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Forum Name: Gastroenterology Topics

Question: Right Upper Quadrant Pain


 mshlmybelle - Sat Aug 18, 2007 10:57 am

I am a 30 year old overweight female with severe right upper quadrant pain especially after eating. I have been experiencing these pains on and off for nearly a year. The pain is directly below my right ribcage and the pain stays in that same spot and does not radiate anywhere else. I had blood drawn when I told my Dr about the pain, he said my bilirubin was 1.5 which was slightly high and thought it was my gallbladder. I have had an ultrasound and a cholecystogram which were both negative.
Over 10 years ago I was dx by upper GI with gastric reflux, hiatal hernia, and IBS w/ constipation. I later was having problems going to the bathroom so I had a colonoscopy and endoscopy. THe Dr stated I had food still in my stomach that he would guess had been there several days. I had not eaten for over 12 hours when the test was performed. I was given an rx for Propulcid which helped, but it was later taken off the market and I haven't taken anything since (just kind of living with the problems).
I had an emergency splenectomy in 2003 for blunt force trauma and lost a tremendous amount of weight (75 lbs). In 2004 I became pregnant and gained all the weight back plus 20 lbs.
This pain could be a number of things I am sure, but my Dr is reluctant to do anything else because he said since it wasn't gallbladder in that area he didn't know what else to do.
The pain occurs usually after I eat anything. It doesn't matter if the food is fat, fiber, or anything else because it all hurts. It comes and goes...I haven't had an episode in about 1.5 months but for the past week it has been every time I eat.
Is there ANYTHING I can talk to my Dr. about to get some other tests run to figure out this pain? My blood tests are otherwise normal and I only take Effexor XR for anxiety/depression.

Thank you
 Dr. Chan Lowe - Wed Sep 05, 2007 1:56 pm

User avatar Hi Mshlmybelle,

Your pain certainly sounds like gallbladder pain. Have you had a HIDA scan? This is a nuclear medicine scan that measures very effectively the ability of the gallbladder to function properly. Even though there are not obvious stones and the ducts are open, the gall bladder can still be malfunctioning from a chronic inflammation. The HIDA scan is very sensitive for picking this up. If you had a small stone blocking the bile duct it can cause the bilirubin level to go up.

The elevated bilirubin level may also be an incidental finding of a syndrome called Gilbert's disease.

Also, you may want to see a GI specialist. This way you can get specialized testing to see what is causing your pain.

Best wishes.

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