Re: Abdominal Pain

Posted By HFHSM.D.-rf on July 21, 1998 at 21:32:59:

In Reply to: Abdominal Pain posted by Trina on July 21, 1998 at 17:46:02:






Hi, I am a 25 year old female with a persistant right upper quadrant pain for 2 months. The pain radiates around the side and into my back.  It began as a come and go pain and now is constant. I have had ultrasound, upper gi, numberous blood, stool and urine tests which all come back normal.  I have had levsin, prilosec, naproxen and now librax.  None of these have had any impact in easing the pain. I had my gallbladder removed 8 months ago.  No other symptoms, i.e. diarrehea, constipation, vomitting, nausea, fever, etc.  Could it be possible to have retained stones that do not show up on ultrasound?  I have had normal liver fucntion tests. My gi thinks its IBS, but bowels are not my problem! Any suggestions or questions I should ask my gi doctor to look for?
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Dear Trina,
The pain that you describe is unfortunately not specific.  Several conditions could cause your pain.  Irritable bowel syndrome is a very likely cause, but one should only invoke this explanation after other treatable conditions have been excluded.  Common duct stones could produce right sided pain, but this would not be a typical presentation.  The classical presentation for common duct stones is sharp right upper quadrant pain often with fever and jaundice.  It is possible that gastritis is causing your pain, but again this would be an unlikely presentation.  Ask your physician about the possibility of the pain originating in the colon or small intestine.  Barium enema and small intestine series would reduce some of the diagnostic uncertainty if they were normal.  If the pain persists and all other dianostic possibilities have been excluded, ask your doctor to do an ERCP to visualize the bile duct and to exclude stones, but make certain that you are familiar with and understand the risks of this test.
This information is presented for educational purposes only.  Always ask your personal physician specific medical questions.
HFHSM.D.-rf
*keywords; abdominal pain, common bile duct stones, gastritis
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