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Chronic abdominal discomfort

Hello. Please excuse my english because its not my primary language.

During the past 5 weeks I have felt some discomfort in the right upper quadrant , sometimes radiating to the lower back. It can be defined as a dull , daily recurrence , which depends on the time (it is almost nonexistent in the early hours of the day and becomes more noticeable during the evening) and movement (i tend to notice it more when I'm walking or moving because its like there is something there thats moving ) . This dull ache sometimes moves towards the right flank , but usually is housed on the top right rib . I have 30 years and I have no symptoms to suggest a liver issue (jaundice , fatigue , pale stools , etc), but I have noticed a little change in stool form , which lately vary between type 1,2,3,4 and 5 on the bristol stool scale , when before have always varied between 3 and 4.

During the last few days I've noticed that the dull ache has stoped being constant (because during the first 4 weeks it was with me almost all day), so now i can be 5 hours with no discomfort, but then the dull ache comes for half an hour and then dissapears. I have certain episodes where this discomfort is a little more intense (always a dull ache though, so i cant define it as "pain").

In the exploration , in dorsal decubitus I tried to palpate the liver to put my fingers under the ribs, followed by inspiration , but I couldnt feel the liver, which suggests to me that I have no hepatomegaly (but im not experienced so i may be wrong). I have noticed something though: when i get in right lateral decubitus position , expelling all the air , when i press with my fingers right below the last rib, i feel like something is moving, with an almost imperceptible sound (sort of like a dislocated bone), and when i release my fingers it moves again to resume its original position , with another sound. If i do this quickly (press and release), both sounds are like a heartbeat sound, to exemplify. The less air I have stored, it is more noticeable (the sensation and the sound). I must emphasize that this movement does not cause any pain or discomfort and i dont know if it was always there or if i noticed now because im more prone to it.

The same discomfort sometimes ocurrs in the left upper quadrant, but is not as recurrent. Id say that 90% of the time is on the right upper quadrant and 10% is on the left one.

Also, since the discomfort began, i noticed some shortness of breath during the day, and palpitations when i wake up, that usually last for under a minute. I dont know if it is related or if it is caused by my anxiety because im very hypocondriac and any discomfort or pain really gets me worried. Also, i noticed that my arms, specially the left one, have some patches near the veins, that are almost unnoticeable, but if you really look at them its like my skin is dirty. Its not very noticeable but its there.

Some things to consider: Im 30 years old, kind of sedentary, no other symptoms are present.

Thanks in advance for your help.
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Avatar universal
Hi, the most common cause for this type of pain which starts at the back just below the rib cage and radiates to the front and goes into the pelvis is 1. Renal colic. It occurs as episodes of pain recurring in nature. The pain is spasmodic in nature as the ureter is trying to push through the obstruction, which is usually a renal stone. The ureter is the tubular structure that connects the kidney to the bladder. So each time the urine tries to pass through the obstruction it causes severe pain. It can be accompanied by nausea, vomiting, sweating and sometimes blood in the urine. The other causes for the pain are: 2. Pyelonephritis (infection of the kidneys) and Glomerulonephritis (inflammation of the kidneys), here you are likely to have fever, 3. Gastroenteritis, diverticulitis, bowel obstruction, polyps and Irritable bowel syndrome, here there should be accompanying bowel symptoms like diarrhea and vomiting. I would advise you to consult your primary care physician for evaluation of pain. He will ask for blood tests, urine analysis, an x ray and an ultra sonogram of the abdomen. Sometimes he may ask for an Intravenous pyelogram and a CT scan.  In the meantime take OTC Naproxen for pain relief and plenty of oral fluids. Hope this helps!!
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Avatar universal
Hello? Can anybody help me please?
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