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Digestive Disorders / Gastroenterology Forum
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Pain in upper right quadrant under rib cage


Hi I am a 38 year old female and have pain in the upper right quadrant under my rib cage which radiates to the center of my back. I excercise 3 to 4 times a week at the gym with cardio and mild weight. I am still about 15 lbs over weight (I was more over weight 2 years ago). This pain actually started about 8 years ago. About 6 years ago I had my gall bladder removed.
The pain did go away for several years. After the gall badder surgery, the surgeon did make a comment that my liver kept getting in his way and he had to move it a couple of times and that it is big, but he said it did not look abnormal. I was in a lot of pain after the surgery and he kept me overnight in the hospital. The URQ pain started up again about 4 years ago. I have had all kinds of tests in the past year. A hida scan (no CCK since I do not have a gall bladder) was normal, barium swallow (I do have GERD and hiatal hernia). An edoscopy showed no ulcers, ducts all clear, normal liver etc... I also had a sonogram of my stomach, liver and pancreas - all normal. I have had 2 blood tests in the past year for my liver and pancreas- both came back normal. This info is not directly related, but wanted to mention that I had a total hysterectomy in Nov 2003 but this URQ pain had started up again prior to this surgery. Sometimes its a dull ache, sometimes it feels like I have ran for too long (but I haven't), sometimes it feels like a mild charlie horse (it actually spasms).

My doctor has just prescribed Reglan a few days ago (I haven't started it yet). What other tests can be done, do you know what could be causing this pain? It's gotten worse in the past 8 months.

Thank you,

Lena
72 Responses
233190 tn?1278553401
MEDICAL PROFESSIONAL
One consideration would be Sphincter of Oddi dysfunction.  This is a condition that can occur in those without a gallbladder.  

Typically, Sphincter of Oddi manometry done in conjunction with an ERCP would be needed for diagnosis.  If present, surgery or endoscopic procedures can be done to correct this.  

The upper endoscopy would rule out many of the major upper GI diseases.  You can consider a 24-hr pH study to evaluate for GERD or esophageal motility studies to look for motility disorders.

These options can be discussed with your gastroenterologist.

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.

Kevin, M.D.
kevinmd_b
Avatar universal

This is a continuation of my earlier post. I should include that I have been tested for H Pylori - negative. I had the upper GI test and abdominal X-rays - all tests came back normal. I have IBS symptoms (bowel symptoms). My appetite is healthy and I have occasional nausea when I miss my prevacid dose (my stomach burns). Thanks, Lena
Avatar universal
I am a 39yr old women and for the past three weeks I have been having pain in my upper abdoman , ribs and shoulder blades. I have had a CT scan and blood work and they could not find any problems with my Gallbladder ,liver and or Kidneys. I have also had soft stools. has anyone had this before
131185 tn?1224292476
I have had this exact same problem. I am 22 years old, of average weight and no other serious medical conditions. I have had this problem for a few years now. The pain is in my upper-most abdominal region. The pain is most prevalent when I'm laying down and have to urinate. In the mornings the pain is sometimes so severe it wakes me up out of a sound sleep. Even though I urinate, sometimes the severe pain persists. During the day it is not as painful, but still a dull pain. My doctor doesn't even know where to start since he thinks I am making this up. What should I do?
Avatar universal
My wife is having similar problems, don't start questioning youself as to if you're making it up.  She had a rude doc say something along those lines while she was in the hospital and it was devastating on her morale.  My wife's problems have not yet been diagnosed but hopefully over time we will solve it.
Avatar universal
I have had a dull nagging pain under my bottom right rib for several years.  At first my doctor blew it off as nothing.  This year he guessed it was gall bladder related - referring to the  - "fair, fat and forty" connection.  However after an ultra sound - that was not the case. They thought they saw kidney stones but after an x-ray test with dye in the kidneys that was ruled out.  

The only thing they found in the ultra sound was "fatty liver" a lesion on my liver. Liver function is normal.  I've been taking statins for over 10 years for high cholesterol and I have to wonder if this long term use has caused a lesion.

It sounds like this typd of URQ pain is fairly common and hard to pin down the actual source.

