Upper Right Stomach Pain, Abnormal Liver Enzyme Screen

[stephann84]

I have been having upper stomach pain on the right side for about 2 months consistently.  It started off as mildly painful and has now reached the point where it is hard to eat, sleep, or work.  It is usually worse after I eat, but the only way I can stop it completley is to not eat for an entire 24 hour period, and drink nothing but water.  I have lost over 15 pounds since the situation started.  I sought the help of a family doctor who ran blood tests and said everything looked normal.  He ruled out the thought that I could have pancrease problems with the blood test he said.  He sent me home with medication for IBS.  It did not help, the pain intensified, and in 2 weeks I went back to his office.  My stomach had become increasingly tender by this point and during the physical examination I vomitted from the pain.  He thought it could be my gallbladder because my family has a history of gallstones and 4 people in my immediate family have had their gallbladders removed.  I had to wait an entire week for teh ultrasound.  In the meantime, the pain became so intense one night at work that I could barely move.  I went to the ER.  They ran bloodwork, which they said was normal, did another physcial exam, which was incredibly painful, and gave me some pain medicine.  Then they performed a CAT Scan.  The doctor said the CAT scan looked normal, that he thought I could have gallbladder issues, and suggested I take it easy until the ultrasound a few days later.  The ultrasound showed no gallstones.  He said he really didn't know what else to do, so he ran another blood test which showed elevated levels of liver enzymes.  At that point he didn't know what to do besides refer me to an internal specialist, who cannot get me in for another week.  He said hepatitis is a possibility.  The situation is very scary, I feel that this doctor was incompetant, and I am incredibly worried.  Any advice you have would be greatly appreciated!!

[Sallytrash]

I have some similar symptoms, but had my gall bladder removed 13 years ago.   My liver enzymes keep climbing, I'm tired and have pain in my right side.   Sonogram and MRCP showed nothing.    Going for an upper endoscopy on Wednesday.   Doubt that will show the problem.   Don't know where we are going from there.   The fact that everything was normal and levels when up suddenly and quickly made the gastroenterologist think there was a problem with a bile duct, but the MRCP showed no problems.    Said he would have assumed it was the gall bladder, if I had one.    I hope they diagnose your problem, soon.   I will be watching your posts.

Sally

[stephann84]

The gastro. Dr. scheduled me for a HIDA scan and wants to see me back in 2 weeks, sooner if the pain intensifies.  Never had a HIDA before.  Does anyone have experience?

[stephann84]

Thanks.  They scheduled me to see one.  Had to wait over a week to get in, but hopefully will get some answers soon!  Will be seeing Dr. Bruce Schneider at Deaconess.  

[HectorSF]

Go see a gastroenterologist. They specialize in diseases of the digestive system. I would suggest one who works at Deaconess Health System. They have about a dozen gastrenterologists. Or if you know of a better hospital go there.
Since all your tests are normal and all the obvious causes have been covered it is impossible to speculate what could be causing the problem. It will require a experienced doctor to diagnose the problem knowing your history and being able to diagnose you in person.

Best of luck.
Hectorsf  

[stephann84]

The ultrasound report recieved today  "Sonographic examination of the liver demonstrates no focal intrahepatic lesions.  There is no evidence of biliary dilation.  Common bile duct measures .52 cm in diameter.  The gallbladder is within normal limits.  There is no evidence of gallstones, pericholecystic fluid, or sonographic Murphy's sign.  The liver parenchyma is relatively hypoechoic.  This can sometimes be seen in patients with hepatitis.  Correlation with clinical findings is needed.  Visualization of the pancreas is somewhat limited secondary to overlying bowel gas.  No obvious pancreatic ductal dilation is seen.  The right kidney demonstrates no evicence of hydronephrosis."

[stephann84]

I forgot to mention that I elminated pork, red meat, dairy, and fried foods from my diet 2 weeks ago.  That has not produced any change.  The past week I have had sporadic bouts of diarrhea, and have been vomiting from the pain.