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What Causes Upper Abdominal Pain?

Posted on Tue, 22 Apr 2014

Question: Hello. Last night I noticed a dull pain in the right upper part of my abdomen. As the night went on, it got worse, so I figured I'd go to bed and hope it will improve. I always lay on my right side, but could not even do that because it hurt so bad. When I woke up, the pain was still gnawing at me and I realized that it was painful to cough. I went to the Urgent Care. They did a blood test and a CT scan. Since I had a partial colectomy in 2007 and the pain was so close to that resection site, he wanted to check to see if it was inflamed. The blood tests and CT showed nothing. He said it could be IBS and sent me home with some type of muscle relaxant It made me fall asleep, but didn't help me at all. Now it is 10pm and it hurts worse than it did before. Something funny came on TV and I realized that I had to hold my side really tight just to laugh. Then I sneezed. It felt like my whole side had been ripped open. Do I need to go back? What should I ask them to check?

Answered by Dr. Enrique Molina (16 minutes later)

Brief Answer: yes Detailed Answer: yes if the pain is severe in the right side of the abdomen you should definitely go back. They can't diagnose IBS from just having a normal CT and labs. Obviously a physical exam needs to be done to see if the pain is muscular in origin or something inside the abdomen. Depending on where exactly is the pain, it could be many different things. If it is in the right upper side of your abdomen, then the gallbladder may be the problem, or the pancreas / stomach. If it is in the right lower area of your abdomen, then the colon, small intestine, ovaries (if still present). I see you have a history of fecal impaction, so severe constipation can also cause this. Another possibility is an early bowel obstruction, particularly with your history of multiple abdominal surgeries. Abdominal pain should not be taken lightly, and i highly suggest you getting re-check. You will likely need a repeat imaging, either an ultrasound or a repeat CT scan with contrast. Also bloodwork to check the liver, pancreas, white cells, red cells, urine tests. If the pain seems to the physician like a muscular pain, then muscle relaxants should have helped already. Hope this helps, let me know if you have further questions or concerns

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Enrique Molina (19 hours later)

Thank you. It doesn't seem as bad today, but it is definitely there. They already did a blood test (right before the CT) and everything came up clear. I had 3 very healthy bowel movements over the last 2 days so I know that there is no bowel obstruction. When I lie on my back, it feels like the pain is centered around the bottom to center portion of the rib cage on the right. He said that the gall bladder scan came up negative. It just seems like a pain like this would be something they could see on a scan like that. Could it be in the abdominal wall itself? I just don't understand this burning sensation, as if something is tearing. Like I said, it seems better today than yesterday, but I've really been taking it easy. Like right now, I feel it in the lower rib cage, not the ribs, but just beneath them.

Answered by Dr. Enrique Molina (59 minutes later)

Brief Answer: Yes Detailed Answer: it could definitely be your abdominal wall. gallbladder could still be the problem even if you had normal testing before. if your pain is improving, then keep on watching and using your current meds, and contact your doctor during the week

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Enrique Molina (1 hour later)

I appreciate it. What can happen with the abdominal wall to cause this weird pain? Some kind of injury? Infection? Just wondering what I can do to prevent this from happening again. Also, when the doctor said that my gall bladder was "clear" based on the CT scan, are you saying that something could have been missed?

Answered by Dr. Enrique Molina (4 minutes later)

Brief Answer: Injury Detailed Answer: usually abdominal wall pain is the result of an injury from either trauma, bad movement, lifting weight. so you basically need to prevent any trauma and be careful with movements and have a good posture when lifting weight

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar