right side abdominal and flank pain

[blue_angel3469]

I apologize for length of this but I want to be sure to cover all the bases as far as my medical / surgical history. I am a 36-year-old female. I have pain on my right side right under my ribcage radiating to my back. I’ve had it for approximately 5 years now.  It’s pretty much constant and ranges from dull and bearable to sharp and to intense to ignore. I have had numerous CT scans in the past 5 years. The most recent showed an umbilical hernia, which I was told, needed repaired.  After the surgery they told me the hernia was not as bad as they first thought and wasn’t the reason for my pain. All my blood work has been normal. I had a HYDA scan 4 years ago, which showed my gallbladder was functioning well. And was told it was most likely a duodenal ulcer. I’ve also been told that a duodinal(sp?) ulcer should not be causing the level of pain I am feeling. Last year I was having problems with heavy bleeding with my period and severe cramps they found fibroid uterine tumors. I realize those cramps and pains from that were lower, however I had a partial abdominal hysterectomy (I kept both my ovaries) last June in which they found old tissue from endometriosis. The Dr. said my uterus was “fused” together with my bladder and part of my intestines.  I have recently had lower pelvic pain but assume since I still have my ovaries it is due to ovulation. That pain seems to be in addition to the other pain and not related. It is my understanding that endo. tissue can attach it’s self to organs other than just reproductive organs. It is also my understanding that it doesn’t normally show up on CT scans.  I also had a kidney stone when I was pregnant in 1999/2000, which was so large it couldn’t be passed and caused my kidney to hydro. They put in a stent, which had to be replaced due to blockages 5 times before I gave birth. After giving birth the stent and stone were removed. I have continued to be plagued with stones off and on but have been able to pass them but the pain is still there and constant. The pain on my right side I continue to experience feels like it is the same as a stone. Is it possible eudiometrical tissue or adhesions from the stent replacements from my kidney surgeries could be causing my pain? I am getting so frustrated. I know something isn’t right. My pain is not slight and something must be causing it. It gets so bad sometimes it interferes with daily activities and I’m unable to push the pain aside and “grin and bear it” The pain is real and it’s there all of the time, sometimes more severe than others but constant. Could you please give me some advice on how to interact with my Dr. and what tests to ask about that could be run to diagnose this problem. I do plan on giving a copy of this to the general surgeon that did my hernia repair other than that I have no clue what to do.
Thank you,
Becky

[Kevin Pho, MD]

Tough to say without examination.  Pain in the right upper quadrant can be caused by the liver or gallbladder.  You have had a HIDA scan already.  Ensure it was done with CCK stimulation to evaluate for the gallbladder ejection fraction.  In those with lower ejection fractions, removal can be considered to relieve the symptoms.

Needless to say, an ultrasound should also be done as an initial evaluation of the liver and gallbladder.  

Once these diseases have been ruled out, you can consider an upper GI series or upper endoscopy to evaluate for upper GI tract abnormalities (i.e. inflammation or an ulcer).  

These options can be discussed with your personal physician or in conjunction with a GI consult.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[blue_angel3469]

So it is most likely a digestive tract type problem? Since the pain is so close to a kidney stone pain could it be related to all the stent replacements as far as adhesions or would that show up on the CT? Is it possible it could be left over endometrial tissue that was not seen during the hysterectomy due to the fact that it was not in the pelvic region? Sorry about the misspelling of endometrial in my first post. My spell check changed it automaticly and I didn't catch it before I posted my question. Thank you so much for your thoughts in this matter.

[doc holiday]

I have suffered from this pain for over 4 years it is under my right rib. I have had all the tests they took my galbladder, have had the pancrease ercp and spinctor of odie clipped,I dont want to depress you but I have even been to mayo clinic. I still cant find anyone who can tell me what this is. On this web site in other areas  like epigastric pain and others they are full of people with these same complaints. Everbody acts like its the first they have heard of this. I can not tell you what it is or I would be well. I can tell you that I have figured out that it is heat related, the Dr has now found that when I am exposed to heat I have a histamine reaction which causes the gas and pain to get worse. this temp. threashold for me is only about 68 deg. with 70 deg. being tops. I stay in side and monitor the room temp.not the thermostat setting. It took me about a week for the pain to get better.

