upper right abdominal pains

by D. Gordon
(Bethlehem NH)

I have upper right side pain that is relieved by lying down. The dull pain appears to be located right where my liver would be (and probably where other organs are), feels like someone kicked me, is under my right ribs and goes through to my back. I can feel it more when I take a deep breath. When I get up in the AM, I am painfree for about 45 min and then it starts. Sitting makes it worse. Standing gives me some relief, but I can still feel it - like something is swollen or inflamed. I had this about a year ago and had a battery of tests - CBC, upper GI, ultrasound on my liver, gallbladder,pancreas, stomach, and endoscopy. I have elevated AST/ALT levels and diagosed with fatty liver. All other tests were normal including cholesterol and triglyserides. My doctor eventually diagosed me with irritable bowel, but I don't feel that this pain is really associated with irritable bowel. I am scared and don't know what to do.

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Dear D Gordon,

I am sorry to learn about your worrying upper abdominal pain - a upper right abdominal pain, worse on sitting down, relieved on lying flat and radiates to the back, with associated pain in deep breathing. I agree with you and also think it is less likely that the pain you've just described is due to irritable bowel syndrome. The chances are very very slim, based on the information you've volunteered.

If it is okay, can you clarify a few things for me? How old are you? Does anyone in your family suffer with irritable bowel syndrome? When exactly did this pain first start - current episode. I understand you has similar pain last year. At about what time last year? How did it eventually go away? What is your weight and height? Is there any relation of the onset of this pain with meals? How are your bowel movements like? Normal stools or do you suffer with constipation or loose stools? Any weight loss, What's your appetite like? Any unintended weight loss recently? Any fever? Do you feel unwell in yourself?

You also said you are scared. Do you mind sharing with me what exactly you are scared of, o what you thought the pain might be that is causing you to be scared?

While I await your responses to those questions, I do think, from what you the information you've provided so far, it is most likely that the cause of your upper abdominal pain could be one of the following:

Biliary colic or gallbladder pain. This is still possible even without a stone seen in your previous scan. A sludge in the gallbladder may not be obvious initially on scan but later seen and they could cause gall bladder pain from time to time


• Right Costochondritis
  
  
• Myofascial Pain syndrome.

I will be looking forward to hearing back from you soon with more information. Bye the way, what are you taking for the pain when it comes on?

I will look out for your response.

Dr Edema
Abdopain.com