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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Abdominal Pain On Right Side Below Rib Cage, Worse In Morning. Normal MRI And Ultrasound. Remedy?

I have an abdominal pain on my right side about 2" below my rib cage. when I first noticed it the pain would wave across my abdomen, now it feels like a stitch concentrated in one area. I have had a MRI and Ultrasound and they have ruled out my Liver, Gallbladder, Kidney and Pancreas. I find the pain is worse in the morning. There is no relief with a bowel movement.
Mon, 29 Jul 2013
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Critical Care Specialist 's  Response
Thanks for your question.
The type of pain your having could be due to APD that is acid peptic disease.APD is due to increased acid output in stomach due variety of reasons. Common being the spicy food, cigarette smoking, alcohol and infection by a bacteria called H Pylori Your ultra sound and MRI abdomen are normal.APD cannot be diagnosed by ultrasound or MRI.APD can be diagnosed by upper G I endoscopy. Consult a physician who may be able to perform upper G I endoscopy on you and may prescribe you treatment depending upon the cause. Hope this answers your question.
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General & Family Physician Dr. Manjeth Kumar G's  Response
Hello,
Welcome to Healthcaremagic.
From your query i suspect that you may be suffering Irritable bowel syndrome (IBS) or chronic functional abdominal pain.
IBS patients usually suffer from worse abdominal pain in morning.Because colon is more active in morning.
It is not final diagnosis.
But you have to do further investigations to rule out any abdominal infections.
The following investigations may be helpful.
Complete blood count- To rule out anemia from parasitic infections
WBC count to rule out infections
ESR-Erythrocyte sedimentation rate - To rule out any inflammation
Antibody testing to rule out coeliac disease
Colonoscopy and endoscopy to rule out any pathology in gastro intestinal tract.

To rule out liver and gallbladder disease, liver function test and lipid profile.
To rule out kidney disease, do urinalysis, urea, creatinine and urine culture.

Hope this helps.
Take care.
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General Surgeon Dr. M Y Shareef's  Response
Hi ! After all the reports of the investigations done so far came out to be normal, you may be having hyper acidity, along with possible duodenal ulcer which is giving rise to such symptoms. I would suggest you to consult a gastro enterologist, who may advise you for an endoscopic examination of the upper gastro intestinal tract to arrive at the diagnosis. Till then you can go for a proton pump inhibitor drug, along with a prokinetic drug which may relieve your symptoms. Wishing you an early recovery.
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General & Family Physician Dr. Athish Peter Margos R's  Response
Hi,
Site of your pain suggests pathology in liver,kidney,gall bladder,pancreas and intestine.By your investigation most of the causes have been ruled out except those related to the bowel.USG and MRI will not pick up pathologies inside the bowel.Pain from the early part of the small intestine can be felt on the right side.The Intestinal pathologies are better picked by endoscopy or colonoscopy ,wherein the entire intestine is visualized from inside.Peptic ulcer could be a leading cause.Even the external causes will be only be rarely missed by scans.Relief with bowel movement is more commonly seen with irritable bowel syndrome.Again duodenal ulcer pain is more in the mornings.
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Abdominal Pain On Right Side Below Rib Cage, Worse In Morning. Normal MRI And Ultrasound. Remedy?

Thanks for your question. The type of pain your having could be due to APD that is acid peptic disease.APD is due to increased acid output in stomach due variety of reasons. Common being the spicy food, cigarette smoking, alcohol and infection by a bacteria called H Pylori Your ultra sound and MRI abdomen are normal.APD cannot be diagnosed by ultrasound or MRI.APD can be diagnosed by upper G I endoscopy. Consult a physician who may be able to perform upper G I endoscopy on you and may prescribe you treatment depending upon the cause. Hope this answers your question.