[P.A.]

I have had the same pain on my right side on  and off for about 3 years now. I just recently had a CT scan done and a cyst was discovered in my left kidney. The doctor says my organs on the right side are fine. It is a constant dull pain which at times can be a very strong pain and then all of a sudden its gone for a few hours and then returns. I am so frustrated with my Dr. I don't know who else to turn to. My Dr. is an internist. Any suggestions of what type of Dr. is should seek?

Thanks,
P.A.

[shawni]

Intersting Stories.  I am a 33 year old male experience pain on the right side radiating to my back and shoulder.  I have had CT Scan, Hyda Scan w/injection, Ultrasound, blood work and endosocpy.  The Dr's came back Diagnosing as Erosive Gastritis and IBS.  What can I do now to alleviate this pain?  Prescriptions don't work and alos inhibit your digestive enzymes.

[ANDIE8893]

I am 34 years old and I suffer with upper right abdominal pain. It's under my ribs and hurts all the way through to my back. I've had my gallbladder taken out 7yrs. ago and was told nothing serious but a little inflamation (inflammation). I've had many test done but nothing has ever pointed to anything. I hurt so bad it is sometimes unbearable. I've had this same pain for 10yrs. Nothing seems to help. Can someone Please give me an idea!! It seems to get worse when I start my period and that to is getting worse. I feel like I grew a new gallbladder. I can't take this much longer.

[amylee31]

It seems like I am not alone. I have been having problems with my stomach for over 2 years now. Within the last few months I have developed severe pain in my right side. I have had all the same pains that everyone has already listed. Right now it is very sharp and it is hard to even sit here. I went to the emergency room last night because the pain was so overwhelming. They did yet another catscan and found nothing. I have had every test done possible. The only thing left for the doctor to do is cut me open. I have gone to 3 different doctors, the first, a stomach doctor, says he can only find acid reflux and gastritus. The second said he believes it is shingles or gallbladder, he is a surgeon. And my family doctor thinks my stomach problems have nothing to do with my side and that I damaged a nerve in my ribs somehow. I am so frustrated. I can not function, my daily life has been interupted. I come home crying most nights because the pain is so severe. No medicine they have given me has helped yet. I am at a loss, I do not know what to do or where to turn next. Anyone have any suggestions?

[Cindylou]

Has anyone thought of myofascial pain syndrome.  It's never ending pain caused by knots in the muscles,fiber, tissue etc. I had Pain in the rib cage,stomach,back, breast bone. I went to the doctors also and no one or nothing helped ease the pain.
   I finally found a massage therapist at a pain clinic who helped me. I still have some pain but it is managable now.

[lgtech]

I'm so glad I found this site. I have terrible pain on the upper right side of my body and it goes to my back. It's a sharp sore pain. I'm due to get a hysterectomy Monday and I have fibroid tumors. I don't see why the upper right pain on my side would be associated with my fibroids. I just started having these pains since Sunday. Should I ask for test to be ran before Monday?
confused and hurting in Macon

[bkay]

Hi Everyone,

I know this is a long post but my experience may help you with your right sided pain.

What I am reading sounds very familiar. Last July I started to have episodes of right sided pain that wrapped around the flank and hip and down into the groin with a very tender area around the appendix. This pain landed me in the ER several times last fall. I was checked for organ problems, gyn. problems, urological problems. I had numerous CT scans, MRI, blood tests, a colonscopy and a diagnostic lap. for endometriosis. During attacks I could not stand up straight because of the pain in my right side, hip area and groin area. I also did a lot of limping during attacks.

Finally the urologist I was referred to checked my back with an MRI. Low and behold my t12 vertebrae was deformed and I had thoracic stenosis on the right side of the t11-t12 vertebrae. I went back to my primary care doctor with the report. He was extremely surprised to put it mildly. Thoracic stenosis is a rare condition. He referred me to a neurosurgeon.
He left the exam room shaking his head and mumbling, "Thoracic stenosis!?!" The stenosis was impinging my t11 nerve.