Avatar universal
I have very similar symptoms, except I am a 31 year old male. I first notice symptoms during a long distace car drive (Oct. 2005). It started with back pain directly behind the gallbladder, which felt like muscle strain. Within two weeks, I had a sunburn sensation below my right ribcage that has never ended. The sensation is always there with varying intensity. Two weeks after the sunburn sensation began (about 1 month after the original back pain), a physical, knotting pain in the gallbladder area of my abdomen. It felt as if I had a bloated organ, so I went to an ER. There, they did a complete blood count, urine test, multiple x-rays, and a CT scan only to say that nothing was wrong, other than a small amount of white blood cells in my urine (ie, kidney or bladder infection). Since then, the pain has intensified (knotting internal pain, sunburn sensation, and back pain) and I have went to a second ER. This time at the University of Tennessee Medical Center. They too, took a blood and urine sample and confirmed that all counts were within normal limits. This doctor did however palpate the abdomen and pressed on the exact spot that hurts internally, which caused elevated pain. He identified this spot as the area where the gallbladder and liver is located and said that I may have a growth/tumor on the gallbladder or possibly, gallstones. He suggested I go to a family practioner for ultrasound, since there was no emergency to be addressed at the ER.

I have not noticed an increase or decrease of intensity before or after eating. Also, when I sleep at night, it is more comfortable to sleep on the affected side.

Since Jan. 12, 2006, I have seen my family physician who sent me to a gastrointestinal doc for gallbladder testing and probably removal.  After a hidascan, colonoscopy, an endoscope, and many blood test, there are still no answers- everything was normal.  My GI specialist referred me back to the family doc for musculo-skeletal conditions.  Not sure what other test should be done, will take any recommendations and let you know what we find out!
Avatar universal
I have been having pain in the upper right side of my stomach and a buldge on the right side at my navel and my right side has been swollen since Sept. 2005. I have had every kind of test that is offered. My Doc. has told me that I may have to have my gallblader removed and I have an appt. with a surgeon, but the Doc. still cannot explain the buldge I have, he told me the 1st time it was probably fat! Well, I'm not overweight. Something is wrong with me & I want rid of it. I have looked on the Web and noticed info. on a Mass, which seems to explain the pain and buldge, it read:usually with a mass-buldge there is some type of infection in the white blood cells and my Doc. told me the 1st time that my white blood count was slightly high,and I recently asked him about this and he still said he didn't know what is wrong with me, except PROBABLY my gallbladder, BUT WHAT ABOUT THIS BULDGE THAT HURTS!? Hopefully I will get a better diagnosis from the surgeon
Avatar universal
Unfornately - I am so glad I'm not alone. I've had the same URQ pain that everyone is talking about for the past 2 years. I had an utrasound and they determined I had gall stones. I have recently had my gall bladder removed (2 weeks ago) and the pain is now worse.  It's a continuous subtle pain but at times is pretty bad.  The pain actually wraps around to the right side of my back under my rib cage. I guess my only option is to go back to the doctor and start the blood and urine tests all over again.  I also had a CT-Scan that showed nothing wrong with my kidneys or liver.
Avatar universal
I was looking on this site and found this condition. I suffered with the same pain for years and could not find a doctor to help me. I had my gallbladder removed years ago and still continued with the pain. I finally found a doctor to give me an ERCP and they found I had stones and sludge in my bile ducts. The ducts are connected to where your gallbladder used to be. They performed a sphinctorotomy (?spelling?) - it's when the cut the bile duct and put a stint to drain the bile. It is very minor and done under a local (like an endoscopy - the ERCP is almost the same exact procedure). Good luck.
Avatar universal
The first time I noticed this pain in the upper quadrant, right side of my stomach was on a 10 hour trip and then again back home, another 10 hr drive.  I have seen 2 doctors about it and one said it was too much stomach acid ( with out any tests) and the other wants me to have xrays and other tests.  I have no gall bladder, also experience no heart burn yet the doc gave me Proactin which I have taken 3 doses of and no help there.
Avatar universal
The first time I noticed this pain in the upper quadrant, right side of my stomach was on a 10 hour trip and then again back home, another 10 hr drive.  I have seen 2 doctors about it and one said it was too much stomach acid ( with out any tests) and the other wants me to have xrays and other tests.  I have no gall bladder, also experience no heart burn yet the doc gave me Proactin which I have taken 3 doses of and no help there.
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