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Dr. Andrew Rynne

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Suggest treatment for right-sided pain in abdomen and itching around anus

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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3597 Questions

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Posted on Tue, 3 Nov 2015 in Medicines and Side Effects
Question: Experiencing pain in upper right side of abdomen since first week of August. Saw GP several times. Had ultrasound, blood test, urine test, all normal except for slightly elevated bilirubin, but GP said it wasn't out of normal range. Waiting for appointment for specialist. Pain increases significantly if drink alcohol, eat junk food - have been avoiding. Had severe itching at night around anus - thought might have pinworms, took Combatrin several times, didn't clear up. Started an herbal parasite treatment including wormwood, green walnut hull tincture and cloves. Concerned I might have taken too much cloves yesterday. Since yesterday, strong pain in same place in abdomen and dark, sharp smelling urine. Feeling of light nausea.
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Answered by Dr. Panagiotis Zografakis 17 minutes later
Brief Answer:
peptic ulcer and gallbladder problems have to be excluded

Detailed Answer:
Hello,

although the pain is in the upper right side of your abdomen, the stomach and duodenum could be involved. I suppose that gallbladder problems (stones, inflammation) have been excluded with the ultrasound scan. An upper endoscopy would be appropriate, in my opinion. Pain worsening after drinking alcohol and eating junk food is another factor which makes gastrointestinal related pain more probable.

Another - not so likely - origin of the pain, is your pancreas. Chronic pancreatitis (related to alcohol abuse) may cause bouts of pain after heavy meals or alcohol consumption. The pain is usually located in the upper and left part of the abdomen though and lasts for hours or days.

Finally, intestinal ischemia may cause pain but this is usually located in the middle of the abdomen.

So in conclusion, I would start with an upper endoscopy. If the endoscopy is not helpful, then a CT scan of the abdomen might provide clues.

Regarding the anal itching, you should be tested for worms. Talk to your local lab, it's simple test where you have to attach a tape during the night and get it to the lab for microscopy.
Your urine does not seem to be related but a urinalysis would be appropriate to identify the cause of the 'dark' color.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Panagiotis Zografakis 57 minutes later
Thank you for your comments. I am concerned I accidentally overdosed on cloves yesterday and this has aggravated the other problem. I took a large dose around 6 am yesterday morning mistaking it for another supplement. This morning feel lightly nauseated and with the dark urine, as well as constant low pain in upper right side. Not sure whether this is related.
doctor
Answered by Dr. Panagiotis Zografakis 15 minutes later
Brief Answer:
the clove overdose could raise concerns

Detailed Answer:
You're welcome!

I've focused on your previous symptoms and didn't mention anything about the cloves. First of all, this is not a very well documented supplement, so the information about it is not abundant! It may cause liver problems, in cases of overdosage. Your urine has to be checked by a doctor to make sure it's not discolored by jaundice. If you're jaundiced then various liver function and assessment tests will have to be done (AST, ALT, ALP, gamma-GT, INR, albumin and others).

Urine in jaundiced people looks like brandy. It's brown rather than yellow. Normal urine can be dark yellow but not brown.

I hope this is clear enough... Here is a link with a picture of urine of a jaundiced individual.
https://www.pinterest.com/pin/0000/

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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