothing by mouth except ice chips.  My amalze had come down to 300 and my Liapase was now at 425.

Yes, this is a most painful condition and  I would much rather give birth again that have pancreatitis.!

This past Tuesday I had my gallbladder removed.  All went smooth, and got to come home after the procedure.  My incision sites are very tender, but today is Thursday and I am feeling much better.  I have not had the heartburn, abdominal pain, back pain etc. since removing this organ.  I have not had any diarrhea either.

I believe the pro's outweigh the con's with this procedure.  At least for now.

God made certain organs expendable.  Yes, everything serves a purpose, but yet, he knew what he was doing so that if things go wrong with smaller organs, they could be removed and one can live a normal life without them.

I am glad I had this procedure.  Good luck!
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A related discussion, rib pain was started.
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I'm scared, I have been having a pain in my right and left sides of the chest area, I am eleven years old and female, about 84 pounds and I have been experiencing pain there and around my ribcage, before I go to the doctors, I want to know my options, or what it might be, I don't have trouble breathing or pain anywhere else, just around the breast area on the inside but closer to the surface, any recommendations?
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