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Suggest Treatment For Right-sided Sharp Pain In Abdomen

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Posted on Fri, 4 Sep 2015
Question: I got this sharp pain in the right side of my abdomen it happen right afterwards i finished eating. It was late and i ate my meal standing, i went to the living room to sit in the recliner when i got a sharp pain, it almost felt like something got hard inside and pulled slowly toward my back. The pain faded away, but the next morning i was sore from my right side . Later in the night when i was going to sleep i was laying in bed when i got the pain again, much stronger. Lasted for no more than 20 seconds again. Went to my doc and diagnosed me with h. Pylori, took the meds, but they gave me a lot of anxiety and pain that i did'nt have at first. Quit taking them on the 8th day. The 9th day i was on my period and started passing clots, panicked because i've always been normal. Took ibuprofen and i'm fine. I know feel alot of discomfort all over my abdomen right and left and ribs area. Like warm liquid and some pinching.
doctor
Answered by Dr. Mukund Savaskar (3 hours later)
Brief Answer:
Acute Abdominal Pain with?Gastritis / Under Investigation

Detailed Answer:
Hi,Dear,Thanks for your query to HCM.
I studied your query in all the details given from you.

Can you five more information on discomfort on right / left abdomen and in rib area.
Is the pain related to dietary intake?What's your routine diet-is it spicy?
Any overindulgence in tobacco/alchohol/smoking/ tea/coffee?
do you get 8 hrs sleep?
What's your daily work and diet schedule?
Also give me your past history of similar illness and other illness,if any.
Please update me with needed documented medical reports of tests done so far.

Besides those please specify the questions which you want to address. I might be able to address your specific concerns accordingly. I requested for specific questions as your case is already treated for H.pylori,on which you were noncompliant for your reasons. Your painful period is also setteled.

In the interim advise on Suggested Remedy-

-Take non-spicy bland/steamed non fried / diet
-Control on your outside food eating,if any.
-Stick to liquid diet for 1-2 days till your get relieved
-Avoid smoking/alchohol/spicy/ fried food for 1 week
-update your stool /edoscopic report if done.

Hope to get more information as what you need currently.

Awaiting your updates,
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mukund Savaskar (9 hours later)
I drink occasionally alcohol drinks also i do not drink coffee or cokes. About spicy i enjoy eating and never had a problem. Never had a problem with dairy. I sometimes get acid reflux, and some nausea but i notice it's when i eat a lot of meat or im under a lot of stress. Some belching in the morning's, but not every day. Also i sleep late at night, around 2am and wake up at 11-12 pm. I take care of an elderly lady with dementia. I was weighing 193 when i went to the doctor, but i've gone down to 185 in 12 days. Another symptom that let's me know i'm gaining weight is my sciatica in the right leg, with a pinching feeling in my mid back side. For now i've been eating small portions of chicken, salmon, with rice and bread only drinking water. I had meat yesterday since i was feeling dizzy, i had a lot of bubbling in my stomach after meal even felt it in my back. It was 8 pm when i ate it, so could it been to heavy. My concern is do i need to go see a gastroentologist? Or could it be my anxiety? I was experiencing some before i got that pain. I was able to control it by going to the park for a walk. The pain i got was on the right side of my belly button under rib area and some how i felt it pulled slowly to my back. Pain was felt only at night. Yesterday when laying in by back i felt like cold fluid running inside my back. Can this all be my nerves? Like i was explaing, the triple pack of antibiotics to treat h. Pylori made me feel worse. Had so many symptoms, feet sweeting, could'nt control my breathing at times, strong pain in stomach, metal mouth, very thirsty,a strong pressure inbetween my shoulder blades that pulled slowly, one night my heart raised quickly because i thought something happend to my toddler, i was able to control myself before it turned into a panic attack. I just want to be normal, I'm starting fall classes in college next week, only taking two. During the summer in XXXXXXX i took two and i was under a lot of stress, since i had never taken summer classes. On july i started feeling mild anxiety, but it was a feeling of something in my chest and my throat tightens. I do admit i was worried when diagnosed with h. Pylori since my grandfather passed away last year from stomach cancer. I was so paranoid i took my kids to get tested and i just got a called of negitive results. I feel that my problem is not in my stomach, but in my intestines i feel movement like if i would have something kicking. I can't be pregnant got my tubes tied almost 3 years ago. Also feel a sensation of when you get air in a side when your running, on both sides of my abdomen. Liquid warm and sometimes cold. Quick pinch here and there. I'm scared of getting that strong pain again in my right side. Could it been i pulled something that day since i had just finished eating my unhealty fried strips with friesand sat on the recliner too fast? Since i was sore the next day from my right side, but then i got it again that same night. Forgot to mention i could't lay in bed in that side because it would cause pain. Now i can sometimes, but i've been sleeping in my left. I will get check this week, but i will be going to mexico since i don't have insurance.
Thank you doctor
doctor
Answered by Dr. Mukund Savaskar (4 hours later)
Brief Answer:
?Acute Duodenal Ulcer with burrowing posterior Ulcer with Gastritis.

