Upper Right Abdominal Pain

[gina_m]

I am a 22 year old female with a history of good health. For the past few weeks, I have experienced severe pain in my lower right pelvic area just above my hip. I consulted my doctor and he ordered a CT scan which showed a 2cm ovarian cyst on the right ovary. I waited until I started my period to see if the cyst would rupture on it's own, as they normally do. The last day of my period was Saturday and on Sunday I started having severe pain just below my ribs on the right side. I've been "gassy" for the last week and have felt very bloated. I can only eat a few bites at a time, if I eat at all, because I feel very full or nausiated. My right shoulder is achy along with my right hip. The most concerning of all is the lightheadedness that I feel when I stand up or take a deep breath. This pain seems to move from my pelvic area up to my rib cage on the right side. I know things usually move "down" so I can't really explain these symptoms. Thank you for your time.

[Kevin Pho, MD]

Upper right quadrant pain can be caused by the liver and gallbladder.  Obtaining an abdominal ultrasound would be a reasonable initial test, along with blood tests looking at the liver enzymes.

If negative, you can consider an upper GI series or upper endoscopy - which can look for various causes of dyspepsia such as GERD, an ulcer or inflammation of the upper digestive tract.  I would also consider blood tests looking for the bacteria H Pylori - which is associated with ulcers or inflammation.

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_

[gina_m]

What are the post surgery symptoms and effects of having my gallbladder removed?
Will I gain/lose weight?
Have diarhea (diarrhea)/constipation?
How long will these last and do I have to be on medication for the rest of my life as a result of not having a bile producing organ?

[Felix'sMum]

Hi Gina, I have polycystic ovaries and know well the pain of an ovarian cyst - however at 2cms, your cyst is small and i would think it TOO small to be causing the kind of sympptoms you're getting. your gallbladder is almost certainly the culprit here and would need to come out. Laparoscopy is almost always the preferred method and a vast majority of people have no future digestive problems, including diarrhoea, afterwards.It will not affect your weight one way or the other - the gallbladder is only a little chamber holding a supply of bile; the liver itself produces bile and passes it down the bile duct to the digestive system. When the gall bladder is gone the liver simply takes over full-time producing bile and releasing it when you eat. Assuming there are no other complications and you have a keyhole procedure (1 small incision at your navel and 3 along your right rib line), you'll be out of hospital in 24hours. You won't need to take medication and usually don't need to change your diet in any way. Good luck!

[Felix'sMum]

Hi Gina, I have polycystic ovaries and know well the pain of an ovarian cyst - however at 2cms, your cyst is small and i would think it TOO small to be causing the kind of sympptoms you're getting. your gallbladder is almost certainly the culprit here and would need to come out. Laparoscopy is almost always the preferred method and a vast majority of people have no future digestive problems, including diarrhoea, afterwards.It will not affect your weight one way or the other - the gallbladder is only a little chamber holding a supply of bile; the liver itself produces bile and passes it down the bile duct to the digestive system. When the gall bladder is gone the liver simply takes over full-time producing bile and releasing it when you eat. Assuming there are no other complications and you have a keyhole procedure (1 small incision at your navel and 3 along your right rib line), you'll be out of hospital in 24hours. You won't need to take medication and usually don't need to change your diet in any way. Good luck!

[gina_m]

Thanks for the advise. I'm just worried and frustrated(with my doctor mostly) because I've never had any health complications until now and I've never had a surgical procedure done before. Sometimes I feel like I'm getting the "run-around" but I know my situation is complicated and my doctor is doing everything he possibly can. They are running every test under the sun and I just got lab work done yesterday to try to figure out exactly what's going on. Thanks again.

[Felix'sMum]

Gina, poor you! I know it often is so frustrating when you feel like you're ill and no-one can figure out what's wrong. I doubt the docs are intentionally giving you the run-around, it's simply a fact that while medicine understands most of the body's systems and functions really well, sometimes a combination of symptoms can make a 100% accurate diagnosis almost impossible. So they just keep trying, testing this, scanning that,until they have a full picture and can be as sure as is reasonable that they know what is wrong. I think you should take comfort in knowing that if you had something really serious it would almost certainly have shown up long before now! Good luck!

[queenkong]

i hope if it is the gallbladder that you get to do the "keyhole" surgery   My surgery was in Feb and went from "keyhole" to 6 hours of open because I had stones that had traveled everywhere   Huge incision and a long and painful recovery,,,, i still dont feel all that well but everyone says its takes awhile after such a drastic procedure and having moved my liver and everything else around.  the good news...i havent had any digestive problems at all  that at least has gone smooth...

