Acute upper right quadrant pain

[JennyWS]

I am a 55 female, excellent health.  For 6 months, I have been experiencing chronic and infrequently acute pain in my upper right quadrant--under the rib cage but in the front, rather than the back of the rib cage.  Originally, I noticed a dull ache when lying on my stomach--though severe enough to wake me up while sleeping. Then, infrequent very sharp pain in my far right chest cavity began to occur when I twisted my torso, such as reaching around for an object, or when I bent in such a way that my chest was compressed, such as when tying shoes.  Occasionally, I feel a 'fullness' in my right chest. An ultrasound and a CT scan of the area revealed normal condition of liver, gallbladder, general area.  The CT scan was ordered by my onologist--I had radiation of right breast after a lumpectomy 14 months ago--to ensure the pain was not the result of radiation damage. On average, I drink 2 cups of coffee, 2 non-caffeine diet sodas, and 2 alchoholic drinks per day.  Infrequently, I am experiencing heartburn after eating rich foods (like ice cream). The may be unrelated to the original condition.

Thank you for your diagnosis and advice.

[Kevin Pho, MD]

The negative ultrasound and CT scan would make liver and gallbladder disease less likely.  

At this time, I would consider evaluating the upper digestive system.  An upper endoscopy or upper GI series can be considered to rule out GERD, an ulcer, or inflammation of the upper digestive tract.  I would also consider tests to look for H Pylori - which may cause inflammation or an ulcer leading to your symptoms.  

If the GI tests continue to be negative, you can consider pulmonary or musculoskeletal causes of the pain.

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

Kevin, M.D.
kevinmd_

[redsoxman84]

Hi all i was wondering if you could help me out. I am in my low 20s and in august i had hig liver enzymes and i had negat hep. test results and a full normal abdomen ultrasound. Lately i can feel when i push in under my right rib cage all the away around a thumping feeling as if i feel like bubbles and i can feel it inside. It only is there really when i am sitting and it only hurts because i poke at it a lot cuz im paranoid. Anyone know what this could be. I am overweight as well so people tell me its fat pockets and other stuff. Help please?

[dlhigh]

Fat deposits or Lipomas are benign tumors, composed of fat cells of the adult type, most commonly located in the subcutaneous tissue. While rarely congenital, they commonly appear about age 40 to 50, grow slowly (often for years) to a size of 2 to 10 cm in diameter. They are usually encapsulated, but may be diffuse. They are soft and fluctuant to palpitation, usually non-tender and transilluminate I light. Palpation or a thermogram may indicate the skin over them to be cooler to touch than the surrounding skin area. They are less dense to X-rays than other soft tissues. It is important that they be distinguished from the neurofibromatosis lesions. Lipomas may occasionally become pedunculated. Their transformation to a liposarcoma is very rare. In contrast to the more serious implications of a lipoma in muscle or a visceral organ, subcutaneous ones are less serious. Many are only of cosmetic annoyance. Lipomas are rare on the face and scalp, uncommon on the hands and feet. Otherwise there is a wide distribution of them. This information can be found at   http://www.jeghers.com/annts/lipomas.htm .    
What you are describing sounds more like bowels.  It takes hours for food to digest, try checking this in the mornings prior to eating breakfast and discuss your concerns with your family physician.  Hope the information helps and stay well!

[redsoxman84]

Hi thanks for the information, it is still happening when i am sitting down.  The location of these thumping feeling pockets or whatever they are located about 2 inches to the left of my nipple if you were looking right at me under the right rib cage so i dont think it is near my liver.  Could this be lymphoma cancer or something in that or is it fat because i am overweight.  I currently do not have insurance so cant afford to see a doctor.  I feel fine and it only hurts when i poke at them to see if they are still there. Thanks

[dori4_1]

A related discussion, Hi was started.