ABDOMINAL PAIN UPER RIGHT ABDOMEN

[19BUDDY]

49 5 FEET 9 181 LB MALE THREE MONTHES AGO HAD BAD
BOUT OF FLU WITH TREMENDOUS ACID COULDN'T LIE ON MY RIGHT SIDE. 10 DAYS LATTER OVERNITE WHEN I GOT-UP HAD MILD PAIN/CRAMP UPPER RIGHT SIDE UNDER RIBS. CONSTANT LIGHT BURPING ATTACKS,COULD BE 40 IN AN HOUR WOULD START AND NOT STOP LASTING 1-2 HOURS. USUALLY 2 HOURS AFTER EATING. CRAMP WOULD GET WORSE WITH REPETITVE BENT OVER ACTIVITY (GOLF)LEADING TO GAS ATTACK NEVER ANY REAL GAS FULLNESS OR PAIN. I WATCHED WHAT I ATE AS FOOD BOTHERED CONDITION AT THE TIME. LOST ABOUT 5 LBS. BUT I WAS ALSO AFRAID TO EAT.

WENT TO MY GP AND TWO GASTRO DOCTORS.

HAD PHYSICAL IN APRIL PREVIOUS TO PROBLEM ALL NORMAL
URINE AND BLOOD ALL NORMAL FOR KIDMEYS AND LIVER. ELECTROLITES WERE NORMAL. BLOOD SUGAR, UPPER LIMITS OF NORMAL. BUT I DO LIMIT CARBOHYDRATES.

AFTER 1 WEEK, MADE FIRST OF MANY DR. VISITS FECAL BLOOD TEST DONE TWICE OK. ALL ABDOMINAL PALPITATIONS OK NO PAIN CAUSED BY TOUCH.

I WAS PUT ON ACID REDUCERS I DONT THINK THEY HELPED.  

ABDOMINAL ULTRASOUD NORMAL HOMOGENEOUS TEXTURE OF LIVER
AND SPLEEN HEPTIC AND PROTAL VEIN NORMAL BLOOD FLOW IN KIDNEYS
NORMAL NO EVIDENCE OF GALLSTONES OR BILE DUCT DILATATION
NO ANEURYSM OR ASCITES.

BACTERIA NEGATIVE FOR SALMONELLA SHIGELLA AND CAMPYLOBACTER
COLOR LIGHT YELLOW. GLU, BIL, AND KET, NIT, LEU,PRO, ALL NEG
PH 6.0 SG<=1.005 URO 0.2 e.u/DL NO H PYLORI

FASTING
BILIRUBIN TOTAL 1.2
ALBUMIN         4.6
UREA NIT        13
BUN/CREATINE    11 RATIO        
AST             21
ALT             20
PROTIEN         7.3
CREATINE        1.2
GLUCOSE         100
AMYLASE, SERUM   51

ONLY THING SLIGHTLY HIGH AGAIN IS GLUCOSE
6/15 100 ON 4/7 99                    
          
7/15 8 LAYER CT SCAN DONE WITH ORAL AND NONIONIC ITRAVENOUS CONTRAST. LIVER SPLEEN PANCREAS, ADRENALS AND KIDNEYS NORMAL
A SPLENULE IS NOTED WITHIN THE SPLENIC HILUM. NO ABNORMAL PELVIC ADENOPATHY OR ASCITES. SEMINAL VESICLES AMD BLADER IMAGE NORMAL.
PROSTATE SLIGHTLY ENLARGED.

HAD COLONOSCOPY AND ENDOSCOPY IN 2004 FOR BLOOD IN STOOL
HAD EROSIVE GASTRITIS TOLD TO STOP TAKING DAILY ASPRIN AND HAVENT HAD A PROBLEM SINCE. EVERYTHING ELSE NORMAL IE
HYPOPHARYNX ESOPHAGUS, GASRTO JUNCTION, PYLORUS, AND DUODENUM.  

ABOUT 9 WEEKS AFTER ONSET SYMPTONS GOT BETTER BELCHING IS GONE
PAIN/CRAMP SEEM TO LESSEN BUT LIGHT CRAMPING MOVED AROUND IN
THE AREA OF THE TOP OF MY STOMACH ON LEFT AND RIGHT SIDE. NOT BAD BUT NOTICIBLE.

SINCE THEN I PERIODICLY HAVE SLIGHT CRAMP IN GALL BLADDER AREA DOSENT SEEM TO BE AGGRAVATED AS MUCH OR LITTLE BY FOOD. MY STOOLS SEEM TO BE LIGHT GOLDEN WHICH IS A LITTLE LIGHTER THAN NORMAL FOR ME. BUT THIS MAY BE FROM ANTACIDS. APPITITE IS BETTER BUT I AM STILL CAREFULL WITH FOODS.

I HAVE OCCASIONAL HISTORY OF PANIC ATTACKS

MEDICATIONS
TAKE WELBUTRIN FOR 8 MONTHS
I TAKE DIOVAN HCT FOR BP  
OCCASIONAL AS NEEDED CLONAZEPAM

ENERGY LEVEL AND SLEEP OK.

NEVER ANY SHARP OR STRONG PAINS

ANY THOUGHTS OR SUGGESTIONS.

THANK YOU.

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation for your symptoms.  

