Upper Right Quadrant Pain

I am a 48 year old female, 2 days ago I began experiencing pain in the right upper quadrant with some naseua, no vomiting. I had point tenderness also. I went to my doctor and he thought gallbladder, sent me to the ER. My pain level was at an 8 at this point. ER did an ultrasound, chest x-ray, and lab studies.
U/S showed no gallstones or sludge. lab studies were all wnl, the chest x-ray showed a large amt of gas in the upper right quadrant. They basically sent me home with pain meds and that was it. I am still in very bad pain, I am not eating or drinking anything as I have no appetite. I just don't understand what is happening, how can I have gas in the right quadrant and this severe pain is scaring me. I feel no better and I just wonder what should be the next step. I hope this is enought information for you

Thank you,
Ann

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are several considerations.  You report right upper quadrant pain with a negative ultrasound, chest Xrays and "lab studies" (I assume you had liver tests).  

With a negative ultrasound, gallstones are unlikely.  You may want to consider acalculous biliary pain - simply put, this is biliary pain without stones.  A HIDA scan with CCK stimulation would be a test to consider.  This can measure the gall bladder ejection fraction.  If low, then studies show a cholecystectomy relieves the pain more often than not.  

Other disease includes dyspepsia (an ulcer or inflammation of the stomach or esophagus), or a stomach/small bowel mass.  I would consider either an upper GI series or upper endoscopy as further tests to evaluate your discomfort.  

If every test is negative, then consideration may be made to irritable bowel.  I would recommend a gastroenterology referral.

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.

[suummerrwwinnd]

Anne,  I am in the same situation, only mine has been going on since last Aug.  I have had my gallbladder removed, adhesions removed and just de-toxed off of some serious pain meds last month.  I still have the upper right quadrant pain, and have every test in the book, so I guess its what they originally diagonsed as Irritable bowel syndrome.  I hope it goes away but have figured out I'm going to have to live w/it.  the bad part is it hurts REALLY bad to have intercourse.  Good luck and post back.  I am interested in your recovery.

[zippy479]

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