[Jaybay]

Dr. Kevin is right - you need to get that gallbladder and liver checked out.  Since you have never had any surgery before, you may even have endometriosis causing this pain.  That really can't be firmly diagnosed without a look-see with the scope.  Also bear in mind that even if an ultrasound of your gallbladder shows you have no stones, it may be infected and not functioning properly.  

An inflamed gallbladder is called "cholecystitis" in medical parlance.  I had no stones or sludge, and the Hida scan showed a low-end of normal functioning gallbladder.  However, when I insisted on an exploratory laparoscopy (I KNOW my body!) the stupid thing was so infected it was ready to rupture, and I had masses of scar tissue all over my intestines - still a problem to this day.

The point is, you know your body.  If something feels wrong, it probably is wrong.  I get so tired of doctors relying completely on test results and not listening to patients.  Endo and adhesions usually don't show up on any scan yet conceived by man, so even if your tests show up as completely normal (as mine did) keep on trying!  Most people do very well after gallbladder removal, and any problems such as diarrhea following a fatty meal, tend to resolve after a few weeks.  Don't let fear of surgery stop you from pursuing answers.  Now go get 'em!

[Mark M.]

Hi,
I too have upper right quad pain just below my ribs. I am a male, 46yrs old 6ft and weigh 175. My pain come and goes and has for about 6 months. It is not severe pain, but at times is more annoying than anything. It feels like there is something in there pinching me. I went to an internal med MD in July. He ran blood tests that all came back fine. He sent me to have an abdomianl ultrascan which showed only "healthy" organs. No dilated bile duct, no gall stones, liver enzymes were in normal range. It is 4 months later and the pain is still happening. When I sit, or bend at the waist, I can feel the pain. It is not a deep, internal pain, but seems close to the surface, just to the right of that little cartlidge/bone that splits the rib cage...just to the right of the stomach. What the heck could it be? My MD put me on Nexium, thinking maybe it is peptic in nature, but 60 days of Nexium and still the pain persists. I am freaking out because my dad passed away this past March due to a rare appendix cancer that several MD's could not find nor diagnose properly once they found it, another story in itself...so you know how the paranoia sets in. I don't have a lot of faith in MD's right now. Anyone out there have any input? Can the liver be screwed up for this long and still avoid being detected? Can inflamation (inflammation) be detected by ultrasound? It feels like it's burning, not like heartburn, but a firey sensation...hard to describe. Someone, please help me settle my fly away brain...thanks.

[Felix'sMum]

Mark, it certainly sounds like gallbladder disease to me. Is the pain worse at night? That would be typical of gallbladder problems. As JayBay said, ultrasound doesn't always tell the whole story and it may be that your problem is more to do with the function of the gallbladder than whether or not it contains stones. Could be infection or spasms are causing the pain. You should take this up with your doctor again and have him do a laparoscopy and/or other tests to check gall bladder function.In the UK we have a medicine available over the counter called Buscopan which is an anti-spasmodic often prescribed for IBS. You might find some relief from something similar (any anti-spasmodic will help) while you await your doctor's decision. Good luck...

[Felix'sMum]

...also, Mark, that odd sensation you're describing is common in gallbladder disease and may indicate a small stone stuck in the bile duct. Many of us experience it as a bubbling, fizzing, burning sensation not unlike the one you get when you are absolutely starving hungry and haven't eaten for hours. Also, re your worries after your dad's diagnosis...remember the appendix is in a very different pace from where you're experiencing the pain; I doubt it could POSSIBLY be connected in any way! And as for liver disease going undetected so long - no way Jose. Enzyme secretion/liver function is well-understood and blood tests would pick up liver trouble in a heartbeat. Don't worry too much...hope you get a diagnosis soon and am pretty sure you have a gallbladder problem only which is simple and easily solved.

[gina_m]

Update...
Well, I had my lab work done and I'm still waiting on the results...you know how that goes. They are testing my liver and gallbladder functioning with the blood work that they ordered. My Gyno has referred me to an internal doctor because I think he's stumped as far as my symptoms go. I know he only specializes in gyn/ob and general med. to a certain extent so I don't blame him for sending me to another doctor. Since my last appointment with my Gyno, I've been getting stools with green mucus in them. I haven't changed my diet nor have I eaten anything with green coloring in it. I have no idea what's going on with my stomach! My CT scan that I had which showed the ovarian cyst reported that all other organ functioning looked normal but I don't know if the fact that I couldn't keep any of that nasty, chalky Barium contrast down had any affect on the results. I tried so hard to think "happy thoughts":-) to keep it down but I just kept throwing it up! Thanks for all the advice. It's really helped me to know that I'm not crazy and I'm not the only one with this problem.

