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Undiagnosed URQ pain and nausea

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On Dec. 29th, I started experiencing URQ pain, starting just below the right ribs and extending around my side and up my back, to the shoulder blades. The pain in the URQ was sharp, while the pain in the shoulder was dull. I went to the ER the following night because the pain had persisted. The ER ran a blood test & urinalysis. Everything came back within the normal range. I was given something for the pain and nausea and told to follow-up with the GP. Both the triage nurse & the ER doc said that I probably had something wrong with my gall bladder.

I went to my GP, who ordered an upper abdominal ultrasound. During the ultrasound, the techie stated that she saw "areas of inflammation", but didn't elaborate where or how inflammed those areas were. I didn't hear from the GP's office for over a week, and even if I called, I was told that someone would call me back later (they never did). I received a form letter in the mail with my name and a checkmark in the box "results normal". There was no indication of follow-up care and no request to see the GP again.

I decided to go to my OBGYN because I do have a history of ovarian cysts and tend to get them on the right side. While I know that the pain I'm experiencing is too high, I have also heard of cysts attaching to the abdominal wall or organs, which can cause severe pain. The OBGYN called for a pelvic ultrasound, which had normal results. During this time period, the URQ pain & nausea continued, spiking particularly after mealtimes.

I requested to see a different GP. Two days before I was supposed to see the new GP, I went back to the ER with sharp URQ pains and nausea. My blood tests were again normal, so I was again given morphine & anti-nausea medication and sent home.

The GP referred me to a surgeon. The surgeon called for one test, a HIDA scan. I was given the nuclear medicine through the IV and told to wait. They started taking me back every 10-15 minutes and, around 45 minutes, my gall bladder appeared on the scan. that's when they started the second part of the test, with the CCK infusion. The doctor introduced the CCK slowly and I experienced URQ abdominal cramping & nausea each time he introduced the CCK. The HIDA test came back normal, with a 67.8% ejection rate.

The surgeon was out of town when my results came back (during the normal range of 24-48 hours after the scan), so I didn't find out my results until 5 days after the exam. When I did, the surgeon said that there wasn't anything else he could do except refer me to a gastro specialist.

After about a week, I'm able to get in to see the gastro specialist. During that time, I started experiencing pain elsewhere (in addition to the usual URQ): on my mid to lower back, at about kidney level. I explained my symptoms and the tests that had been done. At this point, I was pretty frustrated with how little my doctors were telling me, and the long length of time between visits or contact with the doctor, so I had been researching possible complications of the gall bladder online. During the appointment, I requested an ERCP. The doctor called for a series of blood test, telling me that an ERCP would only be called for if my liver enzymes were off. The doc called for a CBC, metabolic, and tests on the liver, kidney and pancreas. Everything came back as normal, so an EGD was called for instead.

The EGD found three minor issues, all of which the doctor assured me wasn't serious enough to be causing the pain I was experiencing (which would be a steady 6/10 on the pain scale, with spikes at the 8-10/10). He found non-erosive esophagitis, a hiatal hernia, and gastritis. He took some biopsies (results are still pending on those).

My follow-up appointment to hear the results is March 3rd. The doctor won't do any other tests until those results come back. He put me on an acid reflux medication and told me to take Alleve for the pain. If the Alleve doesn't help with the pain; or the pain gets worse; or I spike a fever, I should go back to the ER. Well, I went back to the ER on Tuesday because the Alleve didn't help with the pain.

The good thing about going back to the ER was that I had the same doctor as I did during my last ER visit. Because he knew I'd been there before, he took a lot more care with examining me. He called for more extensive blood tests. He couldn't find anything wrong with my blood test. He asked what tests have been done with me and then made the following suggestion: perhaps my pain wasn't caused by my gall bladder, but rather by a floating rib that rubs against the gall bladder when it slips, thus causing the URQ pain and nausea. What's funny is that I've tried eating normal foods since the ER visit and found that my pain is more dependent on my activity (such as lifting things or stretching my right side) than on my diet.

Has anyone else experienced this? When I see my GP on Monday, are there any tests I should request (like a CT or MRI)? is what the ER doc said even feasible? Are my docs just not doing enough to diagnose a problem with my gall bladder? Should it be taking this long to determine if my gall bladder is or isn't messing up?

