Unexplained right upper quadrant pain

[DGracie]

I have had unexplained right upper quadrant pain for a little over a year now. This all started when I started having abdominal pain, inability to eat any normal quantities of food, nausea, back in May of 2007. I was finally diagnosed with gastroparesis(decreased motility in the stomach, causing the stomach not to empty properly) in July 2007. Then in about October/ November of I started having abdominal pain in the right upper quadrant which shoots up into my right shoulder. I had my gallbladder out in 2000, so I knew it wasn't that. I have had every scan, blood test, ultrasound known to man. I was referred to a doctor at MUSC that specializes in digestive diseases. I have been going down there for over a year now and still have no answers. I have been given so many medicines, asked to purchase medicines that we do not sell here in US, can only be bought from Canada through the pharmacist at a hefty cost; and still in pain. It does get worse with some foods I eat, but usually is a constant pain and feels feel somebody has jabbed me in the side right under the rib cage. The doctor down at MUSC states that it could be Sphincter of Oddi dysfunction but all of the blood work that I have had done does not indicate that, so I have become a guinea pig for medicines. The doctor at MUSC states that they are reserved to do the pressure testing for the Sphincter of Oddi Dysfunction because 9 out of 10 patients will develop pancreatitis, another life threatening problem. As with all of you I am sick of being in pain and now I am having constant diarrhea and my abdominal pain with eating has returned. This is why our insurance costs so much, because doctors don't want to go for the most accurate test possible, they want to test and drug you to death first. If anyone has any answers, PLEASE; let me know.

[Rishnir]

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[Rishnir]

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[MUllman]

Hi there,
I am sure you have solved your problem, but this is for those who may be suffering from something similar and are reading this now.
My mother in-law (75) has been suffering from an abdominal pain that stretched from under her right ribs to the center of her stomach. At first it was accompanied by terrible bouts of diarrhea, which after a couple of year developed, into constipation.
The pain was so severe that no pain medication could alleviate it.
She has gone through every test one could think of for the stomach.
Finally, after researching the Internet we figured it out. She had an MRI on her thoracic spine and sure enough there was a tumor there that has gone into the bone and soft tissue. Thank god it's all treatable and she will be fine.
Apparently the tumor was pressing on the nerves that travel into her stomach. The amazing thing is she never once complained of back pain.
I hope this helps…

[bmarkos]

i feel your pain! i have had the samething for years - took forever to finallyspeak-up about it. i also feel like i have been a "lab ratt", every damn test possible - probed front to back. 'they' actually said they found a tumor on my appendix pushing into my lower bowel. i had surgery; an apendectomy with a bowel resection. they took a foot of my colon and i spent 10 days in the hospital, another couple months trying to get back to work. once they opened me up they couldn't find the tumor they saw on the scope, so they opened more -still no luck. guess what - didn't fix anything, still have the same pain - pills work sometimes, but mostly just a distraction the pain does not go away. i have been having a 'flare-up' for a couple days now (really bad) - do you get those? all night terrible pain - and can't sleep..
have you found anything out?

[CalGal]

DGracie, if the enzymes weren't elevated and you didn't get any elevation in pain from narcotic pain meds (?), then it's possible it may not be SOD. But keep pushing to get some answers. I know how hard that can be. You're going to have to be tenacious.

[DGracie]

To CalGal : I have had my enzymes checked during an attack and they were not elevated. I have been on antibiotics, recommended to try domparamine (which can only be purchased from Canada and not covered by insurance), I have been put on an antidepressant Imipramine and all that did was make me want to sleep for days, pain medicine barely eleviates the pain. I go down to MUSC on Friday and I am going to push the issue with seeing the hepatobiliary doctor so that I can get this ERCP done. Oh I know that the manometry has to be done, for my own peace of mind as well. I have not tried anything for the diarrhea, I am already taking BP med, Cholesterol Med, Folic Acid because I became anemic during this whole thing, and Prevacid. I have had every end of my body examined along with every orafice. Thank you for your suggestions.

[CalGal]

DGracie, the ERCP with manometry can cause pancreatitis, but these days most docs will use a stent afterwards to try to prevent the possibility of pancreatitis. Did the doc also inform you that the blood test for elevated enzymes must be done within 24 hours of an extreme attack of pain in order for the tests to be correct? If that wasn't done with you, then it's very possible that you could have 'normal' levels since the spasm may let up and allow things to flow as they should in a short period of time.

Are you following a low fat diet? If you're not, you need to. What meds have they tried? The typical meds that are used for SOD are anti-spasm meds such as high doses of dicyclomine, things like nitroglycerin and specific calcium channel blockers.

Have you tried using a bile-binding resin to stem the diarrhea?

If you want the ERCP to be done, then push for it. But make sure it's done with manometry - without that step it's impossible to tell whether or not you do have SOD.