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Forum Name: Gastroenterology Topics

Question: right upper abdominal pain


 snoopboxer - Mon Oct 20, 2003 2:08 am

I have been having sever right upper abdominal pain off on for the last couple of years. There have been a couple of times however that it has been sever enough with nausea and diarrea to send me to the ER but all test came back ok. Last weekend it lasted all weekend and sent me to the ER twice. Both times they gave me IV pain/nasea medication and sent me home with Percocet because the blood tests were ok.. On monday I went to my PCP and she admited me to the hospital for "pain control and hydration". She does not do hospital visit but uses the hospital doctors so I did not know the doctor that would be caring for me. I have a very complex medical history and I am very involved in my care. The first time I met him I had 30 min before recieved 3 mg of Dilaudid and 12.5 mg of Phenergran so nedless to say my pain was quite a bit less. (Each time I saw him I was medicated.) I was in the hospital for 2 1/2 days and after a HIDA scan and CT scan came back normal he told me that I had just "strained" a muscle. And that since I had been sick over the weekend I was probably going through withdrawls from not absorbing my MS Contin. I tried to explain to him that I have had this pain off and on for a couple of years, not just this weekend and that I have only been taking MS Contin for a couple of months. I also told him that my mom, grandma, and greataunt all had normal CT scans and my grandma and greataunt had normal HIDA scans for abdominal pain, my moms was abnormal. They had their gallbladders taken out during other procedures, but never had the abdominal pain again. He said that he wouldn't refer to a surgeon, even for a consult, because the needed "hard" proof that it was my gall bladder. Could I still have a gallbladder problem even though these test are coming back positive? When I am having the pain/symptoms as an LPN it definatly presents like a a gallbladder attack. I follow up with my PCP this week and I just want another opinion besides mine and the doctor at the hospital. Should I consult with a surgeon or a GI or urologist (pain radiates to back)??Thanks....
 Dr. Tamer Fouad - Mon Oct 20, 2003 6:18 pm

User avatar Snoopboxer,
Your case is very interesting actually. Let me just put down my thoughts in no particular order. Gall bladder pain usually radiates to the shoulder and not to the back. HIDA scans are rather specific in diagnosing cholecystitis but rest on the fact that most cases of acute cholecystitis have associated obstruction in the common bile duct. This ofcourse is clearly not the case. Hence the assumption that a normal HIDA scan does not rule out cholecystitis. CT scans would have shown any stones, but you said it came back normal. However, there is an entity known as acalcular cholecystitis in which stones are not present. Morphine is usually not given to cases with suspected cholecystitis as they may cause even more pain due to their action on the sphincter of Oddi in the gall bladder.

hmmm.. its rather tricky. You are obviously suffering and pain is one of the symptoms that must be taking seriously. I would consider going to a very good GIT surgeon if I were you.

Let me know what comes out of your meeting with him.

Best wishes,
 michigan_Gal19 - Sun Oct 17, 2004 9:44 pm

I have been having the same problem you have explained...mine just started though..Been going on for almost 2.5 weeks..I am in soo much pain I have had the hida scan the cat scan the ultrasound blood work etc everything is normal. I don't understand I am in so much pain I can bearly stand upright i am throwing up everything I eat because it causes me so much pain and now that they gave me zolfran i have diarreah. I don't know if this is associated with the pains that I was having last Nov..it was all over my abdomen they finally went in and took out my apendice because I guess it was about to quit and there were stones. But this pain nothing like it I have pain in my upper right shoulder and in the middle of my upper back pain under my right rib and severe chest pains feels like I am having a heart attack...but I know im not because I went to the ER for this already 4 times and they keep sending me home.. I went one time because I started throwing up blood but the ER doc said oh that is normal..I looked at her like she was crazy..but all the blood tests came back normal...So now I am going to have a EGD on Tues hopefully this will help...I don't know why they just cant go in and look at my gallbladder...my mom went through this same thing and all her tests were normal finally they went in and found that it was her gallbladder... I am about ready to give up I cant take this pain anymore and they doctors are not helping...please help me...give me some answers advice something :cry:
 GWDJR - Sat Jun 25, 2005 3:38 pm

I am having the same problem. Pain in the right upper area like where the liver is. Have had all the test you have had then some and all thay came up with Hep C. But the Dr's say that the liver cant couse pain so where is the pain from? Got to be the gallblader but the test come back normal and the liver looks find,thay say.This has been going on for about 5 years now.Looking for any help. Thank's.
 moonstar - Mon Aug 29, 2005 5:23 pm

there is great help in the book "The Makers Diet" A very informative read and real help for those who are suffering!
 LIBlondie45 - Tue Sep 06, 2005 9:38 pm

I have had upper right back pain since mid-April 2005. The pain started in the chest area, radiated to right arm pit and has stayed in my upper right back for about 3 1/2 months.

I had to go to the ER a month ago because the pain was so unbearable. I was given an injection of pain meds, had a chest xray, sonogram on gall bladder and had 6 vials of blood taken. All came back negative.

I have since had another chest xray, had 2 EKGs, a sonogram on my heart and all were negative.

