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Right Side Pain
Recently I have been having pain in my right side, in the area of the rib cage over the liver. I am Genotype 1a and had TX (pegalyated interferon and ribavirin) ten years ago but relapsed after a viral breakthrough at 6 months. A needle biopsy nearly three years ago showed Stage 1 fibrosis and Grade 2 inflammation which is about the same as a needle biopsy I had over ten years ago. A FibroSURE test of about a year ago showed F0 or "no fibrosis" and A0 or "no activity". An abdominal CT scan at that time showed "scattered calcified granuloma" in the liver. I had a viral load of about 5 million.
I have a visit with the hepatitis center where I have been a patient in about two weeks and tomorrow I am scheduled for an abdominal ultrasound.
How common is this type pain with hep C? Is this pain associated with progressing liver damage? I would like to take some of the new drugs or maybe an existing combination. The Sovaldi + Ledipasvir looks great but I may not have that much time. I have probably been infected for 33 or so years.
I have a visit with the hepatitis center where I have been a patient in about two weeks and tomorrow I am scheduled for an abdominal ultrasound.
How common is this type pain with hep C? Is this pain associated with progressing liver damage? I would like to take some of the new drugs or maybe an existing combination. The Sovaldi + Ledipasvir looks great but I may not have that much time. I have probably been infected for 33 or so years.
Hector, I have my abdominal ultrasound report and here are the findings:
Liver: Overall hepatic echotexture is normal. Scattered echogenic foci are consistent with small calcifications on CT. No architectural distortion or discrete mass.
Gallbladder: Normal. No evidence of gallstones sludge or a bladder wall thickening. Sonographic Murphy sign not reported.
Pancreas: Partially obscured. Appears normal.
Spleen: Small echogenic foci consistent to granulomatous disease on CT.
Impression: Healed granulomatous disease.
Comparisons: No prior ultrasounds. CT abdomen pelvis on 12/26/2012
So apparently it must be the Hep C causing this right side pain or if something else it will show up in the battery of tests as I prepare for TX.
I'm guessing that I will get another liver biopsy and go from there.
I hope the biopsy is little changed so I can wait till maybe next year when the new drugs are hopefully available.
The doctor I'm seeing is Bach and Godofsky in Bradenton, Florida. They are involved in lots of clinical trials for Hep C drugs. They have two offices, the one in Sarasota is called University Hepatitis Center. I went there for years and have no idea what university they cooperate with.
Liver: Overall hepatic echotexture is normal. Scattered echogenic foci are consistent with small calcifications on CT. No architectural distortion or discrete mass.
Gallbladder: Normal. No evidence of gallstones sludge or a bladder wall thickening. Sonographic Murphy sign not reported.
Pancreas: Partially obscured. Appears normal.
Spleen: Small echogenic foci consistent to granulomatous disease on CT.
Impression: Healed granulomatous disease.
Comparisons: No prior ultrasounds. CT abdomen pelvis on 12/26/2012
So apparently it must be the Hep C causing this right side pain or if something else it will show up in the battery of tests as I prepare for TX.
I'm guessing that I will get another liver biopsy and go from there.
I hope the biopsy is little changed so I can wait till maybe next year when the new drugs are hopefully available.
The doctor I'm seeing is Bach and Godofsky in Bradenton, Florida. They are involved in lots of clinical trials for Hep C drugs. They have two offices, the one in Sarasota is called University Hepatitis Center. I went there for years and have no idea what university they cooperate with.
I am glad you had the test done and we'll have to see what the result will be. Techs are not doctors so I would take what she said with a grain of salt.
I didn't know about the calcified deposits in the liver.
Calcified granuloma is a built up of scar-tissue. It usually is asymptomatic but can cause pain. There are various causes for it. Many times it can be caused by an infection or a drug someone is taking. I would think the doctor may looked further to diagnose the underlying cause of the granuloma by doing a liver biopsy or lab tests or other imaging tests.
Is the hepatitis center part of a large hospital?
Hoping for good news on Monday!
Let us know what the result are.
Have a good weekend!
Hector
I didn't know about the calcified deposits in the liver.
Calcified granuloma is a built up of scar-tissue. It usually is asymptomatic but can cause pain. There are various causes for it. Many times it can be caused by an infection or a drug someone is taking. I would think the doctor may looked further to diagnose the underlying cause of the granuloma by doing a liver biopsy or lab tests or other imaging tests.
Is the hepatitis center part of a large hospital?
Hoping for good news on Monday!
Let us know what the result are.
Have a good weekend!
Hector
Hector, I'm back from the hospital where I had the abdominal ultrasound done this morning. My doctor won't get the lab report till Monday but I know the lady who conducted the test and she tells me that there is nothing remarkable to report. No gallstones, no masses in the liver which she says doesn't even appear to be enlarged though she said that was less certain as she has no earlier scan to compare it against.
