Right Upper Quadrant Pain

[mld001]

I am 35 years old and for the last 4 months I have been having Right Upper Quadrant Pain right under my rib.  The pain is sharp that has now become constant.  It's now causing me  difficulty sleeping on my stomach. When I saw my PCP, she felt on physical exam that my liver was enlarged, I had an ultrasound that day, which was negative.  I had an endoscopy and colonoscopy which was negative, I have also had a battery of lab tests that were negative.  I did have my gallbladder removed 4 years ago and have had a hiatal hernia for 16 year that have been treated with Prilosec effectively.  The GI doctor says he can't find anything and my PCP isn't sure what to do.  I'm hoping that someone can give me advice. Thank you!

[Londres70]

Perhaps this is a ductal problem. Have you had or has anyone suggested an ERCP?  This provides a visualization of the bile and pancreatic ducts.  

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
After gall bladder surgery if you are having pain under the right ribs, and liver studies(were they done—if not get them done) are normal, then it could be due to an abscess. A CT scan should be done. Otherwise it can be due to lingering liver infection. It can also be due to acidity and duodenal ulcer. Take a late night snack. Raise head end of bed. Take Omeprazole empty stomach in morning and an antacid gel at bedtime. Refrain from smoking, alcohol, fuzzy drinks and spicy food. Walking around also helps clear gas. It could also be muscle pull that can be treated by applying local analgesic creams. If all these are ruled out, then laparoscopy should be done. Such an undiagnosed pain is usually due to adhesions and cutting the adhesions takes care of the pain. Since a confirmed diagnosis cannot be given on net please discuss with your doctor once. Hope this helps. Take care!