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Gastroenterology (Expert Forum)
Upper Right 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.
Upper Right Quadrant Pain
by AnnM, May 20, 2003 12:00AM
I am a 48 year old female, 2 days ago I began experiencing pain in the right upper quadrant with some naseua, no vomiting. I had point tenderness also. I went to my doctor and he thought gallbladder, sent me to the ER. My pain level was at an 8 at this point. ER did an ultrasound, chest x-ray, and lab studies.
U/S showed no gallstones or sludge. lab studies were all wnl, the chest x-ray showed a large amt of gas in the upper right quadrant. They basically sent me home with pain meds and that was it. I am still in very bad pain, I am not eating or drinking anything as I have no appetite. I just don't understand what is happening, how can I have gas in the right quadrant and this severe pain is scaring me. I feel no better and I just wonder what should be the next step. I hope this is enought information for you
Thank you,
Ann
U/S showed no gallstones or sludge. lab studies were all wnl, the chest x-ray showed a large amt of gas in the upper right quadrant. They basically sent me home with pain meds and that was it. I am still in very bad pain, I am not eating or drinking anything as I have no appetite. I just don't understand what is happening, how can I have gas in the right quadrant and this severe pain is scaring me. I feel no better and I just wonder what should be the next step. I hope this is enought information for you
Thank you,
Ann
Doctor's Answer
by Kevin Pho, MD, May 20, 2003 12:00AM
, May 20, 2003 12:00AM
Hello - thanks for asking your question.
There are several considerations. You report right upper quadrant pain with a negative ultrasound, chest Xrays and "lab studies" (I assume you had liver tests).
With a negative ultrasound, gallstones are unlikely. You may want to consider acalculous biliary pain - simply put, this is biliary pain without stones. A HIDA scan with CCK stimulation would be a test to consider. This can measure the gall bladder ejection fraction. If low, then studies show a cholecystectomy relieves the pain more often than not.
Other disease includes dyspepsia (an ulcer or inflammation of the stomach or esophagus), or a stomach/small bowel mass. I would consider either an upper GI series or upper endoscopy as further tests to evaluate your discomfort.
If every test is negative, then consideration may be made to irritable bowel. I would recommend a gastroenterology referral.
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.
Thanks,
Kevin, M.D.
There are several considerations. You report right upper quadrant pain with a negative ultrasound, chest Xrays and "lab studies" (I assume you had liver tests).
With a negative ultrasound, gallstones are unlikely. You may want to consider acalculous biliary pain - simply put, this is biliary pain without stones. A HIDA scan with CCK stimulation would be a test to consider. This can measure the gall bladder ejection fraction. If low, then studies show a cholecystectomy relieves the pain more often than not.
Other disease includes dyspepsia (an ulcer or inflammation of the stomach or esophagus), or a stomach/small bowel mass. I would consider either an upper GI series or upper endoscopy as further tests to evaluate your discomfort.
If every test is negative, then consideration may be made to irritable bowel. I would recommend a gastroenterology referral.
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.
Thanks,
Kevin, M.D.
Member Comments
by suummerrwwinnd, May 29, 2003 12:00AM
To: AnneM
Anne, I am in the same situation, only mine has been going on since last Aug. I have had my gallbladder removed, adhesions removed and just de-toxed off of some serious pain meds last month. I still have the upper right quadrant pain, and have every test in the book, so I guess its what they originally diagonsed as Irritable bowel syndrome. I hope it goes away but have figured out I'm going to have to live w/it. the bad part is it hurts REALLY bad to have intercourse. Good luck and post back. I am interested in your recovery.
by zippy479, Oct 28, 2008 10:35AM
A related discussion, Pain in upper quadrant was started.
