Pain in upper-mid right abdomen

I have been having a gnawing deep constant pain that is aggrievated by me doing daily activities and gets better but doesn't go away completely with rest.

The pain feels like it is located under my right rib but I can't tell exactly where. It is deep in there some where. If you put your hand on the bottom of your right rib (where it ends vertically) it would be in the center of the right rib.

I have had a EGD which revealed esophagitis, gastritis, gastro-duodenitis, and duodenitis.

I have also had an Ultrasound and they looked at my Liver and Gallbladder and that was OK.

Bloodwork also looks normal (low RBC at first but rechecked and normal now).

Again the pain is a constant chronic pain that I feel seconds after I wake (doesn't wake me in sleep) and sometimes it eases during the day just sitting up and still but feels a little worse when I lye down and also I think sleeping/lying down all night makes it worse that is why I wake with it. Activity makes it worse also.

It is very deep and no where near the muscles in my opinion. I have had muscle aches before and that doesn't hurt bad like this.

My Questions:

Could it be the duodenitis?? It kind of feels like when my stomach is hurting from the gastritis.. but its way to the right and a little lower of where that normally is.

I guess a CAT scan is in order?

[Kevin Pho, MD]

The upper endoscopy would have evaluated for duedenitis.  You can consider an upper endoscopy with small bowel follow through for another look.  

I'm not sure that a CT scan would show anything more in the right upper quadrant that an ultrasound won't show, but you can consider this.  An MRI of the area is another consideration.

Another consideration would be a HIDA scan with CCK stimulation to evaluate the gallbladder ejection fraction.

These options can be discussed with your personal physician.

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

[Linny Lou]

I had my gallbladder removed 5 yrs ago. Since then I experience pain in the upper right abdomen. I ask my doctor what this could be. He said it was probably adhesions pulling on my liver. My liver enzymes are elvated and sometimes I feel I'm having a gallbladder attack.  I have had to ERCP's because stones can develop in the bile ducts. But it was normal. I also had a lapascopic surgery for adhesions and the doctor did remove some in that area but the following week the pain was back.

[Politbru]

A related discussion, GNAWING PAIN was started.