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Forum Name: Gastroenterology Topics

Question: Chronic Severe Right Upper Quadrant Pain


 RNchico74 - Tue Mar 04, 2008 10:26 am

I am a 23 y/o F with no health problems until this last year. I started having right lower quadrant pain and went to my GP who ordered a CT scan. It showed a 7cm cystic mass on my right ovary which I then had surgically removed (laparoscopically) 5/3/07. Then approx 3 weeks later I started to get really bad RUQ pain. So bad that it took me to the ER on night mid June. They did blood tests, all normal except my alk phos was elevated. The ultrasound was clear and they sent me home with the dx of "biliary colic" and to f/u with my GP. He sent me for a CT scan which was negative. He then referred me to a gastoenterologist who ordered a HIDA scan. My ejection fraction came back as 84%. He then had me take a 2 week course of nexium which did nothing. I then had an upper GI series which came back negative. He told me there was nothing he could do for me and sent me back to my GP. I let 3 or 4 months go by, feeling defeated, but constantly in pain. Finally, I had enough and got referred to a general surgeon who said she would do an ex-lap and take out my gallbladder and insurance denied it. I appealed their decision and they upheld it. They have also denied my request to see a specialist at a teaching hospital such as Stanford or UC Davis and would like for me to have a psychiatric consult. Also, my hepatitis panel was negative and my T. Bili is 2.3. Some sort of obstruction? I went to the chiropractor yesterday, figuring it couldn't hurt and she took x-rays which showed free air/fluid right in the area I hurt. I don't know what to do from here and any help would be appreciated. I am a normal functioning person. Been married for 3 years, own our own home, and I work as an RN. I am not drug seeking, I simply want an explanation for my pain so I can get out of it and move on with my life. I know that I have had an extensive work-up, but abdominal pain is not a normal thing and the cause needs to be understood.

The pain is constant, dull and achy. It will wake me up in the middle of the night due to the severity. Most of the time it hurts so bad that it radiates through my back and sometimes goes to my right shoulder blade. I have changed my diet (low fat, no spicy, small meals) and have lost of 20 pounds in the last month just because I have no appetite and everything makes me nauseous. PLEASE HELP!
 jgoble - Sun Apr 13, 2008 2:06 am

I am not a doc or a nurse. I just wanted to let you know that I have had similar symptoms..mainly the RUQ pain. It started for me 5 years ago, after I had returned from a three week trip to Japan. I noticed more gas than what I considered normal and I felt this dull ache in my right side under my ribs. I went to the doc. and over the last five years I have had many tests for this. (upper and lower GI - CT scan, ultrasound) I ended up having my gall bladder removed in 2004, but that did not help. I have had "IBS" for many years...and over the past five years my IBS was out of control. I found that I could not eat a full meal (no matter what it was) without ending up using the restroom with diarrhea within an hour, so severe that I would feel as thought I had totally cleaned out my bowels with the trips to the restroom. Last year, it was so bad, it was hurting my work. I am a teacher, and I would have to find someone to take over my class several times a day so I could go use the restroom. I had been taking anti-diarrhea meds to try to help but it just ended up not helping. Last fall I had another upper scope and it was found that I have a significant amount of Bile in my stomach. Well, the doc put me on a pill (carafate? - spelling) that has helped some with the bowel problem, but to this day I still have the dull ache, and now the dull ache is in my back (similar to yours). It can be very achey, throbbing at times. This past Wed. (Apr. 9) I had a new test...an MRCP to see if there is some kind of blockage in my bile duct or near the pancreas. I can let you know what that tells. Good luck with finding out what your problem is.

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