Detailed Answer:
Provisional Diagnosis-?Acute Duodenal Ulcer with burrowing posterior Ulcer with Gastritis with peri-duodenitis

Hi,Dear,Thanks for the exhaustive reply with all its relevant details.(1st F/u)
I studied meticulously,all the details of your updated reply.
I reviewed your query with the facts of the updated reply.
Now I could understand your health concerns,about the H.Pylori infection,as your Grandfather died of stomach cancer.
The obsession of death and the fear of the excruciating /cutting or drilling pain you had in right abdomen spreading to back,stressed you a lot,due to much anxiety you had there after.
This has occurred due to the stressful events related to your family, job and lifestyle before that night pain attack.


My Impression about the last Acute Emergent Abdominal Pain-

As you had the pain on right side of abdomen, under the ribs,and just right to the belly button,was preceded with some stomach pain, with stressful life patch accompanied by the fried unhealthy strip with pinching pain drilling to the back of the abdomen,
-you seem to have got Acute on Chronic DU with posterior burrowing ulcer,which almost leaked that day due to the fast jolt of the reclined position that night.
This diagnosis, is confirmed from your submissions that you could not sleep on the right side and had to sleep on the left side that night and you had a sore right abdomen the day after that pain attack.(indicating the rigidity from the periduodenitis from the leaking Duodenal ulcer)
-The triple antibiotic and proton pump inhibitor pack only increased the distress,as your upper GI system was in acute shock that night,due to the leaking posterior burrowing ulcer
-The pinching pains abruptly coming suddenly, with sighing air breathing you had that night indicates the irritated diaphragm due to the leaking burrowing Duodenal Ulcer.

Remedy-
If I would have been your attending Specialist-I would suggest as follows-which could be executed under care of your ER Surgeon / ER Gastro-enterologist-

-Urgent Consultation of the ER Surgeon,who would treat it by 2 ways-
1-If no hospitalization,then-
ONLY Nil By Mouth,
Liquids sips/with proton-D with amoxycycline +clarithromycin under doctor controlled observations at home

OR/if need be

2-SoS Hospitalisation is required onlyif there is Air under the domes of the diaphragm,if need be.

-Nil By Mouth- till further orders-This would reduce the leaking and pain associated with it.
-Iv Fluids with Rantac Inj
-X-ray Standing abdomen with domes of diaphragm studies for entrapped air,
-OGD-Oesophago-Gastro-Duodenoscopy
-IV Metrogyl/Amoxycycline/Clarithromycin
-Don't Self medicate your self.Just consult ER Surgeon URGENTLY.

Hope this advise would help you out to plan treatment with your doctors in ER department.

Decision of this acute plan of treatment would be decided by you and your doctor who are the best judge in the given situation.

Hope this reply would help you to satisfactorily deal with your ACUTE ABDOMINAL EMERGENCY,which could be treated so as to prevent further complications,caused by late treatment in such a serious and acute condition you have.

