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Abdominal Pain - Upper Right Quadrant
I am a 27 year old female, 5'6", 170lbs and falling. At 16, I was diagnosed with Irritable Bowel Syndrome. At 25, I had an endoscopy and colonoscopy. They doctors found gastritis and a small hiatal hernia. I also had genetic bloodwork tests performed and I carry both high risk gene patterns for Celiac disease. I stay away from gluten as much as possible.
In October of 2008, I started having attacks in my upper right abdominal quadrant. I went to my doctor and she suspected it was my gallbladder so she ordered blood tests. That night, the pain increased in severity and I went to the ER. Bloodwork revealed that my lipase and liver enzymes were elevated, so I was admitted. The doctor suspected that a gallstone was blocking a bile duct. I stayed overnight, had a HIDA scan the next day and was released because everything was normal. The ultrasound was normal and a second set of blood tests showed that my lipase and liver enzymes had gone back to normal. No answers.
That night, I had a normal meal and in the middle of the night, I woke up with SEVERE burning pain in my stomach as well as my upper right quadrant. The nausea was so intense, I could barely move. I threw up twice before falling back asleep. I woke up around 8am and threw up again. After visiting a doctor who is also a family friend, I was referred to yet another gastroenterologist. My pain and nausea continued and I couldn't eat solid food for over a week. I had another endoscopy, which showed nothing. I also had a gastric emptying test, which revealed that my food was staying in my stomach twice as long as it should. We thought we had our answer.
I got better within the next couple of weeks, THEN...
nearly a month ago, I started having the same pain in my upper right quadrant which radiates to below my right shoulder blade. I had a CAT scan this past week after my doctor suspected my gallbladder yet again. Results: NOTHING except that I still have a small hiatal hernia and an accessory spleen. Neither one explains my pain. She then ordered bloodwork which is not back yet.

The pain is accompanied by bloating, indigestion, tenderness, slight nausea, loss of appetite (at times). Last night, it felt as though my upper right quadrant was being tightly squeezed. The pain is worse when I lie down flat. When it began 3 weeks ago, it was intermittent. Now it is constant. The only change in my diet recently is that I went vegan and have not had animal products of any kind.

I am going to see our family friend doctor, who is also a surgeon, as my doctor thinks that I might need to have my gallbladder removed. Even though the tests have all been negative for gallbladder problems, she believes that this is the problem.

Please help! I am at my wit's end with this!
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8 Answers
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My pain doesn't hurt into my shoulder it just radiates to the middle back around where your bra goes.  I do much bettter if I am lying down or standing insted of sitting.  It feels like everything has been pushed up under my breasts.  Is there anything that will stop the pain?  Do you feel like you've pulled a muscle?  I thought maybe I had pulled a muscle but I just had suregery for Kidney stones and they shocked me 4800 times to get fragments small enough to pass.  I'm not doing any housework...nothing so how could I have pulled something?
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Nope, nothing stops the pain except when it decides to stop itself. It is constant, yet it changes in severity as "attacks" occur every few hours. It's inconsitent and it is difficult to tell when an "attack" will happen. It is definitely not muscle related as I know all too well what that feels like and this is VERY different. For me, lying down actually makes it worse.
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I can only lay on my left side.  As you can probably tell..I CAN'T SLEEP!  I have also been choking quite a bit when I drink something very cold or when I eat meat or rice.  
It won't go down and won't come up.  It's just stuck until my husband either rubs it out or
beats on my shoulders and it finally stops.
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571337 tn?1233261897
Hi, I wanted to ask you if you bloat?  Not your regular kind.  Plus, does your pain begin
in the middle of your stomach and move  around in either direction? Are you having any pain between your shoulder blades?  Even just one Shoulder Blade.  You neck at the nap, Stools which are colorless, or clay colored?  Usually float on top of water?
Have you tried curling up in the fetal position and this gives you "a pinch of comfort?"
Are you so nauseated that you think, If I eat something, It might help, but afraid of eating because it causes severe pain?  Is your blood pressure now low?  Are your ankles swollen?  Are you pretty much fatigued?  Sometimes your B.M. (bowel movement) are ok one minute and the next you are running to the bathroom?  Has this interfered with outside activities?  Well, the reason I was asking all those questions?  Is because, I too suffer from IBS.  I finally was diagnosed: Chronic Pancreatitis.  After a ten yr. search, I get a diagnosis.  Chronic meaning, it never goes
away.  All the way... Loosing weight, blood pressure, the exact pain you mentioned,
Perhaps you can ask for a blood test to test your pancreatic enzymes.  There are two
enzymes they test.  One, is amylase, and the other is for checking your insulin.

