What causes abdominal discomfort with flatulence?

Posted on Wed, 5 Mar 2014

Question: My bilirubin has been consistently elevated for over 20 years during blood tests. It usually stays around 1.7. All other liver function tests have always been normal except this time my white blood count was just ever so slightly up, the doctor said not even enough to mention. I have been having some discomfort in my abdomen mostly on the left side 2 or three inches below the rib cage and every now and then I get a dull discomfort on my right side just below my rib cage. Sometimes the discomfort level raises for a split second or two the goes away. My abdominal discomfort has been off and on for most of my adult life. It started in my early 20's and I'm 52 now. No major pain just slight discomfort (1 on a scale of 1 to 10 and 10 being severe). I've had ultra sounds in the past all have been normal with the exception of an ulcer or two several years ago. I am physically fit about 5' 11" and 175 pounds. I have been around 175 for ten years or so, before that I was 160ish. After I eat I sometimes get lots of gas and my stomach churns and churns. What could be my problem. Each time I look on the internet it leads to liver or pancreas disease. If I had liver disease would my other liver function test be out of the normal range since my bilirubin has been slightly elevated for over 20. I have another ultra sound scheduled for tomorrow. Should I be worried about liver disease, hepatitis or pancreatic cancer. I do have shortness of breath from time to time without being active. I can just be sitting around and have shortness of breath. The more active I am the less I notice it. My blood work for triglycerides and cholesterol was good as well.

Answered by Dr. Meher Lakshmi Konatam (4 hours later)

Brief Answer: neither hepatitis nor cancer Detailed Answer: Sir, from the history you have provided, it looks nothing abnormal. Your bilirubin is stable since a long time. Some people have higher than normal values of bilirubin and it is normal for them. Some are labelled Gilberts, but they are normal variants and they do not have liver dysfunction not they progress to liver dysfunction in future. Since your liver function tests are normal, hepatitis is ruled out. Coming to your question of pancreatic cancer, it is extremely unlikely for pancreatic cancer to remain silent for years together. After it starts it progresses rapidly and becomes symptomatic in no time. Your pain might not be related to cancer since it is there for a long time. But remember no one is immune to cancer and it can apper in anyone at anytime. No use worrying about it. Coming to your symptoms, they might be related to acid peptic disease or irritable bowel. Both are benign conditions and you can seek the advise of local gastroenterologist. all the best

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Meher Lakshmi Konatam (11 hours later)

I went for my ultrasound today they tell me everything looks normal except my gall bladder is smaller than normal. When they were doing the ultra sound and they were over the places I have some slight discomfort from time to time, I ask them what was there and on both side they told me my colon. Sine I am 52 and never had a colostomy done I think my doctor is scheduling me for one.

Answered by Dr. Meher Lakshmi Konatam (35 hours later)

Brief Answer: colonoscopy can be done Detailed Answer: its not colostomy, but colonoscopy. Yes, i feel you need to get one done to rule out lower intestinal problems. I feel you also need upper GI endoscopy. If both are normal, you can sit and relax!

Above answer was peer-reviewed by : Dr. Shanthi.E