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Digestive Disorders / Gastroenterology Forum
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Avatar universal

Pain in right side under rib

I have been having pain in my right side, middle chest area and it radiates to my left and middle of my back.  This has been going on for a year or better.  I have had so many tests.  I have Mitral Valve Prolapse also, I have been to the hospital on two occasions because of chest pain.  I have been diagnosed with diverticulitis also.  But this pain will not cease and desist.  I just recently had an EGD and a Gall Bladder scan. The EGD was normal and when they called on the Gall Bladder scan, they referred to it as basically normal.  I would like to know how precise the scan is in detecting abnormalities in the Gall Bladder and if there is an additional test that can be done to determine if the pain that I am experiencing is due to a bad Gall Bladder.  I cannot in my logical mind just say, "Okay the test prove nothing so there is nothing wrong."  There is pain and severe at most times, where it radiates across my chest to the left and the middle of my back.  I just want to know what is wrong and have it taken care of.  Is that so much to ask.  Any help would be appreciated at this time.

Thank you.

~Ellen~
103 Responses
Avatar universal
Dear Ellen,
there are a number of different tests to evaluate the gall bladder.  If you recently underwent a CCK- assessment of gall bladder contraction, then you had a test which is very sensitive for the diagnosis of gall bladder disease, even in the absence of gall stones.  If the CCK test is normal but you still beleive that the problem is the gall bladder, then removal of the gall bladder would be needed.  If the pain persisted , then a problem in the gall bladder was not the cause.  Needless to say, doctors are reluctant to perform surgery in the absence of an accepted indication and patients are not interested in surgery when the benefits are explained in the terms.

Has your doctor looked for other possible causes e.g. gastroparesis small intestine pathology?  Abdominal pain is often a diagnostic dilemna and a multitude of tests may be needed before a diagnosis is made.
Avatar universal
Ellen,
I know exactly what you are saying.  I have the same set of symptoms and all the tests are negative also.  They went in with a laparoscope last fall and found a bleeding ovarian cyst and removed it.  I improved for a couple of months and then it was back.  They went in again and found more cysts, took the ovaries out.  Now, here we are (since February), I have daily discomfort under my right rib also.  The past month and a half it has gone into chest pain and radiates up into the shoulder and back.  He is planning an ERCP for two weeks.  

Have you had several bowel movements a day?  Is yours aggravated by activity.  Can you wear a waistband around your middle or panty hose?  I can't stand my jeans and haven't been able to for a long time.
Avatar universal
Tracie:  Thank you for your reply.  I can't stand to wear anything tight against my stomach.  I can't even stand to have my husband put his arm around my stomach at night when we are going to bed.  I don't wear panty hose anymore.  I wear slacks to work.  Some days I have several bowel movements a day and then there are days that I go without having any.  I have had a hysterectomy in '95' and then my ovaries out in '96' so those weren't options in this case.  I find it amazing that we can have these symptoms but no diagnosis.  I don't deal well with Dr.s who say that the test came out negative isn't that wonderful.  Yea well thats great so where is the pain coming from.  I am starting to doubt the medical industry.  In as much as technology today is phenominal, people are still in pain and they cannot seem to find the reason for the pain.  I am wondering if the item in the body that is causing the pain needs to blow up before they find out what it is.  But then it won't matter will it because the person who was in pain will probably be dead or wish they were at that point.  Sorry I sound so cynical but I just can't help it.  I can't believe that no one can pin point what the problem is.  My ankles started swelling a year ago, they PRESUME it is some form of arthritis, however, it is such a non-specific disease, or so I have been told, they cannot pin point the exact disease, until it becomes rheumatoid I PRESUME.  Obviously, that is the problem here, this must be such a non-specific disease that they cannot figure out what it is.

Well thanx for listening.  Hope you are feeling better.