Diabetes sometimes hits ya.  But, not me.  Thank God.Also?  What types of meds

are you using?  I hope this helped, as I am not a nurse, or professional.  Just someone who has been there, done that.  Until now.
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Well, unfortunately, my symptoms aren't quite like the ones you described. The only one you mentioned that I have is the pain radiating to under my right shoulder blade, which I know is usually a classic gallbladder symptom. However, the pain has NOW moved to the left, but it is a different kind of pain. I think I have a couple of things going on here. The nausea isn't that bad, although it was back in October. I did get my amylase and lipase checked on Thursday, but the results aren't in yet. I was tested for Diabetes in January and I'm clear. All of my liver enzyme and vitamin and cholesterol tests back in January were all normal.

The only other problem I have is hypothyroidism, which is under control through Synthroid. I also take Xanax and over-the-counter Zantac. An occasional couple of Tylenol for random aches, but that's it.

I have a new set of symptoms today: shooting pain down my left side and chest that lasted for about 5 minutes and then went away; heaviness in the left side of my chest; colon cramping; headache; dizziness. This is BRAND NEW and my other symptoms are almost completely gone, so I don't know what to think.
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Have you had a food sensitivity test?  Do you keep a record of the foods you eat?  Lots of additives in food now.  Look for correlation with a food diary.  This is different from food allergy.  Check out books of Dr. Sherry Rogers.  Look for environmental toxicities from new carpet, furniture, electromagnetic fields.  Did you just get a smart meter installed?  Electromagnetic fields (if lots of them) can do this.  A farabloc blanket will help emf exposure.
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It sounds like your gallbladder is understimulated or there is a possable portal vein obstruction maybe cause of your xtra spleen? Do you experience cognative difficulties at all, lack of quardnation in hands, any head aches, and what color is your stool?
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Hi,
If your Lipase level was raised the first time that means you did have Acute Pancreatitis. It doesn't stay raised for very long before going back to normal and the Pancreatitis can clear up on its own but sometimes it lingers and it can also return.  Also its possible too have Chronic Pancreatitis and not have a raised Lipase level like with the Acute Pancreatitis.  Has anyone checked it again? There is also a condition called Sphincter of Oddi Dysfunction that causes symptoms like you have. You need an 'Endoscopic Ultra Sound' or was that what you had? An ordinary Endoscopy of the stomach duodenum, bowel, etc wont' show your Pancreas. Also an MRCP to rule out it being Chronic Pancreatitis or Sphincter of Oddi Dysfunction should be done too, which can cause Pancreatitis. Gall Stones may be the cause as they are thinking but it may not be. You need a complete workup from a Gastroenterologist who is a Specialist in Pancreatic Hepto/Billiary Disease.
I've have had Acute Pancreatitis 4 times and they have never been able to find out why as my Gall Bladder tests, showed no stones/sludge etc but now they are saying I need it out as sometimes things don't show. However after 4 times having the Acute Pancreatitis I have some enlargement of ducts in the head of the Pancreas. Hopefully it won't get worse and so far no more acute attacks! All the best and I pray they will quickly find the problem. MRCP is a very good MRI type test to show the Ducts in the Pancreas plus a lot of other things. All my Ultra Sounds, CT Scans etc were normal but I had a very high Lipase level with my last attack.
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