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Gastroenterology (Expert Forum)
Undiagnosed Right Upper Quadrant Pain
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Undiagnosed Right Upper Quadrant Pain
by fedup-not crazy, Aug 16, 2005 12:00AM
I am a 33 yr old woman who has had right upper quadrant abd pain x4 months, two months post c-section of 4th baby. It's a constant pain that is sharp and burning sometimes radiating around to my back. It produces nausea and vomiting. No fever, chills, constipation or diahrrea. My labs are normal other than iron deficient anemia and hypothyroidism.
I have had kub xrays, ct scans, ultrasounds all normal except for a "thickening" of the jejunum. I had an ERCP with manometry readings- normal. My doctors have given up and say that I have a chronic pain condition and have sent me to a pain clinic and suggested seeing psych.
My history includes one vaginal birth, 3 c-section births. Four bulging discs, two cervical, two lumbar from being rear ended by a drunk driver while pregnant. I've had my appendix and gallbladder removed. I've had a lap to remove adhesions one from the capsule that my liver sits in! I have fibromyalgia and asthma. I have not had my period since this started however, blood test confirms I'm not pregnant.
I'm not able to work or take care of my kids on my own. I feel like I'm going crazy, but know deep in my heart something IS going on!
I have had kub xrays, ct scans, ultrasounds all normal except for a "thickening" of the jejunum. I had an ERCP with manometry readings- normal. My doctors have given up and say that I have a chronic pain condition and have sent me to a pain clinic and suggested seeing psych.
My history includes one vaginal birth, 3 c-section births. Four bulging discs, two cervical, two lumbar from being rear ended by a drunk driver while pregnant. I've had my appendix and gallbladder removed. I've had a lap to remove adhesions one from the capsule that my liver sits in! I have fibromyalgia and asthma. I have not had my period since this started however, blood test confirms I'm not pregnant.
I'm not able to work or take care of my kids on my own. I feel like I'm going crazy, but know deep in my heart something IS going on!
Doctor's Answer
by Kevin Pho, MD, Aug 17, 2005 12:00AM
, Aug 17, 2005 12:00AM
You have clearly been through a comprehensive evaluation, including multiple x-rays and even an ERCP with manometry. Most of the major causes of right upper quadrant pain would have been evaluated with these tests.
A disease to consider would be an typical presentation of dyspepsia (i.e. an ulcer or inflammation of the upper digestive tract). An upper endoscopy or upper GI series can be considered for this possibility.
If negative, then I cannot think of any further testing to elucidate a GI cause. A manifestation of fibromyalgia is possible. Seeing a physiatrist (rehabilitation specialist) or pain specialist would then be a reasonable course of action.
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.
http://www.straightfromthedoc.com
A disease to consider would be an typical presentation of dyspepsia (i.e. an ulcer or inflammation of the upper digestive tract). An upper endoscopy or upper GI series can be considered for this possibility.
If negative, then I cannot think of any further testing to elucidate a GI cause. A manifestation of fibromyalgia is possible. Seeing a physiatrist (rehabilitation specialist) or pain specialist would then be a reasonable course of action.
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.
http://www.straightfromthedoc.com
Member Comments (1)
by shannonv33, Aug 17, 2005 12:00AM
Wow thats sounds just like me, started back in Feb of this year. I had my gallbladder removed in April, wasnt ever a week later the pain was still there. Now I have IBS from having my gallbladder removed and thats all my doctiors want to focuse on. The pain is soooo bad when I have one of these attacks in my upper chest and back, I find that I am so for a few days afterwards also. My gastro doctor put me on Nulev and Librax and it helps some. He said I could get a ERCP to go in and check everything but dont think it would help me much. Right now he says I have dyskinsia, spincter odd disfuntion, PCS, I think they all mean about the same thing. I put on 20lbs from laying around and feeling sick, so I know the depressing feeling. Its like being helpless.
