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Have PCOS and Graves. Pain in upper quadrant, nausea, bloating and pain when using restroom and passing gas

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Practicing since : 2008
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30yr old female, 5'6" tall, 190lbs

I have PCOS & Graves but graves has been normal for years

Current problem:
Severe pain in right upper quadrant
Nausea after eating
Sharp stabbing pain for days in the same spot
Pain in that spot when laugh/caugh/deep breath
Pain when need to use the restroom & gas

Had hida scann w/cck done Monday - normal but I do have strong family history of gb disease
Posted Tue, 1 Oct 2013 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 11 minutes later
Brief Answer:
Gallstones or peptic ulcer.

Detailed Answer:

Thank you for the query.

Your symptoms are very characteristic for gallstones indeed. I assume that abdominal ultrasound before hida scan were done? If not it should be done (not CT).
If the gallstones were definitely ruled out, next issue to check is peptic ulcer. It is quite common that peptic ulcer pain is misdiagnosed as gallstones.
Characteristic for this issue symptoms are pain in the upper middle or right abdomen which appears some time after a meal. Nausea and chest burning. The pain can be more intense after coffee, alcohol, spicy foods.

I suggest you to have gastroscopy done (if the ultrasound were done). During this test, also Helicobacter Pylori infection will be checked and if present, antibiotics will be necessary.

In a meanwhile please avoid fatty foods, spicy foods, alcohol and coffee. Increase fiber XXXXXXX products and mineral water intake. For gas problem, start probiotic intake.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Have PCOS and Graves. Pain in upper quadrant, nausea, bloating and pain when using restroom and passing gas 4 minutes later
I did also have ultra sound it was normal. Surgeon said maybe irritable bowel and to see GI? Do you think peptic ulcer is more likely? I had these exact symptoms ten yrs ago, had same test done and no answer...except pain is worse this time and won't go away.
Answered by Dr. Grzegorz Stanko 4 minutes later
Brief Answer:
Peptic ulcer is more possible.

Detailed Answer:
It is easy to blame IBS. Maybe it is it. But to diagnose IBS, it is necessary to rule all other possible reasons out first. One of possible reason is peptic ulcer.
In my opinion, your symptoms sound more like peptic ulcer than IBS. So please try gastroscopy before giving up (IBS simply means that doctor does not know what is causing the symptoms and is giving up).
And even if gastroscopy wont give an answer, still some more tests should be done before IBS diagnose. After gastroscopy, stool tests should be done. Rifaximine treatment should be considered. And if it wont help, colonoscopy is next. After this test, abdominal CT with oral contrast (enteroclysis) should be also done. As you can see, many alternatives before giving up.
But gastroscopy first.

Above answer was peer-reviewed by
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