Right side pain and swollen lymph node

[applesandpb]

Advice on a next step? I'm 23 and female, and I have what started as mild, lower right-sided back pain, and has now also progressed to my right side, feeling like it's under my ribs. On occasion, I'll also have like a poking feeling in my mid-right abdomen. Mostly now the pain is felt in my right side in the lower rib area.

I've already had some blood tests to check liver function, as well as ultra sounds of my bladder, uterus, and right kidney. The doctor poked me to check for gallbladder, I've been going to a chiropractor for 2 months and have also stopped eating gluten. Although these last two steps have helped other things, this side pain remains, and I still have no answers.

About 2 months ago, I also found a moveable, swollen lymph node beneath my right armpit. I got it checked by a surgeon, who said to watch it but that he wasn't worried. Honestly, though, I'm concerned since these things have been going on for so long. All are low grade, but I'm beginning to worry I have lymphoma or a tumor or something going on in my right side. Is that just being paranoid?

Any thoughts? Should I request a scan (like CT or MRI) of my right side? My general doc didn't think I needed one just yet, but I'm getting tired of just waiting. Thanks!

[redroks2]

SAME symptoms here! I've seen 7 doctors over the last 8 months and have had a battery of tests and scans. They only thing found so far was a large mass on my thryoid which was removed, but symptoms persisted. The thyroid mass was found to be papillary cancer so now I have to have the other half of my thyroid removed in a few weeks. I have swollen lymph nodes ALL up and down my right side and my arm pit often gets so swollen my hand is cold tingly for hours on end. I've even had swollen lymph nodes around my elbow! The pain around/under my ribs persists so now I am demanding a full PET scan. I also have a new mass in my breast so I am not convinced the thyroid mass in the primary site. All I can say is DO NOT GIVE UP!!! Doctors are getting so much worse about brushing people off so you have to stand up for yourself and stay in their face. I learned that the hard way and here we are 8 months later and I am just now starting to get answers!

[Mailchick62]

I have had similar symptoms since 2006...although mine doesn't exactly feel painful..more like a swollen feeling.  I get pins and needle feeling, and twinges in my back also.  I noticed it is more prevalent after I've had a few beers after watching football on a Sunday afternoon.  Have had ultrasounds, CAT scan, Hida scan, and other tests..nothing positive.  No problems with gluten or allergic to any foods.  One difference I have though..is I had a gastric bypass for weighloss 20 years ago.  It was successful, but I am now 52 years old and have in the last year gained 20 lbs with no change in eating habits, and I have a very active job (mail carrier).  My doctor has no clue.  I'm scared to death that I've got a hidden cancer somewhere, but my doctor tried to calm that fear.  Blood tests always negative, and my blood pressure, triglycerides, and cholesterol levels are all awesome.  I hate this!

[lifaceeek]

If the ultrasound and blood tests are normal, it's probably not have to worry, everything will be fine. But I would recommend going regularly to the study. I personally work in a clinic http://www.polski-lekarz.co.uk if I could help you, please write.

[Admendo]

Hi..
I am also having similar conditions. Poking pain on the right in mid-lower abdomen region, radiating to the back. Ultrasound and blood tests are normal. A swollen lymph node in the same area, but DRs said, nothing to worry about it. The pain is not stopping me from doing any activity, but its unknown cause bothers me. I am also burping more that usual, also can observe bubbles coming out from stool sometimes..scary!
Please let me know any updates from your side

[GinFit]

Hi there,

I'm experiencing VERY similar symptoms and my Vitamin D was also low.  Same feeling just under rib that started on right side and shifted to left and now feel on both sides of ribs, more towards the end of the day.

Had an Ultrasound done that showed nothing irregular and blood tests that showed nothing other than the Vitamin D.

I hope that you're feeling better... I know how un-nerving it can feel when you don't know what's going on in your body....

Tanks for your post and if you've had any updates, I'd love to hear them!

[applesandpb]

I'm not sure about the Lyme disease thing. But I think if I had that for the past year it would have gotten worse. The doc hasn't mentioned it, so it could be worth mentioning in a few months.

I was told my vit D is a little bit low, but nothing too bad to worry about. The doc suggested a little supplementing, but didn't sound worried about it.

