what may be my problem?

[6man6]

I am an 34 years-old male.5 months ago one day in the morning I wake up
with a sharp pain in
my right quadrant below liver. One week later, I went to doctor
and after ultrasound
and blood tests they told me that I have liver inflammation and
from blood test results my liver enzymes were 3 times higher than
th  maximum value in the normal range. During 3 months, I followed a diet
(mainly vegetables and yogurt) and did a blood test every month.
The liver enzyme levels gradually decreased and in the third test they were in the
normal range. However, the pain under right quadrant below liver continued so far.
I have shown the place where I had this pain and my family doctor told me
it is called intercoasted nearology.
In fact, the pain radiates over the right quadrant.


Moreover, during last two months  I feel a lot of
gas, bloating in the right quadrant and a sequentially changing diarrhea and
constipation. A lot of bowel movement and rumbling.
Sometimes 1-2 days during a week I feel better but most of time
I have discomfort. There is a lot of gas,bloating and
the associated heavyness in the right quadrant (the dull pain).
I have no vomitting, no blood in the stool and no fever. No apetite loose also.
At the beginning of february, I did a CT scan for the right part of abdoman and
everything (pancreas, gallblodder,kidney, etc) was normal.
From my blood test, no hepatits a,b,c also.
What may be the cause of my problem when the above history and medical examinations
are taken into account?
Thanks in advance.

[6man6]

thanks for your comments. but why did you not suggest  first  to see a gastroenterelog? in fact, the gastroenterolog i went so far did not fin the reason. my my symptoms is a lot of gas everyday and the sequential constipation and dierrhea.

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. Possible causes of the GI symptoms that may need to be considered include dietary causes, GI infections, inflammations, GI motility issues, IBS, hormonal/ endocrine abnormalities etc. Aside GI issues the right upper quadrant pain could also be related to causes such as respiratory tract infection/ inflammation, pleuritis, costochondritis, chest wall inflammation, neuro-muscular issues etc. I would suggest getting this evaluated by an internist initially and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist care may be sought.
Hope this is helpful.

Take care!