RUQ Pain/ Pressure

I am a 42 year old male, 5'11", 200 lbs and for the past 5 years, I have experienced reoccurent RUQ pain and other associated symptoms. The right side pain is a dull sensation of fullness or bloating that causes the bottom rib to be tender to the touch. Bending over is uncomfortable and I also guard the right side during any activity. I have also noticed that my stomach is tender to the touch 1" above my navel and again 2" above that and slightly to the right. Pain is not asscoiated with eating or going to the bathroom. These symptoms may last from anywhere from a 1 month to 3 months and then go away for the same period. I cannot associate any activity or item that tiggers these symptoms. I have changed my diet to exclude fats, diet cola (all soft drinks) and alcohol. Other symptoms include tiredness, general malaise, dizziness, inability to concentrate and extreme red eye. Occasionally I will get cold sweats with no high temp. Also during this time, my vision is foggy or distorted, as when running a fever, even though my temps are normal to slighly elevated (99 deg. max) So far all tests from blood work, liver to gall bladder CT scans have all come back normal. Stomach scoped last year normal. Gastroenterologists suggested depression, but I doubt this. I am very frustrated with this condition as it is affecting my work and personal life. I have always been a very active person, but now I do not have the energy. I usually fall asleep by 6:00 pm and sleep all night yet I am still tired during the day. Any help would be appreciated!

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation for the symptoms.  Many of the major GI disorders would have been ruled out with the CT scan and endoscopy.  

You can consider more specialized testing at this point.  A HIDA scan with CCK stimulation can evaluate the gallbladder ejection fraction.  An MRCP can also be considered to evaluate the biliary ducts for any stones.  

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

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.
kevinmd_

[Joanie68]

hi there -

i get this pain too and have also just written in to find out more.  your symptoms sound liver related to me - your lived can be  damaged and it might not show up on cat scan or ultrasound.  have you been tested for hepatitis and had liver panel test done?  the only way to fully evaluate a liver for damage is through biopsy.  you can also have them run a test for autoimmune hepatitis - they test for certain antibodies.

[Christy62]

Have you been checked for Hepatitis.  I have hepatitis C and it can cause pain in the right upper quadrant.  A lot of doctors think that if you have normal liver enzymes you couldn't have hepatitis.  This is not true.  My liver enzymes (LFTs) have been normal on many occasions but I still have the hepatitis C virus (diagnosed by PCR and two liver biopsies). They say you can't feel pain in your liver but the tissue around your liver can become inflamed and cause pain in that area. I have even had spasms there.  Your liver is under your ribs on the right side. You mentioned other problems such as being tired. The main symptom of hepatitis is fatigue and feeling like you have the flu and there can be many other symptoms. There is a wealth of information on hepatitis sites all over the internet.  This is just a suggestion to get checked.

[ChristineM]

Could be your thyroid... ask for blood tests!