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Experiencing foul breath and pain in upper quadrant. Endoscopy normal. What test should be done?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Light gnawing occasional pain in upper right quadrant. Experiencing foul breath. Negative endoscopy and abdominal ultrasound. What do you think? What else should I have tests for?
Posted Thu, 14 Feb 2013 in Abdominal Pain
Answered by Dr. Mayank Bhargava 28 minutes later
Welcome to XXXXXXX forum.

With the available described information, there appears to be possibility of right lower chest pathology.
Presence of pain in upper right quadrant (close to right lower chest) and foul breath suggests the diagnosis.
Other possibility may be muscle sprain and halitosis as a separate entity.
These possibilities should also be kept in mind as pain is not persistent (you have mentioned occasional).
As the pain on right side, there appears to be least possibility of heart disease (right side heart pain may occurs in "dextrocardia".)

You should consult with XXXXXXX medicine specialist and should go for thorough check up.
You should go for chest x XXXXXXX complete hemogram on preliminary basis.
Any sort of lower chest pathology may be demarcated by these simple investigations.
In case of any doubt, you can go for CT scan thorax.
Meanwhile, you should take analgesics along with muscle relaxant.

As such there is no correlation between blood pressure and high cholesterol with the described chest pain.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Experiencing foul breath and pain in upper quadrant. Endoscopy normal. What test should be done? 8 minutes later
Forgot to mention many years of belching. Very gassy. Especially after eating.
Answered by Dr. Mayank Bhargava 48 minutes later
As you have normal endoscopy, there is least chances of gastritis.
Yet you should also go for urea breath test for Helicobacter pylori bacteria.
This bacteria is responsible for gastric problems.

You should also follow few dietary changes:
Avoid tomatoes, citrus fruits, onion, garlic, tea, coffee, spicy and oily food.
Keep difference of 3 hours between meals and sleep.
Avoid putting dough and boiled potatoes in refrigerator.
Take only 200 ml of milk (contains 34 gm lactose); more than this causes excessive gas formation.
Take soft diet with yogurt in small amount frequent meals.

You should also take proton pump inhibitors along with prokinetics for relief of your symptoms.

Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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