I'm frustrated and tired of being in pain. I'm also worried that, if it is my gall bladder, it might burst while my doctors are dragging their heels about figuring out what's wrong with me. My doctors are very reluctant to refill any medication for me without a week-long fight, even if it's for my nausea. I just want to find out what's wrong and how to fix it.
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replied February 24th, 2008
Abdominal pain
You might have cronic lymes disease. I have had abdominal pain for 7 years, feels like an organ is going to rupture. Along with headaches, sinus problems, muscle pain, anxiety, rapid heart racing and many more problems. The abdominal pain is unbearable even with the percocet.
Ive been tested for everything but nothing ever showed up in tests. They have never checked for infections. I recently came across cronic lymes disease and found out not everyone gets a rash and fever.
You cant always detect lymes, but if you have had it along time its cronic lymes and cant be cured by antibiotics, there is some vigorous treatment they do.
Lymes gets in your fat cells, in your lungs, muscles,brain,bile. Since it isnt in your bloodstream your antibodies cant attack it. It is a crippling disease. You dont have to have all the symptoms thats why doctors overlook it. I am going to an infectous disease doctor because i definetly think i might have cronic lymes.
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replied February 24th, 2008
abdominal pain
When i ent to the hospital on many occasions they thought it was my gall bladder too, but it wasnt. Abdominal pain is tricky i have been to 2 mayo clinics, and many doctors. Finally they told me it was cronic. I know it isnt cronic the pain has been getting worse, and im bed ridden alot. Did you find out what your problem was? My doctor tried to cut my percocet off, i couldnt believe it, the pain is so bad now the percocet herdly helps. Stay away from emergency rooms and conventional doctors.Go to an infectous disease doctor. Just keep trying because the pain will get alot worse and you will end up like me, at home in pain, rarely ever able to leave the house. Ive decided im going to try to find out the problem again. Search the internet for diseases and conditions with your symptoms, sometimes you can diagnose yourself. If it goes on a long time they will tell you its cronic or you have fibromyalgia and you will suffer. Many of us are suffering needlessly because doctors arent that smart. Dont buy the cronic pain story, keep trying to find out what your problem is.
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replied February 24th, 2008
I have been told, and I believe it, that not all gall bladder problems will show up with testing.
After all that I have read, I would not be in any hurry to have my gall bladder taken out. Boy there are a lot of people struggling with chronic health problems because of that and once it's gone, you can't get it put back in.
Unfortunately a lot of responsibility lies on the patient to research and look into your own diagnosis. Still, it can be daunting. If you
ve read over any of my posts, you'll see I'm a big believer in trying to help out myself and through supplements/home remedies I have helped myself and would like to say it is possible.
I have read that acid reducers can make some problems worse, and almost all prescription pain meds are addictive and can cause other problems.
Be wise and weigh all advice given to you carefully before making any decisions.
If you don't get any help from your doctors, keep researching your symptoms until what you find makes sense to you.
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replied February 25th, 2008
abdominal pain
I have had abdominal pain for 7 years, the first thing they wanted to do is take out my gall bladder before i even had the tests they had told me that was probally he problem. it wasnt. i have been to the hospital 3 times thinking my apendix was about to rupture,it wasnt. My abdominal has been getting worse and worse, i get barely stand it percocet, its unbearable.i started at one a day and am now at 5 a day plus alot of advil. i really dont care if its addictive, im in pain. they say people in pain usually dont get addicted to pain meds. so if you were ever cured you would stop taking them and i would.acid reducers are ok from time to time, but there are many reports that show they are very bad,
taking out organs is not a good idea, many people end up getting 2-3 organs removed and still have the pain, also the surgery is risky and the scar tissue can put you in more pain. abdominal pain is very hard to diagnose if they cant see the problem or find it in a test.so they usually tell you its cronic and you suffer for life. cronic pain usually stays about the same, it doesnt keep getting worse. people suffer for years needlessly.we suffer in silence,people in alot of pain who cant work or go out and do much are tucked away in bedrooms while the rest of the world goes on.you dont here much about people that suffer in terrible pain.
if your pain continues to get worse its not good, i have tried alot of home remedies. most doctors are not aware that not all diseases or conditions, you dont have to have all the symptoms so they can overlook what you have. that is why i am going to an infectous disease doctor, which no doctor ever reccomended.
