upper right quadrant pain

[ken__0]

Posted by kenn on June 04, 1999 at 02:21:03PDear doctors, I was diagnosed with Hepatitis A 9 months ago (Sept. 1998)after becoming ill in Mexico following a long travel excursion. I experienced symptoms generally associated with Hep A (i.e. jaundice, loss of appetite, nausea, headaches,etc) but no pain in the upper right quandrant until three months after being ill and after my other symptoms had long disappeared. This pain continues to bother me nine months after the initial illness. It is a dull pain that bugs me on and off but fairly persistently. Other symptoms included dry throat and mouth and eyes. I was checked for diabetes in March and the test was negative. In March I visited a physician who conducted blood tests on me. My liver function tests came back normal, however my IGg test came back inconclusive. I have since continued to experience the pain although ultrasound and x-rays that followed were normal as well. My doctor seems to think that the pain may be due to a liver still in the process of Posted by kenn on July 02, 1999 at 17:45:38
It's me once again with few more questions or comments. I wrote in May about my persistent discomfort in the upper right quadrant area below the ribs. I had been diagnosed with Hepatitis A last September after travels in Mexico. My most recent "liver function tests", conducted last week June 23 or so, came back "normal" as did ultrasound readings of May. Yet the discomfort continues, although following my last message to you in late May I experienced three weeks of less persistent even rare pain only to be followed by recurrence of discomfort. The pain, as I said before is persistent and dull, at times is also a "burning" type of discomfort and at other times feel like a "tightness" in the area. It is not effected one way or another by diet and is not more prevalent at certain times during the day. However, one thing I neglected to mention in the last message involves my stools which are consistently loose and soft and often a dark brown, though not black. Since the liver tests and ultrasound show no abnormalities what might I ask my doctor, who is a not a gastro-enterologist to check for in my next visit? Thank you for everthing!
Posted by HFHSM.D.-D.M. on July 11, 1999 at 14:43:54
Dear Kenn;
I appreciate your follow-up questions and again I’ll try to make some general comments to help.  Abdominal pain can be a frustrating problem for both patients and physicians.  Physicians are frustrated by their inability to make a specific diagnosis for the patient and patients sometimes feel that their physicians don’t care.
What we like to do is to do a careful evaluation that is guided by the patient’s complaints and our findings.  We like to rule out catastrophic problems such as cancers or infections that can become severe.  If we don’t find a specific problem, we treat the patient for their symptoms and than we observe the patient to see how their symptoms evolve.  If the symptoms change or worsen, this can direct us to additional tests that can make a diagnosis.  While, I can’t give very specific recommendations to your physician, he/she should repeat a careful physical examination.  It also sounds as if they are already repeating your blood work periodically.  There is typically more concern if the patients is losing weight and it will be important to know about that.  Finally, if your stools are really different, it is relatively simple to test them for blood or infections such as parasites and C. difficile.  In addition, I still feel that stomach problems such as gastritis, ulcers or a helicobactor pylori infections remain a consideration.  
I hope this additional information is helpful to you and again, good luck with your situation.  If you have additional information or questions, I would invite you to post the material to MEDHELP.  The direct number to our Liver Clinic at Henry Ford is [phone]. We have an active group of liver specialists and gastroenterologists.  
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.