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Suggest treatment for pain in lower back and right upper abdomen

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Posted on Mon, 7 Dec 2015
Question: I have been having low back pain that radiates around my back over my hip bones and down into my pelvic area. I have also been having pain in my upper right abdomen under my rib cage. I have now had an abdominal ultra sound at the hospital and a vaginal ultra sound at my OB's office (he could not find my right ovary however). Both were considered normal. I have also had blood work done - again no issues. They did find a bladder/kidney infection - took 7 days of antibiotics and now seems to be gone. Symptoms better, however, still very constant. OB suggested going to Gastro doctor and possibly getting a CT scan.
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Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Other conditions need to be evaluated if symptoms persist

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Your pain is in the lower back and right upper abdomen. Though the ultrasound scans of abdomen and pelvis are normal, there is a bladder and kidney infection which has been treated with antibiotics.

2. Not finding one of the ovaries is a common situation and this happens due to gas containing bowel in lower abdomen.

3. Ultrasound is not a complete investigation and CT scan of abdomen is recommended if clinical symptoms persist to visualize most of the organs more clearly. You have mentioned that the symptoms have got better but quite constant and this is probably why your OB wants you to consult a gastroenterologist keeping in mind the pain in right upper abdomen. An endoscopy might be recommended by the gastroenterologist depending on clinical examination.

4. Blood work being normal is not confirmatory for the absence of any medical condition. However many of the important causes like severe infection, any blood problems and liver and kidney functions can be evaluated.

5. It is most likely that pain in lower back and pelvis is from kidney and bladder infection. If there is no significant resolution of symptoms then, the pain in lower back going in to the pelvis can also be from any problem in the lumbar spine at your age. This also requires attention and evaluation.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Vivek Chail (23 hours later)
Hi Dr. Chail - I forgot to add that I had my gallbladder removed 3 years ago and this almost feels like the same symptoms I was having (especially the nausea and upper right abdominal pain). I also have noticed stools are sometimes clay colored and have read this might have something to do with bile issues. Thank you for your continued help. I am calling a gastro doctor tomorrow.
XXXX
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Symptoms are known to persist after gall bladder surgery in some patients

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Symptoms of nausea and upper right abdominal pain are seen in many patients for months and rarely few years after surgery. This is from mild digestive problems arising after surgery. It is important to consult the gastroenterologist and get an ultrasound scan or CT scan abdomen done if required. Probably the bile drainage is the cause of your symptoms.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (3 days later)
Thank you Dr. Chail - Does an ultrasound see enough of the pancreas and upper right abdomen or do you suggest I have a CT scan?
doctor
Answered by Dr. Vivek Chail (47 minutes later)
Brief Answer:
CT scan is recommended for pancreas evaluation

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. The ultrasound scan is suggested to evaluate pancreas in an emergency. There are many difficult areas like the distal body and tail in the pancreas which is not well seen on ultrasound scan. The choice of investigation for pancreas is CT scan. I recommend a CT scan for pancreas evaluation.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vivek Chail

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Practicing since :2002

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Suggest treatment for pain in lower back and right upper abdomen

Brief Answer: Other conditions need to be evaluated if symptoms persist Detailed Answer: Hi XXXX, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. Your pain is in the lower back and right upper abdomen. Though the ultrasound scans of abdomen and pelvis are normal, there is a bladder and kidney infection which has been treated with antibiotics. 2. Not finding one of the ovaries is a common situation and this happens due to gas containing bowel in lower abdomen. 3. Ultrasound is not a complete investigation and CT scan of abdomen is recommended if clinical symptoms persist to visualize most of the organs more clearly. You have mentioned that the symptoms have got better but quite constant and this is probably why your OB wants you to consult a gastroenterologist keeping in mind the pain in right upper abdomen. An endoscopy might be recommended by the gastroenterologist depending on clinical examination. 4. Blood work being normal is not confirmatory for the absence of any medical condition. However many of the important causes like severe infection, any blood problems and liver and kidney functions can be evaluated. 5. It is most likely that pain in lower back and pelvis is from kidney and bladder infection. If there is no significant resolution of symptoms then, the pain in lower back going in to the pelvis can also be from any problem in the lumbar spine at your age. This also requires attention and evaluation. Hope your query is answered. Please do write back if you have any doubts. Regards,