i am also wondering if alot of stress or anxiety can put you in pain. i was married for many years to a very abusive man and have had several abusive boyfriends. now i have been with my boyfriend for almost 8 years, i starting getting sick months after we got together. for the most part he is good at heart, but there is something very wrong with him, he is very controlling of my every move. he is always stressed out all the time and yells at me, criticizes me, and insults me. this is abuse and i told him it was. he keeps saying he will be nicer but it doesnt happen.i really wonder if he can without help. im afraid to tell anyone what i have been going thru with this man for all these years. he has taken care of me when i was bed ridden for years, but he might be the cause of my pain.
i feel very trapped and my family doesnt talk to me hardly ever because i became sick, everyong i knew and loved disapeared when i got sick and in pain. this happens alot to people, i just never thought it would happen to me.
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replied February 25th, 2008
You poor thing. I do sympathize with you. Stress does affect us most certainly. If the pain is in your right side, under the ribs following the line of the right nipple, but directly below the last rib - that is exactly where the liver and gall bladder are located. If you have stomach upset and pain that spreads to the back associated with food or after a meal especially with any amount of fat, I would really guess it would be the gall bladder. But you probably could heal it on your own. This is my guess, my gut instinct, after struggling with my own problems. And I only want to help.
As far as the other stuff. An abusive boyfriend is no way to live your life. Do you have any children with him? If not, you should seriously think of creating a healthier life for yourself.
I lived with an abusive boyfriend for 3 years. I had kids from a previous marriage and his behavior was affecting them. That was really what gave me the courage to leave him. I then suffered nightmares about him for about 5 years.
Please do not be afraid to tell people what you have been going through. Don't you think it's time for some peace? Other people actually want you to reach out to them and share your life. We need to nurture each other with love and kindness. We should not allow mean people to have authority over us. I was trying to think of the right way to word that...I just don't think you should feel obligated to put up with someone being mean to you.
I will pray for you.
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replied February 26th, 2008
Actually the pain is in the lower abdomen, it feels like im in the last hour of labor and its at my lower right side, feels like an appendicitis. my organs throb, hard to tell where the pain is coming from really. i have been abused from every man i have ever been with,like an endless cycle. my boyfriend does really good things for me, but very controling.he was abused when he was younger, so he gets angry easily. he doesnt hit me though. i have children with my ex husband. did you find out what your problem was? is it resolved?
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replied February 26th, 2008
I think I have had several problems over the winter because I've had lots of other symptoms. I had all the symptoms of an ulcer and I took Mastica or Mastic Gum and that helped considerably. In fact I would recommend it for anyone. It acts as an antibiotic in some cases and also supports the digestive system. I also had blood in the urine, high white blood cell count, probably a kidney infection and also my gall bladder which seems to slowly, very slowly, but definately is getting better. Thank goodness. For a while I thought I was going to pass away this winter! I actually have days where I feel normal and the slight pain in my gall bladder is very subtle. It was so bad before, that it felt swollen. I think maybe it was inflammed for a while.
Maybe, like you said, you have a bug/virus, infection of some sort. I hope you don't have lymes. Doesn't that come from ticks?
Verbal abuse and controlling is just as bad as physical abuse, in my opinion. That's how my exboyfriend was. He would rant and rave, sometimes get drunk. He would control me all the time and put me down. He would tell me my family didn't care about me. He isolated me so that I was dependant on him. It took a scary couple of months of planning to leave him sneakily while he was at work. I lived in fear of making him mad. Just like that expression "walking on broken glass" - that's exactly how it was. It's a terrible way to live. It sounds like you have lived this way for a very long time. Do you remember what it is like to live in peace? How old are your kids?
As far as my health problems...The doctors around here aren't that great really and they just guess. I was suppose to make an appt with a surgeon concerning my gall bladder, but I don't want surgery! So I'm trying to get better on my own. If I feel like I'm going to pass away again, then I'll make an appt, but not before! Very Happy Plus I don't have health insurance.
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replied March 1st, 2008
Hi bigdxxxxx,