I don't have any relatives with autoimmune conditions, but I have had some minor discomfort when pressing areas on my chest that are painful. That was more last summer, but still flares up every once in a while. I'm beginning to wonder if I might have a cartilage inflammation problem, because there's a spot beneath my right arm (around bra-line) that has been sore off and on for a few months. It's always that spot, but it doesn't feel majorly different from the same spot left side. I don't really know though. I'm sort of at a standstill, but will try and let you all know if I find anything else out.

The stomach meds are to control acid reflux, which I definitely have to an extent. Whenever I stop taking the Prevacid, I burp twice as much and wake up with a sore throat and gross teeth.

[Ken_PA]

Did you ever have anything like a MRSA rash? MRSA can get into bones. Oftentimes, a patient who is very self-aware can sense things about their condition that provides really good clues - so maybe some osteomyelitis

Some shots in dark:
--are you in Lyme country? Lyme can act mysteriously
--do you avoid the sun? I don't believe in the vit D hype, but somebody who is very, very low can have diverse symptoms
--any close relatives with autoimmune conditions?

I assume that pressing on bones doesn't hurt or you would have mentioned that.

My guess would be that it's something immune related (because of the nodes), and maybe the origin has to do with why you need the stomach meds in the first place? Why do you need the meds?

[applesandpb]

Thanks for your response. I started the PPI a year or two ago, first Prilosec and now Prevacid, which works better. These symptoms are much more recent.

I've been told by two separate surgeons now not to worry about the lymph nodes in my armpits, so I'm trying not to think about them or touch them too much.

The GI doc tested me for Celiacs and it was negative. He said if the right side pain comes back he'd like to get ultrasounds of my liver and pancreas to check for disease and if that doesn't turn anything up, might consider doing an endoscopy. Honestly, it seems unlikely to me. The pain in my right side doesn't seem to correspond to my nausea, and doesn't increase with motion or exercise. It's like a burning pain around my lower right ribs, and sometimes I get a similar feeling on the left side, although. I'm wondering if it could possibly be bone related, like inflammation.

I haven't been tested for H Pylori. And I got a Sed Rate and CBC and they were both normal. I've been keeping a food journal too so maybe I'll see patterns, but right now I don't.

I guess I'm unsure how to proceed, as the right side pain isn't going away but not getting worse, and my stomach has been, off and on, better. (as in less consistently nauseous but still sometimes).

[Ken_PA]

Kay, did the PPI precede the major symptoms? I ask because suppressing acid can:
1) predispose to infections that would have been killed off by the acid
2) result in insufficient digestion, and also in reduced absorption of minerals

Do you have Hx or Fx of a highly reactive immune system? Allergies, autoimmunity, reactions to bee stings... Really that should be a first question for an unusual case.

Btw, there is some sort of testing to analyze the type of gut fauna in a person. Just to mention how far that thinking can go, the extreme end of that field is a "fecal transplant".

This item: "pain that feels as if it's on the bone directly under my right breast"
might drain to and cause this: "a moveable, swollen lymph node beneath my right armpit".

Also, without a point to focus on (the poking point you mention being reduced now), a CT might just be getting radiation without providing any information.

ESR might not be such a sensitive indicator. E.g. not being high while inflammation is still present.

What if you fast for day to see what happens?

Tested for H Pylori?

Olive leaf extract (which is OTC) might kill a pathogen. Or maybe Grape Seed Extract. I mention those as shots in the dark for self experimentation.

[Mochadelicious]

I don't know what else it could be, but don't give up.  Maybe keep a journal of the pain, where it's at and how severe it is.  After a couple more weeks, if the pain is as bad or worse, go back to your doctor and ask for a CT or MRI scan.  Show him your journal and tell him you can't continue with the pain and need answers.  Be persistent. Sometimes it takes several trips to the same doctor before they start realizing the problem isn't going away on its own.  Good luck and please keep us posted on what you find out.

[applesandpb]

Thanks for your response, and no I haven't been anywhere exotic lately. My weight has also stayed the same through all this.