~Ellen~
Avatar universal
Ellen,
I also have had a hysterectomy in 1995 and the ovaries last year.  Do you take estrogen?  Have they done an ERCP on you?  Have they tested the sphincter of Oddi?  Are you seeing a gastroenterologist?  Have they done an ERCP?  You can e-mail me and we can talk more privately:  ***@****-net.com
Tracie
Avatar universal
Dear Ellen and Tracie,
       I have been having uper abd pain since May of this year. I have posted a question- Upper LEFT abd pain. I am just writing a reply because I am sharing in your frustration! I am part of that medical profession. I am an RN in an ICU. Even having access to so many physicians doesn't help. No one is willing to listen and just say well maybe you should do this or that.
       Anyway, I can't believe the number of people who post that have unexplained abd. pain. On one hand it makes me feel better but on the other hand it is very discouraging(sp). I am going for a second opinion with a GI specialist on Nov. 1st. I made that appointment back in Sept. I think that is pretty ridiculous too! At first I had great hopes of finding the problem with this MD but now I'm not so sure.
       Please let me know if either of you find out anything more about what is going on with you and I will do the same.
                                  Elizabeth
Avatar universal
Elizabeth,
Have you ever heard of the use of Nitroglycerine for suspected gallbladder disorders?  My doctor gave this to me.  I get some relief from it for an hour or two.  I do wonder about sphincter of oddi dysfunction too.
Tracie
Avatar universal
I've never heard of using nitro to treat gallbladders! That is very interesting! How much do you take and how often?
                              Thanks,
                                   Elizabeth
Avatar universal
Elizabeth,
I really think he is giving me the nitro to cover two of his areas of thoughts of what is going on.  I think he feels it may be sphincter of oddi dysfunction or else calculi in the biliary ducts.  The nitro opens up the ducts through the whole body and for some strange reason it gives me relief.  That tells me that it probably is not the gallbladder itself.  All of my tests on the GB have been normal.  I read further in the archives of this forum on the sphincter of oddi and the symptoms described there are exactly what I have going on.  (That helps me so much to know I am not CRAZY!).
Avatar universal
I forgot to tell you, I take it on a p.r.n. basis when the pain is very intense.  I take l (.4 mg) and then in five minutes take another if the pain hasn't let up enough.  Usually two helps.  I've never taken 3 because it does such strange things to your body.
Avatar universal
Hi Ladies,

  I too was having the same pain. Still am actually.  Finally I went in for a CCK Hida Scan.  This test is specifically for the gallbladdder - done in Feb.99.  Came back fairly normal.  Then 2 wks ago I had another one done due to the pains coming back badly.  The repeated Hida Scan showed that now my gallbladder's ejection factor(which is what they measure) went from 30% to 12%!  It should be at 35%.  Which is why the doc questioned whether or not it was gallbladder after the first scan.  Well, it is and it is coming out!!

  So, what I am trying to say is keep on the doc about the pain.  I DO NOT have gallstones.  So, dont let them tell you because all these tests show NO stones that it is not your gallbladder.  I am living proof it is.  

  The pain I have goes from rt upper back, rt shoulder, rt upper quandrant (under ribs), lft shoulder and back and mid line stomach.  So, just keep after the doc!

Just by the by, I have read that once the gallbladder is removed and they do a pathology on it, gallstones are usually found.  It is just they were too small to be detected by any of the tests.

  Good Luck!
Avatar universal
Phyllis,
Is there more than one kind of Hida Scan?  I am not sure if they looked at the ejection thing on mine.  Is a CCK a certain type?  I don't know if they know how much mine emptied.  They said it filled and emptied fine, not how much.  It was quite large on the scan.  (?????????)  Can distention stretch it out?
We are a mystery.  Thanks for your input.   More to think about.  Will be curious to see if this does indeed take care of your pain.  God Bless You!
Avatar universal
Tracie,

  The CCK component in the hida scan I had, is a hormone your own body makes.  It is directly linked to the gallbladder and liver.

If you have had a hida scan and were told it filled/emptied fine, then you may have a problem other than gallbladder.

  From what I was told, the CCK hida scan, is pretty much the final diagnostic tool for checking gallbladder disease.

