RUQ Pressure

[charliew703]

I have been having RUQ pressure now several months under my rib cage, no sharp pain but rather dull pressure that varies in intensity.  Lately I've noticed tiredness after lunch and appetite is not as big as it normally is.  I've been to the doctor and had kidney/liver tests which I was told were normal.  When I twist my upper body the pressure becomes slight pain in my right side mostly under the rib cage.  Also, stools change often from soft/hard and in color where the last few have been light in color (clay like color) but that varies as well.  I've had hepatitis b/c tests that have come back negative.  I've had some heartburn issues which I take prilosec for.  I've also had lower abdomen tenderness.  Any suggestions/comments on what I should look out for or possible solutions would be appreciated.

[Dr Santos]

Hi,
Thanks for the updates. It is good that the results of the culture and urinalysis were negative for infection. Additional diagnostic tests may  be requested depending on the results of initial tests and your doctor's diagnostic plan. If the pressure persists, further evaluation may indeed be done. Talk to your doctor about this also and discuss the  management being considered. Hope this helps. Take care and best regards.

[charliew703]

Thanks for your reply.  I have had several blood tests and urinalysis with results that appeared normal to the doctor.  I had higher white blood cell count in urinalysis of 2-4 but no growth was found from culture.  I had ultrasound and CT scan and the only thing found were some small kidney stones that the doctor said should be small enough that I shouldn't have any symptoms from them (1-2mm).  Unfortunately I'm in a country where the medical facilities and personnel are not up to western standards so I'm not even sure how much I can trust what they say.  I haven't had an ERCP, would I need to request that or should they just do that based on any concern they find from other tests?

[Dr Santos]

Hi,
I understand your concern regarding your symptoms. Stools that are pale, clay, or putty-colored may be due to problems in the biliary system -  gallbladder, liver, and pancreas. Presence of liver  infection that reduces bile production or blocked flow  of bile out of the liver  needs to be ruled out. For proper evaluation, additional diagnostic tests may need to be done such as blood tests, including tests to check liver function and for viruses that might affect the liver, Endoscopic retrograde cholangiopancreatography (ERCP) as well as imaging studies such as an abdominal ultrasound or CT scan. It is best that you have this checked by your doctor for proper evaluation. Take care and do keep us posted.