I'm sorry to hear about your stomach pain and I want to ask you a question. You stated that you have pain in your lower right side - do you have any other symptoms like mucus in your stool, diarrhea, or constipation? Do the syptoms get worse after eating or when you are stressed out?
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replied March 1st, 2008
Hi bigdxxxxx,

I'm sorry to hear about your stomach pain and I want to ask you a question. You stated that you have pain in your lower right side - do you have any other symptoms like mucus in your stool, diarrhea, or constipation? Do the syptoms get worse after eating or when you are stressed out?
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replied March 1st, 2008
jmc2007,

It's possible that it could be your gallbladder, or something else. I went through 4 years of pain and testing before they found my problem. I did have some negative liver function tests and a Ejection fraction of 17%. The doctors in the ER were still trying to convince me that it was an ulcer, and one surgeon trying to tell me that it was my hernia causing the pain. Had this hernia for years and it never caused pain like that.

With me, it was my gallbladder; biliary dyskenisia. My problem was structural. It had nothing to do with sludge or gallstones, so all the supplements in the world wouldn't have helped me( and I tried many of them).

My bile and cystic ducts are very tiny, and it was not pushing the bile through my gallbladder as well as it should. This was causing my gallbladder to contract wildly whenever I tried to eat something. It felt as though I had a clenched fist sitting in my upper right side.

The surgeon discovered this when he operated on me. In fact he said my ducts were so tiny that he was not able to perform the cholangiogram, and actually amputated my cystic duct in the process.
None of the tests that I had taken previous to surgery had discovered this fact.

The same thing with the ducts in my breasts. When I went in to have a tumor removed, the technician who performed my tests prior to surgery said that my ducts were as tiny as spider webs. So in my case it seems to be some genetic problem with my body's "duct" system.

I had surgery 3 weeks ago, and so far I haven't had any negative side effects. My surgeron told me that I wouldn't and I haven't. No nausea, no vomiting, no long-term diarrhea. I had diarrhea twice, and that was after taking laxatives to kick start my digestive system after my appendix was removed(I had it taken out at the same time as my gallbladder).

With the esophagitis, hiatal hernia, and gastritis - I have suffered from all of these.
I currently have a medium hiatal hernia. All of these conditions can cause epigastric pain with nausea and vomiting, but I never had upper right quadrant pain that swept around to my back until I started having problems with my gallbladder.

Get copies of all of your test results and x-rays - even the ones from the ER, because you can have them on hand when all of your other tests are coming back normal. You do have some proof that there have been some negative results, and this will aid the doctor in finding out what is going on. Furthermore, they won't be able to tell you that it's all in your head.
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replied March 19th, 2008
Sounds like gallbladder...
JMC,
I have done so much research on all this information for myself personally. Like you, I have horrible URQP, and right under my right ribcage it is tender and I swear my gallbladder is protruding from my side! I am on 10/500 loratab for pain..and anti everything from nausea to spasms. I had an upper GI, HIDA SCAN that came back at 96%, and ct scan that showed zero stones. Liver enzimes are high and GI doc said I had gastritis. Here's what I have found. The higher your infraction rate means the higher amount of bile being forced into your stomach and intestines. This causes all your upper GI problems including nausea and vomiting. Yes, of course the GI doc will find Reflux, Gastritis etc...When you eat, as in my case, I feel better stomach wise because my tummy's not empty but on the flipside, my upper quadrant pain becomes unbearable. Everytime your gallbladder flares up, it becomes inflamed and can scar. When the scar tissue becomes severe enough, this will cause more flares! Also, the scar tissue forms and can attach itself to other organs such as your liver, and now you have some really nasty problems. As much as you change your diet, or eat or not eat, that scar tissue will always be a problem, so really you have no choice but to get your gallbladder taken out. It's your doctors job to rule out everything other than your gallbladder, as you really do need it. Your liver has to work double duty afterwards, and there could be additional lower and upper GI problems from your gallbladder being gone. Myself..I don't want my gallbladder out..no way..but mine is sick and causing more trouble than I'm willing to put up with, but I wan't my doctors to check out every avenue before this will be considered. Your high infration number is what is holding everything up right now, but don't give up...Keep us posted on how you are doing!
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replied September 18th, 2009
Dear New User,
Your ER Doctor is probably right on. I had Upper Right Quadrant Pain about just under my rib cage.

I ended up going to my chiropractor. He told me about 2 recent patients. One had paid out $62,000.00 and had had open heart surgery. The other one had paid out $57,000.00. Both of them finally got total relief after seeing him. One after 2 visits and the other after 1 visit. I got total relief after one, but did a follow up visit just to be sure.

My pain would usually keep reducing until I had hope it would go away, then it would flare up to severe when I just did a simple task that I had done a zillion times before with no pain.

I would suggest go to a reputable chiropractor. Believe me after a few months of continuous pain that seemed to range from mild to severe, I thank God for relief.

Surl
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