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Re: upper right quadrant pain
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Re: upper right quadrant pain

Posted By CHRISTOPHER on July 15, 1999 at 09:58:53
I am a 37 yr old male. I have had upper right quadrant pain that comes and goes for appx 10 years.  The pain in not sharp but more of a dull pain, a tenderness or fullness.  I also seem to have many soft or loose stools that come and go also. No fever, nasuea, or weight loss is involved.  I do not drink much (mabey once or twice a month).  But the pain always presents itself the day after I have had a few drinks and stays there for 2 or 3 weeks and then fades away.  I have been to my doctor and had normal liver function results and a clean upper GI so he says everything is ok. My concern is if there may be an enlarged or fatty liver, gallbladder problem or pehaps a problem with the intestinal track.  The pain is basically always in the same place, the upper right quadrant.  Any help or thoughts would be greatly appreciated.




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Posted By kat on July 18, 1999 at 12:09:25
I have the same problem as you--I can't decide if the slight discomfort in my right quadrant is my imagination or not.  My liver enzymes have always been normal, and I'm generally not sick.  I'm sorry that I can't answer any of your questions, but I'm glad to know someone else feels that exact discomfort (especially after they drink).  




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Posted By HFHSM.D.-D.M. on July 18, 1999 at 15:06:56

Dear Christopher:
I found your situation and questions interesting and Id like to make a couple of comments.  Youve had right upper quadrant abdominal pain for 10 years, soft stools and you note that the pain seems associated with alcohol intake.
Well theyre are a couple of possibilities that are worth thinking about.  Alcohol use (even relatively small amounts) can cause marked deposition of fat in the liver and the liver can be enlarged as a result of this.  In some circumstances, this can cause stretching of the capsule that encloses the liver (Glissons capsule) and this can cause a vague abdominal tenderness.
Another possibility is that you have an ulcer or inflammation of the stomach (gastritis) that might be exacerbated by the alcohol use.  This can especially  be a problem if there are other factors that are also hard on the stomach (cigarettes, anti-inflammatory medication, bacteria).  This would be easy for your physicians to evaluate.  I agree that there is some potential for the symptoms to come from the gallbladder although your symptoms are not classic for gallbladder colic.  Typically an ultrasound is a good test to exclude gallstones and to look for other anatomical problems in the liver.  
Finally, there are a host of other, more unusual causes, some of which can be serious. One possibility is that youve caused inflammation to your pancreas (pancreatitis) which we see with marked alcohol use.  This pain can persist after alcohol is stopped.  The pain is usually more in the middle than to the right but there are always exceptions.  It is easy to test for pancreatitis with blood tests.
Good luck getting things sorted out.  Abdominal pain can be frustrating to the patient and physician.  The patient is frustrated by the amount of pain and the physician is frustrated by his inability to pin it down.  However, often a condition will announce itself.  If the symptoms are really substantial, your  physician may want to do additional tests especially if you are losing weight.  
It sounds like you would benefit from a visit to a thoughtful physician.  I hope this information is helpful to you.  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 (313) 916-8865. 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.  





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Posted By TERESA on July 22, 1999 at 23:37:10
HI I HAVE HAD HEPATITIS C FOR 11 YEARS.  I HAD THIS SEVERAL YEARS AGO BUT IT WAS
AT A STAGE THAT THEY COULD DETECT IT.  SO ANYWAY I HAVE THE C VIRUS AN I ALSO HAVE PAIN IN THE RIGHT SIDE ALOT KNOW WEIGHT LOSS NAUSEA SOMETIMES I HAVE KNOW GALLBLADDER OR EPENDIX. I DO NOT DRINK ALWAYS TIRED MY LIVER COUNT IS NORMAL PLEASE TELL ME WHAT I SHOULD DO SOMETIMES THE PAIN IS SO SHARP IT TAKES MY BREATH.  I DONT WANT MY DOCTER TO THINK JUST BECAUSE I HAVE JUST BEEN TOLD IT IS THE C VIRUS THAT I AM GOING TO START COMPLAINING PLEASE HELP

                           THANK YOU TERESA





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Posted By HFHSM.D.-D.M. on July 23, 1999 at 10:32:51

Dear Teresa:
It sounds like you are really frustrated by your right upper quadrant abdominal pain and it sounds like it is really bothering you.  A lot of my patients with hepatitis C complain of right upper quadrant abdominal pain though the pain is typically more dull.  A sharp pain that almost takes your breath away would be a little unusual for hepatitis C.
Right upper quadrant abdominal pain can be caused by many things.  It really does require a thoughtful evaluation including a good history from the patient and a careful examination. If the pain is significant we often do a few tests to check out the pancreas, gallbladder and stomach.  We will often consider an abdominal ultrasound because this is a completely safe test which can give us some good information especially about the gallbladder and liver.  
I hope this information is helpful to you and good luck.  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 (313) 916-8865.  At Henry Ford, we have an active group of liver specialists and we have an interest in the care and research of  hepatitis C.
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.  





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Posted By david lewis on September 12, 1999 at 06:18:37
I JUST STARTED GETTING PAIN THIS MORNING 09121999 I AM PANICING THINKING THIS IS IT IM A GONNER, I HAVE HAD HEP C SINCE 1982 WHICH IS CHRONIC OF COURSE.WHAT ARE THE LEATHEL SIGNS YOU NEED TO BE CONCERNED WITH?




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Posted By HFHSM.D.-D.M. on September 15, 1999 at 16:55:42
Dear David Lewis:
I appreciate your questions and your sense of urgency and Ill try to make some comments that might take the edge off your panic.  
A lot of MEDHELP participants have a sense with hepatitis C that one day youre fine and the next day you are in an intensive care unit with a failing liver.  Hepatitis C just doesnt work that way.  It is an extremely gradual disease that evolves over decades.  Both symptoms and laboratory findings evolve very slowly and we typically can see deterioration in the lab findings or liver biopsy years before some one starts to come down with symptoms of a failing liver.
Ironically, abdominal pain is an unusual symptom of advanced liver disease.  While many of my hepatitis C patients have an uneasiness or dull pain in their right upper abdomen, this symptom does not correlate with a failing liver.  Patients with advanced fibrosis and hepatitis C are at some risk for liver cancer on some occasions the liver cancer can present that way.  Again, this would be somewhat unusual.  Obviously there are a variety of other processes that can give pain in this are including gallstones and ulcers.
The important thing is to be followed by some one with experience with hepatitis C.  Good luck.  I hope this information is helpful to you.  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 (313) 916-8865. We have an active group of liver specialists and we have an interest in the care and research of hepatitis C.
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.  





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Posted By Phil on September 22, 1999 at 21:55:23
I have had the pain right below my right ribcage now for a month.  It's happened before in the last couple of years but this time seems different.  I also feel alittle nausea from time to time.  I've been through interferon, the combo treatment, and now in midst of interfergen.  Also this area seems firm to the touch.  I also hurt all the time in various places--back,hips,neck, and just generally feel terrible.  Always tired.  Hepatits doctor who I see every few months won't give anymore pain meds because he's afraid of the government.  I've mentioned the pain before.  Help.










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