I would love to help out till you come out of this critical problem.
Don't worry and just resend any further query in this regard to Me by a direct question to ME, if need be.

Wishing you fast recovery of this abdominal pain.
Await your further query in this regard to ME.
Have a Good Day.
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Mukund Savaskar (2 hours later)
Thank you doctor, i will be seeing my a doctor soon and request the following. Posting a picture of the side i got the pain and somehow i felt it moved toward the back.
doctor
Answered by Dr. Mukund Savaskar (8 hours later)
Brief Answer:
?Acute Duodenal Ulcer with burrowing posterior Ulcer /Under Investigation

Detailed Answer:

Provisional Diagnosis--?Acute Duodenal Ulcer with burrowing posterior Ulcer with Gastritis with peri-duodenitis / Under Investigation(3 rd F/Up)

Hi,Dear thanks for your relieving remarks and confidence you got with this reply ordeal over last 2 sessions,though it was time consuming at my end.
I reviewed your photograph and I am relieved that the things appear to be limited to the right abdomen still.
After the photograph it seems that many other possibilities need to be ruled out before the final opinion after check up with your doctor, is arrived.
I don't want to confuse you more by telling the technical details of the differential diagnosis as Your doctor would take care of it.
IN CASE YOU NEED ANY HELP-in time to come, you are welcome at any time with direct question to ME at HCM.
And hope everything will be right if you stick to advises given strictly.

Remedy- Suggested till you consult your doctor-

-Only Sips of Liquids/diluted Milk shakes without cream-if it is allowed by your stomach feel and nothing else to avoid any increase in pain.

-Don't take solid food till the time you are cleared from your doctor upon which you can very well consult ME by direct query at HCM.

-Continue drugs prescribed by your doctor (Triple antibiotic pack with PPI-Omeprazone,amoxycillin, clarithromycin with Metrogyl / Ornidazole)

-Don't take any painkillers as you took in the past, because things would complicate more with it.

-you may need CT/MRI studies with endoscopic(OGD and Fiber Colonoscopic Studies) study of GI (Gastro-Intestinal)system,if need be,which would be decided by your treating doctor, or you could consult ME at HCM at that time.

-Thus a team of ER Surgeon and Endoscopist would be required to deal with your problem.


I Hope that with this reply,you would be satisfied and relieved of your anxiety and worry you had with your complex abdominal problem.

Write excellent review and hit thanks, with your strong comments which would improve my rating for the new visitors at HCM.

Await any further query in this regard in time to come.

Wishing you fast recovery from this emergency -complex health problem.
Keep ME informed at my YYYY@YYYY about further help and progress,as I am curious to follow your case for its outcome.

Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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Suggest Treatment For Right-sided Sharp Pain In Abdomen

Brief Answer: Acute Abdominal Pain with?Gastritis / Under Investigation Detailed Answer: Hi,Dear,Thanks for your query to HCM. I studied your query in all the details given from you. Can you five more information on discomfort on right / left abdomen and in rib area. Is the pain related to dietary intake?What's your routine diet-is it spicy? Any overindulgence in tobacco/alchohol/smoking/ tea/coffee? do you get 8 hrs sleep? What's your daily work and diet schedule? Also give me your past history of similar illness and other illness,if any. Please update me with needed documented medical reports of tests done so far. Besides those please specify the questions which you want to address. I might be able to address your specific concerns accordingly. I requested for specific questions as your case is already treated for H.pylori,on which you were noncompliant for your reasons. Your painful period is also setteled. In the interim advise on Suggested Remedy- -Take non-spicy bland/steamed non fried / diet -Control on your outside food eating,if any. -Stick to liquid diet for 1-2 days till your get relieved -Avoid smoking/alchohol/spicy/ fried food for 1 week -update your stool /edoscopic report if done. Hope to get more information as what you need currently. Awaiting your updates, Dr.Savaskar M.N. M.S.Genl-CVTS XXXXXXX Surgical Specialist