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What Causes Diarrhea,blood In Vomit And Severe Right Sided Pain At Back?
Question: I keep having bilious attacks, almost once a month now and sometimes less than that, it seems to effect my bowels too, making my stools watery and unpleasant. I also have blood in the vomit, which starts off very thick yellow like egg yoke, then turns brown and then as it progresses it gets pale and very acid. ITs wearing me out. MY Dr thinks I am just susceptible to picking up bugs, but this happens even iff I don't have contact with others. The latest one started with severe pain in the lower right side of my back that hurt worse when breathing in.
Brief Answer:
Liver problem, bile duct, GERD and kidney disease
Detailed Answer:
Hi and thanks for the query,
I think a careful biological review (blood testing) and some ultrasound exams need to be done. The pain you describe deserves a careful exclusion of a problem with the bile duct, the gall bladder and the liver.
A simple abdominal ultrasound shall be very useful. Specific blood tests like ALAT/ASAT (specific liver exams that if raised could indicate liver damage), Total, direct and indirect bilirubin levels, 5' Nucleotidase are all exams that could indicate blockage of bile flow.
Depending on the results of these tests and the ultrasound, an abdominal CT scan could be useful, but not always.
It is also possible that gastroesophagal reflux disease (GERD) could cause stomach contents to go up to the mouth. This repeated leads at times to destruction of the membranes at the lower end of the esophagus leading to bleeding. This could be seen in the vomitus as you describe. pH measurements and diagnostic testing, using proton pump inhibitors like Omeprazole, if response is obtained, could indicate GERD.
Severe pain on the lower right side of the back could either indicate a liver or a kidney problem. An abdominal ultrasound shall be very useful. Based on its findings, a simple urine analysis in search for positive nitrites and leucocytes could be diagnostic of a urinary tract infection. A urine culture would then be asked.
A proper review from your internist, with this ideas in mind could be very helpful in making an appropriate diagnosis. Thanks and kind regards.
DR Bain
Liver problem, bile duct, GERD and kidney disease
Detailed Answer:
Hi and thanks for the query,
I think a careful biological review (blood testing) and some ultrasound exams need to be done. The pain you describe deserves a careful exclusion of a problem with the bile duct, the gall bladder and the liver.
A simple abdominal ultrasound shall be very useful. Specific blood tests like ALAT/ASAT (specific liver exams that if raised could indicate liver damage), Total, direct and indirect bilirubin levels, 5' Nucleotidase are all exams that could indicate blockage of bile flow.
Depending on the results of these tests and the ultrasound, an abdominal CT scan could be useful, but not always.
It is also possible that gastroesophagal reflux disease (GERD) could cause stomach contents to go up to the mouth. This repeated leads at times to destruction of the membranes at the lower end of the esophagus leading to bleeding. This could be seen in the vomitus as you describe. pH measurements and diagnostic testing, using proton pump inhibitors like Omeprazole, if response is obtained, could indicate GERD.
Severe pain on the lower right side of the back could either indicate a liver or a kidney problem. An abdominal ultrasound shall be very useful. Based on its findings, a simple urine analysis in search for positive nitrites and leucocytes could be diagnostic of a urinary tract infection. A urine culture would then be asked.
A proper review from your internist, with this ideas in mind could be very helpful in making an appropriate diagnosis. Thanks and kind regards.
DR Bain
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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