Sharp stabbing like pains upper right rib

[kwilki]

I'm a 42 yr old female. The pain started 9-12-06 in my lower right abdominal area and seemed to spread to my upper right rib area and upper right back area within the week. I've had severe bouts of diarrhea, constipation, bloating, nausea and pain.Recently I've noticed trembling in my hands almost like I have low blood sugar. Without pain medication the symptoms progress as the day goes on. The pain gets better if I lay down, but I cannot tolerate lying on my right side. I have since had an Abdominal ultrasound that showed several cysts on my right ovary. I've been to see the gynecologist and put me on birth control to see if the pill doesn't help resolve the pain from the cysts. Blood test were negative for H Pylori, kidneys, spleen were alright as well.I've also had a CT scan of my upper chest area as well as my pelvic area.( the morning of the Ct scan I had a severe bout of diarrhea but the Ct scan showed that my bowels were not completely empty) I finally ended up in the ER because the cramping & bloating were so severe. The ER Dr sent me for chest & abdominal X-rays and the Dr said that he had never seen someone with intestines so full( this was within a 10 days of the CT scan). They prescribed Trilyte, said I was constipated and sent me home.
The CT tests also showed that there was a thickening of my colon near the spleen. I was then sent for an Endoscopy..showed nothing( I knew that). Was then sent for a Colonoscopy which showed 2 small polyps, there was no mention made of the thickening. I've had bouts of constipation and diarrhea with some nausea and severe bloating since 9-12-06. My abdomen area feels like I've done 100 sit-ups.
My Gallbladder was removed in 2002 and ever since then I've experienced nothing but pain. I get these attacks in the center of my chest and directly in the same area in my back, feels like I'm having a heart attack, sweats and severe pain that last from a few minutes to several minutes. These attacks are less frequent now but they started the day that the Dr. removed my gallbaldder.The pain I'm having now is constant unless I'm taking something to control the pain or unless I've been sedated. The GI Dr said that there is a possiblity of liver stones because this is the same pain I was having when the Dr decided to remove my gallbladder. the Dr did mention the my red blood cells were slightly elevated for my liver but showed no real concern.
Are there any other tests available that could show whats causing this pain? I feel like I'm going crazy because the tests have all come back negative, but the pain is continuous and constant. By dinner time last night I would rate the pain a 9 on a scale of 1-10. I've quit taking the pain meds because the Drs think that's what made me constipated. But I was constipated with bouts of diarrhea for at least 2 weeks prior to my first Drs appt.

I hope I gave enough info.

Thank you


  

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation - many of the major disorders would have been seen on the tests that you have had.  

You can consider more specialized GI testing such as a gastric emptying scan or esophageal motility studies.  These tests can look for gastroparesis or motility disorders respectively.  

Sphincter of Oddi (SO) dysfunction can be considered as well, and be evaluated with SO manometry.

If the tests continue to be negative, irritable bowel syndrome can be treated.  Medications like antispasmodic agents, tricyclic antidepressants or antibiotics like Rifaxamin can be discussed.

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_

[samiamo1]

A related discussion, right-upper abdominal pain and burning was started.