I got a Sed Rate and CBC a week and a half ago and both came back normal. I also went to a GI, who didn't think anything in particular needed to be done since my symptoms were calmer at that point and none have been severe (no vomiting, bloody stools, severe constipation, etc). If the poking comes back he'll do additional gallbladder tests. He also tested me for Celiac and that was negative.

I also got a second opinion on my lymph nodes from a surgeon and she said she wasn't concerned at all. So I'm feeling more at east about that. The frustrating part is that I still have no answers as to what's causing this stomach/back stuff. My stomach has been acting up again and I've had an upset lower abdomen throughout the day for a few days now. I can't link it to any foods, although I'll start keeping a journal. The side pain comes and goes. None of my docs thinks any serious tests need to be done, and my logical side agrees. I just don't like having these problems with nothing to go on. It seems odd that "nothing" would be causing them.

Any other thoughts on what it could be? I am a healthy eater and only indulge in a little dessert most days. I am skinny and moderately active (do a lot of walking). I take Prevacid for acid reflux but that doesn't seem to help with the nausea. I've never tried IBS meds but the GI said I didn't have typical IBS symptoms. I have no known food allergies. Any other suggestions welcomed. Thanks so much!

[Ken_PA]

The feature that stands out is how the pain moves, so that could indicate something in the intestine. I'd ask your GP to phone in for an LDH blood test. If it's in normal range you could relax a bit more, about the possibility of lymphoma. Also, get a copy of the test mailed to you.

Saying that the bone seems to hurt? Seems more like inflammation than lymphoma as a guess.

Have you been in any exotic areas? (i.e., parasites) Been around any poisons, like pesticides?

[Mochadelicious]

I don't think that is asking too much, you could at least ask about it.  I'm assuming your blood work was normal?  Why did you have 2 separate blood tests?  

I once had a very large kidney stone that had to be removed via surgery as it was way too big to pass on my own.  It was even too big for lithotripsy.  It took about 6 months to get diagnosed as they thought I had a kidney infection and kept treating me with antibiotics which obviously didn't work.  The pain was right where my kidneys are and it felt like pulses of pain in the flank of my back that got worse with time.  They finally did a MRI which showed this massive stone.  

I tell you this just to keep in mind, but I would think the ultrasound would have shown that if you had a stone.  If your doctor thinks there is a possibility of  cancer, he may want to biopsy your enlarged lymph node.  Be sure to tell him how long you've had it.

[applesandpb]

Thanks for your response. The pain actually originated in my right flank area and over the past few months sort of migrated to mostly in my right side under the ribs. Just this past week it's been more prevalent in my mid-right abdomen as a sort of pokey feeling, and the pokey feeling moves a little bit up or down in my abdomen. I've also noticed it occasionally with turning movements.

I've gotten two separate blood tests over the past few months to check my organ functions, and also a complete blood count. I also got a urine test done a few months ago. As mentioned above, I got ultrasounds of various organs in the pelvic area, including my kidneys. Peeing hasn't been an issue, and I haven't had any typical symptoms of a bladder infection that might lead to a kidney infection.

On occasion, I feel a similar discomfort in my left side, but only under the ribs in my side, not in the abdomen. I've also been feeling sort of generally unwell. Not nauseous as if I'm about to throw up, but just uneasy in my stomach. I've been burping quite a bit and also passing gas a bit more than normal. I woke up this morning with a new pain that feels as if it's on the bone directly under my right breast. Like, if I press on the part of the bone that sticks out, it's sore.

Any additional thoughts as to a good next step? My next visit is to a GI (as referred by my GP) and I'm tempted to ask him if I can get a CT scan or an MRI. Would this be asking too much?

[Mochadelicious]

Hello and welcome.  Just to clarify, when you say the pain is on the right side, do you feel it more in your back flank area or in your abdomen?  Has it spread to your left side as well?

Your description of the placement of the pain sounds very much like a kidney infection (which I don't think would be picked up by an ultrasound).  That might explain the swollen node as well.  Have you had any blood work or urine tests done?  If not, you might want to see your doctor and ask about that.  

Pain that lasts longer than a couple of weeks tells me that this is something that isn't going to go away on it's own and needs to be further  addressed by your doctor.