[Jaybay]

Hi Mark.  You've only just begun the testing phase of figuring out what might be wrong.  Yes, it MIGHT be gallbladder related, but it could also be many other things.  Have you had an endoscopy yet?  Since the location of your pain is upper abdomen and has a burning quality, an edoscopic exam by a gastro doc would help nail down an h. pylori infection and many other problems in the stomach and esophogus.  Try not to panic yet, and if you're not getting good answers, move on to another doc who will work with you and get to the bottom of it.  Sometimes it takes quite a while to find the right one.  Good luck!

[little Sam]

My daughter is 16 and for the past 2 months she has had almost the same symptoms and others on top of that.  The doctors don't know what is going on.  At first we went to the ER and they found nothing on her blood work, but her Dad and I insisted on a CT scan.  The scan showed cysts on both of her ovaries, 4 cm and 6 cm, an abnormal amount of lymph nodes, (I didn't think you could have extra lymph nodes?), in her bladder and uterus, something on the base of her lungs, and her spleen was slightly enlarged.  From there we went to a ob/gyn oncologist, to a pediatrician, to a regular ob/gyn, to 2 G.I. doctors, back to a children's hospital ER, then finally to the Children's Hospital in Birmingham for all-day tests....of which we won't hear back from until next Wednesday.  Her symptoms started out as pain in her stomach (right side only), nausea, and just a general "not well" feeling.  Now the symptoms include those plus pain on both sides of her abdomen,dizziness, shakiness, exteme fatigue, periods of being very hot, pain in her right thigh, heat and redness on both thighs,waking up many times a night being very hot (but not sweating), and constipation.  She has been tested for thyroid, gallbladder, cancer, lupus, plus a whole lot of other things that I don't even remember right now.  A couple of jerks have even said it was depression or stress. My daughter is a out-going, tender hearted young lady who, even now that she's sick, is still upbeat.  Her Dad and I don't know what to do, we are so frustrated.  We've spent a lot of money already and just feel like we are getting the run around.  Because a doctor can't figure it out they dismiss her as depressed.  Meanwhile she's getting worse.  She has missed about 3 weeks of school since the end of October.  By the way....she had H-pylori the end of September but not now.  She also has had Mono sometime in the past, but not now.  Any ideas....we are desperate.  

Thanks for listening,
Robin

[little Sam]

Oh! Also she has severe headaches.  She's had another CT scan and it showed that her spleen was back to normal and other things normal, but her SED-rate, which measures the rate of inflammation in her body, is up from 15 from the first ER trip to 45 now.  

Her next appt. is another ob/byn appt. for Nov. 28th and they will do an ultrasound to check her cysts.  

I think that's all!

Robin

[Felix'sMum]

Hi Robin..if you start your own thread with this information, one of the moderating team of Forum doctors will address it for you, rather than expanding on gina-M's thread. I'm not sure I could add much to what has already been said here, other than that raised body temperature is usually a response to infection so it is strange that it comes and goes for your daughter. Please also remember that she has had pretty extensive tests already and if there was something major wrong, it would have been identified by now so try not to worry too much.

[MrsHeetmiser]

Hi,
I have also been having similar symptoms. I am 39 years old, female & I have pain and burning in the lower right rib cage area, bloating, a full feeling after eating a little, and intermittent diarrhea.  I had an ultrasound and a CT scan.  The CT scan showed that I did not have any stones in my gallbladder, but I have a slightly fatty liver, and 2 benign tumors.  One is very small and the other is 2cm. I went to see the GI specialist today & he said that my pain is not from the the liver tumors, but must be caused from something else.  When I described the burning pain, he seemed to think it was caused by a "nerve" rather than anything else.  I have been down this road before with doctors, it took me 3 years to finally get a diagnosis for endometriosis, so I am always sceptical when a doctor implies it is a "nerve"(or something in my head????) He did send me for blood work to test my liver function, and I have an appointment for a CCK Disida scan to test my gallbladder function.  Has anyone ever had this before?  Does it hurt?

[Jaybay]

A hida scan is not painful at all.  Just lie down on the table and wait while the machine takes its pictures.  They'll give you an injection that causes the gallbladder to contract and measure how well it functions.  In people with poorly functioning gallbladders, this step can cause some short-lived, but intense nausea.  Happened to me!  All in all, you have nothing to lose, and possibly a diagnosis to gain by having this test done.  Good luck!