One option would be to consider a HIDA scan with CCK stimulation.  This can evaluate the gallbladder ejection fraction - low numbers can cause symptoms similar to gallbladder pain.

Other options can include a 24-hr pH study with esophageal motility studies.  Atypically, GERD and motility disorders can lead to such symptoms.  

Another consideration would be Sphincter of Oddi dysfunction - which can be evaluated via an ERCP.  

These options can be discussed with your GI 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.
http://www.straightfromthedoc.com

[Marilene]

I am 52 years old and have had no health problems. But for the past year I have a constant dull ache in my upper right side of my stomach under my rib cage. The doctor told me it was a condition known as costochondritis and has me taking Celebrex as needed. But I don't really feel that this is the problem. I've had all the tests done, upper and Lower scopes, cat scan of liver which shows I have a cyst but he says that's a normal thing with age) My blood test showed a higher than normal count (relating to the liver) but he said it wasn't that high and could have been related to something I ate.

It appears, at times, that my stomach on that side is a little higher then the other side.

I'm going today for another blood test (at my request) to see if it comes out any different.
I am someone over weight for my size, could that cause problems with my liver? I also have a Hiatal hernia but no real problems with that except for heart burn.
thank you
Marilene
Any ideas will be greatly appreciated.

  

  

[wibdibm]

Also, pain on right side and cannot sleep on right side or will be awakened with even more severe pain and nasau.  So far no evaluation done for it and I plan to discuss it with Doc at physical but have been able to limit pain by not sleeping on that side, however pain on that side is constant on a scale of 1 to 10 its a 2-3 right now.  Notwithstanding I am 320lbs, 5'8" so I blame it on the fat on that side of my waist and have had my gallbladder removed.

[wibdibm]

Forgot to mention, I also have GERD and hietal hernia which I've had since the early 90's and now take Prevacid or Prilosec OTC if I'm out of Prevacid of course I have to take it at least every other day or that'll become a major problem.

[bobntresa]

I have the same pain.  Front, upper right rib.....  I have had this since I was pg with my last son (I have 3 kids).  Had ultrasound then but was ok.  Tomorrow (two years later) I go again for another u/s to see what the heck is going on??  It has me a little scared.  you always think what if it's my liver?  what if? what if?  I will go through that other test with dye if this comes out ok.  I am just tired of it hurting.  I also have a cotton wool spot in my eye and my dr is testing me for ms, lupus, etc etc.  Between the eye surgeon and my regular dr they are scaring the **** out of me!  Any feedback is appreciated......

[Renee38]

Ok I am having some of the same problems listed above. I am 38 yrs old, 3 children. I am overweight, but cholesterol, triglicerides (triglycerides), every test taken comes back normal. Lipase, amalayse, HIDA, endoscopy, colonoscopy, stool, and urine samples. Cat scan of the kidneys showed tiny stones and not anything they said could cause pain. Liver showed small amount of fatty liver. I have been to a Hepatologist, he told me fatty liver does not cause pain. He also is sending me to a gastro specialist(I have already been to one) who he thinks can help by measuring the presssure some test for the Sphincter of Oddi. He said it was that or Pancreatitis. The thing is the pain is collicky always there. I am on Librax because since they found nothing else they said it was Irritable Bowel, also Dilauded for the pain as it has gotten that bad. If I do try to eat a real meal, nothing even greasy I have horrible pain in that same area, right side under the ribs. How can so many tests and so much pain and trouble eating not show anything? I am no doctor but I don't believe that would be caused by Irritable Bowel. I am starting to feel hopeless, just pretty much giving up on eating. Its when I feel my best so why not?

[barbara_s]

I also have pains in my right side just under my rib cage.
I do have a problem with a hernia in my stomach that i am currently waiting to have surgery on. It's only been within the last couple of weeks that i have been having pains there in my right  side and I am wondering if that has to do with the hernia or if it has to do with something else?

[lisamar]

I also have pain on right side, radiates to back--right of spine.  also under rib cage, stomach, aching pain, sometimes severe.  all tests thus far negative--h. pylori, mri for back, colonoscopy, endoscopy, ultrasound, etc.  I have poor digestion, am underweight because i don't want to rock the boat when i feel decent take prilosec, pepsid and everything from the healthfood store for digestion and ulcer (even though no ulcer showed so far).  my cousin has ADHESIONS and says my symptoms are similar.  i was operated on (lower stomach for cyst a while ago).  i do have facets syndrome in lower back, received steroid shots for that because it is severly degenerated.  last hospital visit (where they did virtually nothing except give me pain meds) my electrolytes were low, white blood count slightly elevated, and was dehydrated.  have been making concerted effort to remediate these situations.  have removed caffeine from diet, no longer ingest any alcoholic beverages or spicy foods, and have not found any form of consistent releif.  it has been a year on and off.  have scarring in pancreas from a former kidney infection.  also GAVE UP ON EATING except for times when i am home, done with work, and have no obligations (and therefore can chance any pain that could be related to eating though i am unsure of any direct correlation).  i take vicodin for lower back and no longer use ibuprofen.  vicodin does not help stomach pain in my case but does work for back.  i take probiotics too.  meds are nexxium, temazepam for sleep and very occassionally, xanax.  any ideas appreciated.

[Reef77]

A related discussion, Abdominal Pain was started.