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Digestive Disorders / Gastroenterology Forum
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Multitude of Symptoms

I'm a 30-yr. old male, non-smoker, do not do drugs, am not overweight (5'11", 169 lbs.), am a social drinker (usually 3-5 drinks during the course of a weekend), and exercise moderately each week.  For the past few months, I have had a dull ache right underneath my right rib cage in I guess what is referred to as the "upper-right quadrant".  In fact, the discomfort is focused on an area under the rib cage almost directly beneath my right nipple.  The discomfort is more noticeable as I sit, and less noticeable when I stand.  Twisting towards my right side aggravates the discomfort, much like when I lay on that side or sit.  

My stomach does not hurt when pressed nor is it hard. It almost feels like a pulled stomach muscle or a knot.  Occassionally the pain radiates towards my lower stomach on a line even with my belly-button.  I have lost 27 lbs. during the past year primarily on the Atkins diet.  Prior to going on this diet, I'd say that I ate ok, with occassional splurges on fatty/greasy foods.  I experienced this discomfort for months along w/the IBS symptoms below before going on my diet, and as I ate better, my discomfort gradually went away as I lost the weight.

However, this past Christmas, I gained a few (3-5) of these pounds back.  I ate more carbs, and drank a bit more than usual given the various social functions I attended.  Also, I noticed that the IBS-like symptoms that I experienced when I was heavier a year ago were back, specifically, the alternating bouts between diarrhea and constipation, typically brought on by stress and/or a heavy meal or any alcohol I may have consumed.  I always felt like the amount that I "moved" was never commensurate with the amount I felt that I had to "move".  Bloating and a feeling of tightness are common.  I especially noticed a sudden urge to have a bowel movement after consuming my usual 20 or so oz. of coffee in the morning.  I have NEVER experienced the following: blood in the stool; itching; jaundice, or back pain.  

I have never tried any over the counter antacids or other related stomach medications.  Further, I am on Claritin, and have been for years now.  Given my age, sex, the above history and the symptoms listed, is it possible that I could have gall or kidney stones?  It seems to me that pancreatitis is unlikely, as I have not ever had a gruelling centralized pain or a fever.  Further, I don't believe that I'm a heavy enough drinker for this to be any type of alcohol related liver disease.  

I have never been to the doctor for this.  My guess is that I have an ulcer that I am irritating with my food/beverage choices and my bodily movements/positions.  Or that I have IBS.  It should be noted that I have an extremely demanding job (I'm a trial lawyer).  In the past week I have begun to really watch what I eat (low-fat, high-fiber meals), am laying off any alcohol for a while, and have reduced my daily caffeine intake to 6-8 oz.  

I appreciate your thoughts.
1 Responses
233190 tn?1278553401
MEDICAL PROFESSIONAL
Gallbladder and liver disease, as well as the various causes of dyspepsia (i.e. GERD, ulcers, or gastritis) are certainly possibilities.  Rapid and dramatic weight loss predisposes one to gallstones.

I would suggest an abdominal ultrasound and liver function tests to start.  These tests can evaluate the liver function as well as gallstones and any other anatomical abnormality of the liver and gallbladder.

If negative, the workup can be expanded to include an upper GI series/upper endoscopy as well as blood tests for H Pylori (a bacteria associated with inflammation and ulcers).  

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.
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