  Good luck to you.
Phyllis
Avatar universal
Ellen,
I have been experiencing a pain in my right side, beneath my rib cage for about 18 months.  It is not a constant thing but stress seems to aggrevate it.  Sometimes it is like a sharp knife in my side and I can't even manage to take a normal breath for about 5 minutes.  I have been tested for hepatitis (every kind), mono and have had a liver biopsy.  After the liver biopsy the doctor said that I had a fatty liver and to lose twenty pounds and it would go away.  I lost 40 pounds and I still have the problem.  I hate to go back to the doctors because they act like I am a hypochondriac or something.  I also have elevated liver counts, has this been a problem for you?
Avatar universal
Vanessa,
My blood counts and serum amylase and everything is normal so far.  Nothing, I mean nothing, is out of the ordinary.  I am not overweight either.  You didn't mention your gallbladder.  Is it okay too?
Avatar universal
Dear Ellen.  I have also the same pain.  I know how you feel.
I went to Mayo Clinic in Scotsdale and spend 15 days on test.  The doctors said all test were ok but I was feeling terrable.  I coudn,t eat and have a lot of nausea.
Well, at last do you know what I had  ??
* Superior mesenteric artery syndrome *
Tell your doctor to check this on you.
Hope to be help you on some, and also hope that you don,t have this syndrome.           Carmen.
Avatar universal
Dear Ellen.  I have also the same pain.  I know how you feel.
I went to Mayo Clinic in Scotsdale and spend 15 days on test.  The doctors said all test were ok but I was feeling terrable.  I coudn,t eat and have a lot of nausea.
Well, at last do you know what I had  ??
* Superior mesenteric artery syndrome *
Tell your doctor to check this on you.
Hope to be help you on some, and also hope that you don,t have this syndrome.           Carmen.
Avatar universal
I had an ultra sound done on my gall bladder and they did not find anything.  I have had a few people tell me that it sounds like my gall bladder.  It seems to act up the most when I get very tired or stressed.  I don't want to wait until I have a severe gall bladder attack before I find out what is wrong, but the doctor doesn't seem to take me seriously.
Avatar universal
Ellen.  It,s  me again.  Just would like to know if you find out about * Superior  Mesenteric  Artery  Syndrome *
I am now 48 year old and this problems starts when I was 23.  Please, ask your doctor about this Syndrome or look it on internet to see if this is your case.  It is a very rare case, but it happens.       Carmen.
Avatar universal
Carmen,
Were you always so sick that you didn't eat or did it get progressively worse over time.  Did you refer yourself to Mayo Clinic or did your doctors send you.  How do you know when to give up and quit after the tests are all negative?  Was it ever just a dull, constant aching?  What did they do to help you?
Avatar universal
I am sorry that can,t understand what you mean by dull and aching, I am mexican and don,t speack a good enlish. Just to tell you that I just call Mayo Clinic for apoinment. There are 2 persons you may call theme.  Beatriz Argeta  and  Ermilia Vargas, they made everthing for me.  May I ask where are you from ??  Because I have a frien at Mayo Clinic in Jacksonsville and he is exelenet doctor. I also feel worse when I am stressed. Please, make this, go to bed and go down ( I don,t know how I tell you in english ) with your face and body down ( not up ) see if the pain goes better and then tell me.  If you like some more detail feel free to mail me- ***@****        And the last thing, the doctor told me * Carmen, every thing is normal * I was angry and said * Sorry doctor but I am not going home till I know what I have *.  The rest I preffer to tell you by mail.  Goog luck.
Avatar universal
Dear All,
After all the negative tests, today I had results with my ERCP. They found stones in the gallbladder that for some reason wouldn't show on anything else.  I hope and pray that when they remove it the pain is finished.
Avatar universal
what is ercp.  I too have pain in urq and had ultrasound today that showed no gallstones.  wonder what will be next test.
Avatar universal
Dear Tracie,
      I am so glad they found results with your ERCP! No problems after the procedure? I ended up with pancreatitis after mine. What is your next step then? Will you be having your gall bladder out? Nothing has shown up that points to gall stones or gall bladder problems. I am going to a new gastroenterologist on Monday. I hope he can help me.
                        Take care,
                            Elizabeth
Avatar universal
Tracie, I am so glad for you that they found the problem.  I hope everything works out for you.  The pain I have is getting progressively worse.  What started out on the right side and middle chest has now radiated to the around the right side to the middle of my back and my left side.  The pain is always there, it never eases up, it is agitated whenever I move, last night in bed I had a severe pain in my right side that lasted about 5 minutes, I prayed to God to make it go away.  I kept saying I can't go to the hospital, I have to work.  The pain eventually went away, but it was short lived.  I can actually feel like there is something swollen on the right side.  It is a really weird feeling.  I never feel good.  But again the pain is constant, not unbearable to the point where I would have to go to emergency, yet, but always there.

Again, I am so glad for you, let us know how things go for you.  Good luck and God Bless.

~Ellen~ :)
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