I have learned from my doctors, the web and physical therapists that pain from the t11 nerve radiates around the right side of the body and down through the hip and groin area. Like sciatica you do not feel it in the back but in a location below the pinched nerve.

The neurosurgeon was surprised by the report. He too explained that what I had was very rare especially for a 41 year old whose back was in very good condition--despite this problem. He orderd a CT scan to evaluate the deformed t12 vertebrae. He also ordered a steroid injection to find out if my pain was truly caused by the t11 nerve. The injection worked wonders. I was pain free for about 4 hours until the local anthes. they injected in wore off then things were the worse they had ever been. All the pain I had been feeling was exacerbated that evening--Thank God for narcotics. The steroid part of the injection calmed things down over the next couple of weeks but never really took it away.

As for the CT scan it turned out that at some point in my life I had broken my t12 vertebrae. I never knew I had broken my back. The surgeon refers to it as a very old fracture.This broken vertebrae lead to the thoracic stenosis. Obviously at some time last summer I did something that aggravated this condition.

I had a t11 nerve root decompression on June 7th. What the surgeon found was a swollen and very irritated nerve. He had to remove bone from around the t11 nerve so it has enough room. The right sided pain is almost gone. I was told that it takes many months for a nerve to calm down and mine was very irritated. I am still recovering from the surgery and do have back pain now but I definitely notice a difference in my right side.

Before my surgery I had never had back pain just right sided pain. I was dumbstruck to find out my pain was a result of a back problem--who would have thought.

I know this is very long but there is a point to all of this. If you have not done so get your back checked out. It may all be referred pain from a pinched nerve in your mid back.

Bkay

[hellyun]

I also have right-sided rib pain right under my rib which feels like a knife sticking in there most of the time.  I can only control it through meds.  It worsens with how much I do around the house, especially like vacumming, scrubbing the tub, trying to mow the lawn (all of which I try to stay away from knowing I'm going to pay dearly for it). This started after a TAH in Dec. of '99.  I also had severe abdominal pain, rectal, vaginal pain which turned out to be adhesions.  I had an adhesiolysis which two very experienced surgeons that are well-known for doing adhesiolysises in June of 2000.  They felt that I probably had adhesions on my diaphram which was causing the rib pain.  The surgery helped with the adhesions, but as soon as I awoke I said my rib was hurting worse than before the surgery.  With all the saline they filled me with this seemed to exasperate the rib pain and the rib pain over the next few days became excuriating.  They had no reason for the pain, said the gall bladder was fine, saw no adhesions up in the rib area and just shook their heads and said they had no clue. I continued to have to see a pain specialist, had another CT scan, tried PT (also caused severe pain, will never do that again).  So, here I am 5 years later with the horrible rib pain.  I just saw another doctor and he said what you were talking about, that perhaps the pain is being caused from another part of my body, and that we needed to look elsewhere for perhaps a pinched nerve somewhere else and is causing the pain under my rib.  All along the doctors have thought that the pain was either nerve damage from the hysterectomy, muscular, or possibly adhesions that the surgeons didn't see.  Just thought I would comment on this, and that this is an avenue that I hadn't explored yet.  Still can't imagine a TAH causing a pinched nerve somewhere, but at least I now have hope that they can finally find this.

For those of you having abdominal pain, don't rule out adhesions, as they can't be seen by a CT scan, MRI or any x-rays, they can only see organs moved.  I had a CT scan and they read it as normal.  My GYN after months of my complaining of abdominal pain had another radiologist read it and it showed loops of bowel adhered to my abdomen.  Afer my adhesiolysis they said I had massive adhesions everywhere and anywhere they could adhere.  You can check out the website www.adhesions.org which is very insightful regarding adhesions and has a chat room which offers help for those suffering from adhesions.

Anyone that has any information regarding the "right-sided rib pain or would like to discuss it further, I'd be happy to listen.

Thanks for listening, hellyun

[roseyQ]

A related discussion, Thank you was started.