[Bastianyanni]

Hi everyone, I have been reading about eveyones undiagnosed upper right quadrant pain.  I am a 42 yo female. I too have been dealing with this for about a year and a half.  But my pain first started as a 'side stitch' from running and is always worsened by physical activity.  I thought I had a hernia but an endoscope ruled that out.  If I work out in the morning, whether lifting weights, running riding the exercise bike, I have a burning discomfort in my URQ the rest of the day.  And if I exercise two days in a row, I am in pain for a week.  I cannot make any correlation to diet.  I eat a very healthy, lowfat, high fiber diet.  I am normal weight, in good shape, etc.  But I feel like a mental case because no Doc seems to be able to help.  I have stopped seeing doctors for now because I am frustrated.  But we cant all be crazy.  At Least I hope not!
Thanks for listening.  Susan

[Jaybay]

Have you seen a gastroenterologist?  Any other medical testing yet?

[Bastianyanni]

Hey Jay,
I have had every test...heida scan, colonoscopy, endoscopy, ct scans, ultrasound, blood tests for liver enzymes.  I have been to 3 GI docs, 2 surgeons that are sports guys.  One surgeon says its an abdominal wall strain, one says its GI related. 2 GI docs says its not GI related, one says it is but cant figure out how.  He says the pain could be from the hepatic reflex on the right and the splenic reflex on the left.  But gives no reasons why or what to do about it.  Needless to say it is driving me insane, almost literally.

[Crystal-Holl]

Hello everyone with URQ pain.  Just under the rib and pinching.  Been there done that for 14 years now.  Mine started when I was pregnant with my son. I have had it off and on.  Right now its on unfortunitly.  I have had numerous ultrasounds and MRI and many lab works done.  I have been to quite a few doctors on this one all over the country and they just simply have guessed everything from muscular to skelital to a bone spur to nerve ending.  I don't know.  I am with you all it's enough sometimes to make me crazy.  Initially they all guess that it is gallbladder till ultrasounds and test come back negative.  I don't know.  However I can empathize with each one of you.

[bebetobe03]

I had the same kind of pain up under my ribcage on the right side, nausea sometimes. My primary physican thought it was either my gallbadder or liver and sent me for an ultrasound.  They found multiple hemangiomas (benign tumors) on my liver, the largest being 6cm.  After that I was getting extremely bloated if I ate anything and nausous and terrible pains in the middle of my stomach every time I ate or stood up and was moving around too long.  It got so bad I ended up going to the emergency room. They did a ton of blood work, all came back normal, so they did a cat scan, everything looked good except my liver, the doctor said they also saw the multiple hemangiomas. the doctor at the emergency room said he knew nothing about them and to go see a liver specialist.  I told this to my primary and she ending up sending for a Hida scan (gallbadder function, which came back normal (which I knew). I was still in pain and told me to take Prilosec (sp ?) and if I was still in pain she would send me for a Endoscopy. I'm supposed to go Dec 15th. I think I just need to see a gastro to monitor the hemangioma for growth. It seems like alot of you have the same symtoms.

[sfmaleneedshelp]

I experiencing upper right dull abdomen pain that has been on going for about 4 months.  I'm also experiencing dizziness, low grade fever, change in stool (not always light, but it doesn't float), eye problems (floaters and blurriness), excessive mucas in the throat, sneezing and hair loss.  I've read that some of these symptoms are related to HCV, but can the be related to another disease as well?

[Preggo001]

i have the same symptoms, Mark.  have you gotten any results?  followed Flex Mum's advise?

[Preggo001]

i have the same symptoms, Mark.  have you gotten any results?  followed Flex Mum's advise?

[rainynighgsintx]

I am a 45 yr old female who had gall bladder removal laproscoptically in 1991, since that time the URQ has returned slowly for years it was as if tghere was a twisted muscle that would bunch up and I would have to stand and stretch that area to get it to "release", that has tamed a bit in the last ten yrs since I quit smoking I dont think those are related but I do believe the additional weight I gained may have given my body the extra room to be un twisted, sad, but, the URQ, has worsened, I have had the liver test, H-Pylori , blood tests, taking a new drug called Aciphex (who names these drugs???:D) with not much help and feel the same burning pinching hurting, 24/7 it is worse when standing little better when sitting and still hurting but less with lying down. I am set for a consult on an edoscopy this friday, I also experience the nausea and sometimes vomiting. weird since I have no gall bladder. These sypmtoms could very well be scar tissue but remember they started about a month after my surgery , a follow up showed nothing.
Mark did you get the endoscopy yet and if you did what are your results?
I wish I could pay for the docs advice but with all the other docs working on it, maybe I can share some experience with everyone here. Yes i have lower back problems and the pain doesnt generate from the back to the front. Actually these have gotten so bad the pain generates from the front to the back all on one side
will gladly take any help response and advice, and will post once the tests are done, ps, the weight thing is being fixed with gastric bypass a whole new life for me..........