Pain in upper right quadrants

[jasonfish]

I am a healthy 37 year old male in good physical condition. I have never smoked,drink only very occasionally, and am not overweight.
For the past 3 years I have had intermitent pain right below my lowest rib.  Sometimes the pain is on the right side, and sometimes it presents on the left. And occassionally it comes on both sides along the same axis below my last ribs.   The pain feels like a burning sensation, and if I press on the area it becomes much more sensative to the touch.  The pain only lasts a couple of seconds and then goes away. A minute or two later it comes back.   This will last for a couple of days at a time (maybe a week or two) and then not come back for two or three months.  The pain has not increased in intensity during the 3 years that I have been bothered.

During the last couple of years, I have had multiple utrasounds, a CT scan, and X-rays of my ribs, and blood tests.  None of the tests have showed anything.  My internist and gastro specialist have both told me that because they see nothing to worry about from the tests, and that the pain is on both sides, it is probably inflamation (inflammation) of some sort, or stress related; especially because the pain has not gotten worse over time. But the  anti-inflamitories have not really worked and I cant relate the pain to anything that I eat.  Of course I worry about the worst, and that the tests are not picking up the actual cause of the discomfort.  My father died from pancreatic cancer when he was 62, and although I know that is not what I have, I am sensitive to bothersome abdominal pains. It is difficult to live with a pain on and off for three years and not know what is causing it.

Any thoughts?  Could it just be stress? (I do have stress in my life)

[Kevin Pho, MD]

With the negative test results, major GI or musculoskeletal diseases are less likely.  

One consideration would be a low gallbladder ejection fraction.  This can present with gallbladder-like pain in light of a negative ultrasound.  

A HIDA scan with CCK stimluation can evaluate for this possibility.

This test 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_

[andrewk]

I have had the same problem for a few years and it's gotten worse (I feel burning just about all the time in the area where my liver is  --- generally after I eat or drink something it's worse). Like you, I've had a lot of tests (just had a second ultrasound last week) and the doctors can't seem to find a problem and I'm concerned it's something serious.

I also have thrombocytosis (high platelet count in my blood) -- are you aware of having this as well? Currently my level is 575. So far none of the doctors have seen the thrombocytosis as a problem or connected to the pain, but my platelet count has gotten higher as my pain has increased.

I'm going to another GI doctor this week and will probably see a hepatologist as well (haven't tried a hepatologist yet because my doctors have told me it's not my liver).

[towie]

I have had a pain under my right rib, a burning nagging pain, not stabbing or excruciating. My ribs are also sore and if I press on that area, it tends to hurt more. Some days it bothers me more than others and sometimes it depends on what I eat. Not consistant though. This has been going on for 5 months. I have gone for one test after another trying to figure out what is causing this. I went for an abdominal ultrasound last week which came back normal, no gall stones or masses. My doctor had said if the ultrasound came back normal she wanted me to have a HIDA scan to check the function of the gall bladder. Last Thursday I went for a HIDA scan which I found out today was abnormal, my gall bladder is not functioning properly. I wish I would have gone for the HIDA scan several months ago, it would saved a lot of time and unnecessary testing. My doctor thinks I should have the gall bladder removed, so I have an appt to see a surgeon on the 12th.

So, even though my ct scan and ultrasound came back normal, it is possible that the gall bladder is just not functioning properly which would cause the pain. I would request to have a HIDA scan done. Feel better!

[CurlyFriez]

I have pain as well under my ribs except my is also on my sides and the groin as well. I been experiencing this pain for months. I had numerous tests done and nothing is showing up. I been to one of the top hospitals in the world and traveled far to get there so I am still in the process of finding out whats wrong. I recommend getting that gall bladder test done but I also recommend if nothing shows up with that one to check your kidneys. you could have a stone in there. trust me they could be painful. i had 4 of them. you could have one stuck some where and the test that they do for that is called an IVP. those are the two best tests I recommend that the doctor just did at this hospital and then we are taking it from there. Good luck to you.