Right upper quadrant abdominal pain

Hello.  I am a 37 year old female.  I have been having a sharp pain under my rt rib area with laughter, sudden movement, bending, sneezing, etc for about months now.  I also have been having feelings of dizziness, seeing floaters at various occasions without particular activity, also generalized fatigue, lt sided chest pain with palpitations. Also joint pains lately.  I was seen by my doctor and even gone to ER for these same symptoms.  Ultrasounds and x rays were normal. Chest xray was normal.Ultrasound showed all my organs looking very normal. No Gallstones. My blood work was abnormal.  My ckmb was elevated, my potassium was low, my blood sugar was low, my liver enzymes were elevated, my creatnine was slightly elevated, and hemoglobin was 9.  My doctor keeps sending me home with antibiotics after antibiotics also donnatol.  She also prescribed iron and folic acid.  I have been popping motrin like candy for the past year for my pain in order to function.  I feel that my doctor is missing something that may be wrong with me.  Her treatments have not been working.  I am about 30 lbs overweight but I stay moderately active. I dont have any diagnosed medical problems and I dont smoke or drink.  I dont take any medications.  I do have very heavy and painful menstrual cramps every month.  I have to take plenty of motrin for that also.  Please give me any of your ideas of what may be happening to me.  Thanks.   Hope

[Banned1]

I'm so sorry you are suffering.  I just entered a very long post and I'm pasting it here for you, rather than typing it out again.  I hope you get something out of it.  Forgive the length.  I want to try to provide as much information as I can.  I wish someone had done the same for me in the beginning.  I'm not a doctor and I know nothing about medicine beyond what I've experienced.  They might run a test called a HIDA Scan (Hepatobiliary Imino-Diacetic Acid scan) to evaluate how well your gallbladder is functioning.  If the ejection fraction rate is 35% or less, your gallbladder could be the culprit and may need to be removed.  

Doing your own research can only help.  Check out the "First Principles of Gastroenterology", http://gastroresource.com/GITextbook/en/Default.htm.  I would take special note of the biliary system, Sphincter of Oddi Dysfunction and pancreatitis.  Learn as much as you can before you go through ANY surgery ~ especially how your biliary system works.  Knowledge is power.

Diet is KEY!  Keep a log of everything that goes into and comes out of your system, including medications and any holistics.  A low-fat, fibre-rich diet can make a BIG difference.  If you eliminate fried foods from your diet and start with bland foods only, you may get to a point where you have no pain.  Then you can add new items to see how you feel.  Less than 30 grams of fat per day is a great starting point.  

A few other less invasive tests such as the Endoscopic Ultrasound (EUS) and MRCP-S (Secretin) can image the whole thing including pancreas and ductal system.  If you like the GI you are seeing, s/he might be willing to try an EUS or MRCP-S.  ERCP (Endoscopic Retrograde Cholangiopancreatography) is more serious and riskier, from what I understand.

Are you taking Metamucil or a similar daily fibre product?  This is a great help for MANY people and might help.   It does not make you go, it makes you regular by adding fibre to the watery stools, making them firm.  

Many people have great success with digestive enzymes and pancreatic enzymes.  This is something you can talk to your Doc about.  You'll want to make sure that they only contain Proteases, Lipase and Amylase and no other active ingredients.  Prescription enzymes are the best.  There are sustained-action enzymes and immediate release enzymes.  A combination of the two can work wonders but you'd need to get instructions from your doctor and then figure out what works best for you.  Enzymes take several weeks before they work.  Enzymes are also sold in health food stores but, again, watch the ingredients.  Some contain acids and that can be bad news, depending upon your symptoms.

I mentioned keeping a log earlier.  It also helps to keep a journal.  It's a great way to review your situation objectively and identify patterns in your foods, symptoms, medications, bowel habits and pain level.  Hindsight is 20/20 and keeping a log might help you look at things more objectively over the longer term.  Also, when you do go into Emergency, you can say, this has been the pattern...  

You’d be shocked to learn how many people with abdominal pain are ignored or disbelieved.  Especially when it goes on for a long time without any answers, even those closest to you might have their doubts.  Please read the "spoon theory".  It is incredibly helpful and a MUST-READ for everyone: http://www.butyoudontlooksick.com/navigation/BYDLS-TheSpoonTheory.pdf.  It puts things in perspective for those suffering from chronic pain.

Remember that you are not alone!  Try to stay positive and reach out for support when you need it.  Talk to your Doctor, family, friends, co-workers, church or social service volunteers or anyone you feel safe with.  

Yahoo! support groups can be wonderful.  To find one, search the web for Yahoo! groups.  Once you have the page where you can search the Yahoo! groups, search or "sphincter" (for Sphincter of Oddi).  Also, the best website to visit is top5plus5.com and there is an amazing forum/support group there.  Of course, there are no costs associated with these groups.

When you do find answers, it would be wonderful if you could let us know the root cause(s) and how you got rid of your pain.  It gives people on this site hope to hear success stories.  Post or email me anytime.  Email if you want a quick response.  I don't check in here that often anymore.

Take care of yourself.  Good luck and Godspeed.  All the best,

Sam