She sees the calcified deposits in the liver and a small cyst in each kidney that was there years ago. But other than that nothing remarkable.
Anyway, Monday I may have the written report and I will post what it says.
Thanks again for your help. I would never have considered that my pain problem might be due to something besides the liver.
She sees the calcified deposits in the liver and a small cyst in each kidney that was there years ago. But other than that nothing remarkable.
Anyway, Monday I may have the written report and I will post what it says.
Thanks again for your help. I would never have considered that my pain problem might be due to something besides the liver.
Thanks Hector. I looked up the gallstone symptoms and my pain could very well be that. Dad had his gall bladder removed as did an aunt and an uncle.
All of the pain is in the area of the right ribcage and I first noticed it maybe a week ago when I would take a deep breath or cough. The pain is steady and occurs when there is pressure put on the ribcage area. At first it was the upper right that was most noticeable but now the front of the right rib cage just above the bottom rib is sensitive to pressure too. When I stand up there is less pain unless I take a deep breath or cough. It would be hard to describe the intensity of the pain, it is substantial but has not prevented me from sleeping.
But I don''t have the other symptoms such as fever or nausea though I have felt a bit poorly lately. And the CT scan of my abdomen from a year ago mentioned nothing about gall stones but did say "Calcified granuloma in the liver and spleen".
I'm not so sure about that FibroSURE test. I read somewhere that reduced kidney function could cause the test to misread and I have a bit of that. I have Stage 2 kidney disease, with my glomerular filtration rate (GFR) between 60 and 90.
I did have a good friend who died with Hep C after a long battle with it and he had lots of pain in his liver area. I worked with him and he would have considerable pain that eventually caused him to leave his work. He died about 5 years later. I just thought due to his experience and from what I have read online that pain of this sort was common with Hep C.
I am off to the clinic shortly so thanks for your reply
All of the pain is in the area of the right ribcage and I first noticed it maybe a week ago when I would take a deep breath or cough. The pain is steady and occurs when there is pressure put on the ribcage area. At first it was the upper right that was most noticeable but now the front of the right rib cage just above the bottom rib is sensitive to pressure too. When I stand up there is less pain unless I take a deep breath or cough. It would be hard to describe the intensity of the pain, it is substantial but has not prevented me from sleeping.
But I don''t have the other symptoms such as fever or nausea though I have felt a bit poorly lately. And the CT scan of my abdomen from a year ago mentioned nothing about gall stones but did say "Calcified granuloma in the liver and spleen".
I'm not so sure about that FibroSURE test. I read somewhere that reduced kidney function could cause the test to misread and I have a bit of that. I have Stage 2 kidney disease, with my glomerular filtration rate (GFR) between 60 and 90.
I did have a good friend who died with Hep C after a long battle with it and he had lots of pain in his liver area. I worked with him and he would have considerable pain that eventually caused him to leave his work. He died about 5 years later. I just thought due to his experience and from what I have read online that pain of this sort was common with Hep C.
I am off to the clinic shortly so thanks for your reply
How common is this type pain with hep C?
Very uncommon. What makes you think it is your liver when all tests (biopsy and FiboSURE) show you have little to no damage to your liver despite being effected with hepatitis C?
The most common serious cause of pain in the upper right quadrant is gallstones. Of course there are very many less serious causes of pain in that area of the body. Since you don't describe the pain, it is really impossible to venture what it could be.
The ultrasound to look for any structural abdominal abnormalities which would include gallstones.
Liver disease is a slow moving disease. If your fibrosis is only stage 0 or 1 you have very slow moving liver disease if you have had it over 30 years. Either way people with stage 0, 1 or even 2 can wait for new, more effect treatments without peg-interferon and ribavirin are being tested in clinical trials now and will be available within a year.
Good luck with your ultrasound!
Hector
Very uncommon. What makes you think it is your liver when all tests (biopsy and FiboSURE) show you have little to no damage to your liver despite being effected with hepatitis C?
The most common serious cause of pain in the upper right quadrant is gallstones. Of course there are very many less serious causes of pain in that area of the body. Since you don't describe the pain, it is really impossible to venture what it could be.
The ultrasound to look for any structural abdominal abnormalities which would include gallstones.
Liver disease is a slow moving disease. If your fibrosis is only stage 0 or 1 you have very slow moving liver disease if you have had it over 30 years. Either way people with stage 0, 1 or even 2 can wait for new, more effect treatments without peg-interferon and ribavirin are being tested in clinical trials now and will be available within a year.
Good luck with your ultrasound!
Hector
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