Upper right abdominal/back pain

I'm a 49 yr. old woman and I had my gallbladder removed 14 yrs. ago.  About 3 yrs. ago I started experiencing a dull pain just under my right ribcage which radiates to the right side of my back.  The pain peaks in the a.m. hours, just when I wake for the day though it does come and go throughout the day.  It doesn't appear to be food related since it is there when I first get up in the a.m. and comes and goes throughout the day, regardless of meals.  The pain level is consistant, alway dull - never sharp.  I have a "feeling" of something deep in my abdominal area but I don't know how to explain it other than a "feeling of something".

Three years ago I had a blood workup and an ultrasound that showed nothing unusal.  The doctor said that since I am in such good overall health it's probably just a muscle spasm originating from my back.  Here it is three years later and I still have the same pain.  I'm becoming paranoid thinking of all kinds of worse case scenerios.  Since I don't have a gallbladder do you think this can be my liver or bile ducts?  Can you please recommend some tests you think might help me to get to the cause of this pain?

[Kevin Pho, MD]

Stones in the biliary ducts are still possible without a gallbladder.  This can be evaluated with an MRCP.

I would also consider Sphincter of Oddi dysfunction, which can occur in those without gallbladders.  If suspected, Sphincter of Oddi manometry can be considered.

If the tests continue to be negative, evaluation of the upper digestive tract can be considered with an upper endoscopy.  More specialized tests can include a gastric emptying scan to look for gastroparesis.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com