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Is Persistent Right Abdominal Pain Suggestive Of Cancer?

Posted on Thu, 19 Jan 2017

Question: I know I’ve asked about this multiple times, but I’ve foolishly neglected to mention one item…
I’ve been experiencing this upper right abdominal pain (just below the right rib) for about 8 months. It’s most pronounced when I sit, however, when I press in where the pain is, it relieves it (see image for reference of exactly where pain is/where I apply pressure). My gastroenterologist believes that this is something pancreatic related (due to a low Trypsin count), but says that it could be something as simple as an ulcer.
I’m just curious if this could be symptomatic of cancer of something, considering that applying pressure relieves the pain? Or maybe this might lead to pancreatic failure? I hope not.
Thank you

Answered by Dr. Hari Charan Perigela (2 hours later)

Brief Answer:
You should be investigated.

Detailed Answer:
Hi
Liver and Gall bladder are present in right upper quadrant of the abdomen. Lesions in these two organs can be diagnosed by Ultrasound abdomen.Stones in the Gall bladder can be excluded by Ultrasound. It also gives a clue about Pancreatic disease.
If Ultrasound abdomen is normal,Upper GI endoscopy has to be done to rule out Ulcer in the Stomach /Duodenum.
If pain is relieved after applying pressure, it is not Cancer.It could be related to muscle.If all the investigations are normal,then the pain could be due to musculoskeletal cause.I prescribe skeletal muscle relaxant tablet containing Thiocolchicoside to my patients .
Please consult a Gastroenterologist,get examined clinically and proceed accordingly.
In my opinion, it is not related to Pancreas.
Nothing to worry.
Hope I answered your query.
If you have any questions, I will clarify further.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Hari Charan Perigela (2 days later)

I only mention the pancreas because my gastroenterologist says he thinks its possibly pancreatic. If there were legions, arent legions indicative of cancer? It has some days where i literally feel this organ hurting, whichever one it is. I went to an er a while back and the ct scan only saw fatty liver, but they said that doesnt normally hurt.
I hope youre right that this isnt cancer because if it is, these are masses that have developed .

Answered by Dr. Hari Charan Perigela (3 hours later)

Brief Answer:
Your Pancreas looks normal.

Detailed Answer:
Hi
As per your CT report,you have only fatty liver.Any lesion in the Pancreas will be confirmed by CT scan.
Please get an Upper GI endoscopy and rule out acid peptic disease.
You can take Rabeprazole 20mg twice daily 15mts before food and see the response.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Hari Charan Perigela (40 hours later)

Yes but that was several months ago. Ive noticed that i can actually feel whatever organ this is at times. I could be looking to hard, but it also feels like a very slight bulge where the pain is. I dont feel that as pronounced on the other side .

Answered by Dr. Hari Charan Perigela (2 hours later)

Brief Answer:
Ultrasound abdomen will give a clue.

Detailed Answer:
Hi
Some swellings that are present beneath the skin like Lipoma,Sebaceous cyst etc will produce a bulge in that area of abdomen. Ultrasound abdomen will confirm whether swelling is present or not.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Hari Charan Perigela (6 hours later)

Ill try to get an ultrasound. The only way is an er though and thats alot of money just for one scan. Would this pain, since its been increasing more frequently be a possible sphincter of oddi problem (since ive had my gallbladder taken out)?

Answered by Dr. Hari Charan Perigela (53 minutes later)

Brief Answer:
It is not related to Sphincter of oddi.

Detailed Answer:
Hi
The site of pain doesn't show any relation to Sphincter of Oddi.
I have done many gallbladder removal surgeries without any post operative complications.
If you come back after Ultrasound abdomen, I will clarify further.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hari Charan Perigela (20 minutes later)

Ok. I dont imagine this being good news then. Because its not getting better. Ill try to get an ultrasound then, to hopefully rule out anything fatal .

Answered by Dr. Hari Charan Perigela (2 hours later)

Brief Answer:
Ultrasound abdomen will give a clue.

Detailed Answer:
Hi
Ultrasound abdomen will give a clue about any swelling /lesion in the abdominal wall/abdominal cavity.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Hari Charan Perigela (20 hours later)

Will do docor. I'll wait until my appt to do so.
If I may ask just one more question...ive taken apple cider vinegar before and never had a problem. I tried it with some lemon juice and tumeric and it caused my stomach to turn, but also felt it in area where this pain has been. Could that be indicitive of anything?

Answered by Dr. Hari Charan Perigela (22 minutes later)

Brief Answer:
It could be due to Irritation of Stomach.

Detailed Answer:
Hi
The symptoms are due to Irritation of stomach.
I prescribe Tablet Rabeprazole 20mg twice daily 30minutes before food to my patients with similar complaints.
Please avoid stomach irritants.
Regards

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy