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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for severe back pain

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Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 3154 Questions

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Posted on Fri, 3 Mar 2017 in Abdominal Pain
Question: Quick question,

I don’t mean to ask the question over and over, but I was just had a quick question about this upper right quadrant pain….

As in previous posts, I’ve been having this right upper quadrant pain for the past 10 months (that is accented with sitting/being hunched, as well as when eating/drinking something that isn’t water).

My question is, would applying pressure to this area (see picture of example), that when doing that relieves the pain/ache, probably be a tumor/cancer?
I’ve also noticed that when I add pressure, I can feel a pulse, if that means anything. There is also radiating back pain that occurs too, not always with the abdomonal pain, but its there at times.

My GI doc seems to not think so but this ache/pain is pretty constant and scary. My recent blood tests came back normal, so there’s that.

Please let me know!
Thank you
doctor
Answered by Dr. Albana Sejdini 2 hours later
Brief Answer:
Seems distented colon from gas...

Detailed Answer:
Hi Chase,

I understand your concern.

Now, the pain you are feeling on your upper right quadrant of abdomen when all the tests resulted normal seem to be related to gas.
Accumulated gas after you have something to eat is causing distended colon, that will make you feel the sensation of pain.

However, it is true that gallbladder and liver issues should rule out too.

Sometimes, hidden appendicitis can precipitate such symptoms even in cases of normal blood count. Abdominal Ct-scan with contrast can help rule it out.

We can't think over cancer if you have pain for the moment. We should exclude other more common causes first. Furthermore, if you have had tests so far, they could have identified the cancer already (if any).

When you press with your finger, the gas is being re-organized giving the sensation of pulse. This pressure is also put on the nearby nerves and back organs/structures explaining why you have back pain too.

So, to me, you do not need blood tests only, but other radiological examination like ct-scan abdomen with contrast, abdominal ultrasound, colonoscopy, fecal examination/analysis.

Hope this helps.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 20 hours later
I understand doctor. I suppose that the reason im concerned is that its been persistent (slowly gotten worse) over the past 10 months. It also does occur on my upper left side at times as well. The blood tests are normal and the last ct i had (9 months ago) just found fatty liver disease. I should mention that i had my gallbladder removed 12 years ago .
doctor
Answered by Dr. Albana Sejdini 14 hours later
Brief Answer:
Still thinking of diet and lifestyle changes...

Detailed Answer:
Hi back,

Thank you for providing additional information.

Having your gallbladder removed requires special attention from your part when it comes to foods/drinks consumed.
When you eat/drink wrongly, your GI tract will suffer including your bowels. And you'll finish with the painful scenario.

Fatty liver disease makes me think or strengthen my idea that you are not eating/drinking right. Most probably you are consuming alcohol or high calorie/fatty foods that are making your liver suffering and fatty.

Perhaps you might have started any new medication (e.g. antibiotic or another) that might have altered intestinal flora.
Intestinal parasites can also give the symptoms you are feeling.
If you have ct-scan 9 months ago, then, appendicitis is ruled out.

To me, stool examination for ova parasites, and food intolerance is recommended. Pancreas and liver function test to re-check too.

Changing diet habits and being more physically active can also help.

Hope it helped.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 8 hours later
I definitely do not have the healthiest diet, but i do not drink alcohol at all. I have not started any nee medications. This pain came on out of nowhere and hasnt gone away. Nothing was abnormal about that day .
doctor
Answered by Dr. Albana Sejdini 14 hours later
Brief Answer:
Stool examination/intolerance tests/abdominal ultrasound to run further

Detailed Answer:
Hi back,

Ok then, discuss with your doctor to run stool analysis and culture and to intolerance tests.
Furthermore, another abdominal ultrasound is recommended since the pain is not getting away together with following a healthy diet plan.

All the best.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 4 minutes later
Ok will do. I have an MRI next monday. Hopefully that identifies if. Could a parasite, as you mentioned, cause this back pain too?
doctor
Answered by Dr. Albana Sejdini 4 minutes later
Brief Answer:
Ok, then, let me know the reports...

Detailed Answer:
Hi back,

Ok, then it's ok for MRI.

Parasites will cause alterations in intestinal flora possibly bloating. Distended bowels will press on the nearby nerves deriving from the back and giving the pain on the back.

However, we should identify other problems like urinary tract infection (through urine analysis) or those related to other organs inside the abdomen to determine what is really causing the back pain.

Let me know how it goes.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 4 hours later
Will do. When I went to the ER last month, they ran 3 tests: CBC (blood count), Comprehensive Metabolic Panel, and Amylase, all of which came back normal.

The oddest thing about this pain, is that applying pressure relieves it. Makes me wonder if it's a rumor or something, but as you said, only an image can show that.
doctor
Answered by Dr. Albana Sejdini 3 hours later
Brief Answer:
To me, it's gas...

Detailed Answer:
Hi back,

To me, it's gas.

However, let's have the image studies conclusions first.

Let me know how it goes.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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