I had an MRI a week ago but haven't learned the results. Unbeknownst to me, my doctor scheduled me for an CT scan tomorrow. I wasn't aware of this CT scan till the CT scan place called me a couple hours ago. My doctor hadn't even called me to say why he was scheduling the ct scan.

Can anyone tell me what the MRI might've shown that I have to go thru an CT scan with the dye?

Thanks for your help.

Patty
 shannonv33 - Sat Oct 15, 2005 7:19 am

My pain is the same as yours, I had my gallbladder out in April for the pain but it made everything worse. I also live in Michigan.....was in grand Blanc hospital if you know where that is. Now I am lined up for a EDG scope in November, but don't know if I can wait that long. I am in a group for pancreatitis, looking at all my symptoms matched up to that but cant say for sure if thats what it is. I need to have a ERCP, have you had one of these yet? I have the pain under my ribs and also feels like I am having a heart attack mixed with back labor pains. Would love to know more about what your going through!!
 LIBlondie45 - Sat Oct 15, 2005 5:27 pm

shannonv33 wrote:My pain is the same as yours, I had my gallbladder out in April for the pain but it made everything worse. I also live in Michigan.....was in grand Blanc hospital if you know where that is. Now I am lined up for a EDG scope in November, but don't know if I can wait that long. I am in a group for pancreatitis, looking at all my symptoms matched up to that but cant say for sure if thats what it is. I need to have a ERCP, have you had one of these yet? I have the pain under my ribs and also feels like I am having a heart attack mixed with back labor pains. Would love to know more about what your going through!!


Hi,

I had the endoscopy today which was easy as anything. No pain or anything negative. He spotted some esophagus and stomach irritation (no kidding, lol) and will put it under microscope to see further. I was given prescription for some meds and will learn more in a week or so. KEEP pursuing medical tests till you find results as it could be something serious. Good luck and keep us posted.
 wvufan - Wed Mar 19, 2008 2:32 pm

For the past several days, I have had chronic abdominal pain in the epigastric and periumbilical area. I have also had nausea but no vomiting. TI also experience chronic constipation. Two years ago, after losing approximately 50lbs, I had these same symptoms and was given a CT scan to rule out appendicitis. The CT scan was normal. I was then referred to a Gastroenterologist for IBS. The physician asked if I had any indigestion or heartburn associated with this abdominal pain or in general. Only on occassion did I or do I get heartburn or indigestion. The doctor then ordered an upper endoscopy which was normal and then an upper GI with small bowel follow thru. This was also normal. The physician suggested we wait three months and repeat the endoscopy. I refused to have it repeated since the first one was negative and was told there was nothing else to be done. I went to our local ER with this recent onset of pain. I again was given a CT scan and again it was normal. I was told to see a GI physician to have an endoscopy or upper GI done to rule out an ulcer or GERD. I have recently quite smoking and have gain approximately 20-25 pounds. I am also experiencing chronic constipation w/occassional diarrhea. Since the first tests done were negative, should they be repeated? Should a HIDA scan be done to make sure that my gallbladder is working as it should?
 SherryHB - Thu Apr 02, 2009 8:11 am

I had my gallbladder taken out in Sept. Now I still have the pain in the upper right part of my belly under the rib and especially at night I have the pain and it makes like a gurging sound. My stomach is swollen. I'm tired all the time especially after I eat. I've been check for diabetes cause it runs in my family but that's not it. I'm on Prevacid but it doesnt help.
 Miss Kitty - Sat May 16, 2009 11:20 pm

I have exactly the same symptoms-right side, just under the rib cage, toward the middle. It often feels full or enlarged. The pain is sometimes sharp and other times dull. I can feel it pulse and it gurgles. At times I need to lean to my left to feel more comfortable. I get nausious frequently: 3-8x's per month--this was a daily occurrence before I had my gall bladder removed in 08. I have a hiatal hernia and GERD and take Nexium. An ultra sound was normal. An MRI found a thickened duodenem. I've lost 20 pounds this year. My doctor says to just eat right and keep weight off---for what? It still hurts!!
 panga8 - Sun Oct 25, 2009 1:51 pm

I have been having very similar problems for the last 4 months. It all started when I was out to eat one night. I took a bite of food and immediately felt like I was going to throw up. I didn't end up throwing up though. From then on, I have had horrible nausea like that. It just pops up randomly, but very strongly. I have thrown up a couple times with it. About 2.5 months ago the pains started in my upper right quadrant. I have had a CT, endoscopy/colonoscopy, ultrasound, HYDA, small bowel follow through with upper GI, probably about 20 bouts of blood work, stomach emptying test, and urine tests. The pain sent me to the ER one day. Since then I have been on Darvon, Lortab, and Zofran as needed. It helps some, but the pain is unbearable sometimes. I have seen an infectious disease doc, surgeon, GI doc, numerous family docs, and a pain specialist. In the beginning, they all thought my liver was enlarged until one doc said it was my abdominal wall. The other docs don't agree because there is a fullness in the upper right area. It's not infectious, not IBS, not lupus, etc. All of the tests come out normal, besides my being anemic. I am scheduled for an MRI this week so I am hoping something will show up there. My docs are thinking the next step is a university medical center. I am just so frustrated with this! Any suggestions would be great....

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