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What Causes Discomfort In Right Side Of The Abdomen Below The Rib Cage?

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Posted on Mon, 12 May 2014
Question: Hello - i have been having ocassional discomfort in the right side of my abdomen just below the rib cage, sometimes on the directly across from my belly button. Its more like a fullness feeling. Ocassionally it radiates to my back, but goes away in the morning. That has only happened once or twice and seems to happen when I am really tired. I was told it could be my gallbladder but it doesnt hurt when I drink alcohol. Could it be acid reflux?
doctor
Answered by Dr. Grzegorz Stanko (56 minutes later)
Brief Answer: Gallstones. Detailed Answer: Hello! Thank you for the query. It sounds like gallstones pain indeed. Please note that alcohol does not have to trigger the pain. Gallstones cause pain when there is gallbladder contraction. Bile is used to digest fat mostly. So in case of fatty meals there is a strong gallbladder contraction what results with pain. And the pain is not always present. It also depends of the stones position (the pain is more intense if the stone obstructs the entrance to gallbladder). It is very characteristic for gallstones to cause upper middle or right abdominal pain/discomfort which radiates to the back. Other organ which can give similar symptom is pancreas. Pancreas pain is strongly associated with alcohol intake. Acid reflux does not give back radiation at all. It gives upper middle, dull pain, chest burning and nausea. So it is hardly possible that your symptoms are caused by acid reflux. In differential diagnostics, peptic ulcer should be considered. In my opinion you should: - have abdominal ultrasound and liver tests, bilirubin levels and amylase levels first - if this tests will be negative, gastroscopy should be second In a meanwhile you should avoid fatty foods, spicy foods, fried foods, coffee (very important). Hope this will help. Feel free to ask further questions. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (8 minutes later)
Hi i had a liver test dont recently and it came back fine. It was in Feb. I had an ultra sound of my abdomen a year ago without any issues. Do gallstones always require surgery?
doctor
Answered by Dr. Grzegorz Stanko (4 minutes later)
Brief Answer: . Detailed Answer: Gallstones not always require surgery. We can avoid it in case of elder age or lac of symptoms. Young age (which is yours) and symptoms (which you have) are both single indications of surgery. Please note that some gallstones (especially small like few mm) can obstruct pancreas duct. If it happens, acute pancreatitis can be a serious complication of it. Since last year lots could have change. Especially if in that time there was no symptoms. Liver tests are usually negative in case of gallstones. They are used to diagnose other, liver and bile ducts related issues. Hope this will help. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (3 minutes later)
Does the discomfort come and go? I can go weeks without any issues.
doctor
Answered by Dr. Grzegorz Stanko (3 minutes later)
Brief Answer: . Detailed Answer: Yes, this is very characteristic. Like I have mentioned before, it depends of the stones position in the gallbladder. Many people (especially woman are prone to have gallstones) have gallstones and do not know about them. It is because the gallstones can be painless for many years or give occasional discomfort. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (1 minute later)
Is the surgery a major surgery?
doctor
Answered by Dr. Grzegorz Stanko (8 minutes later)
Brief Answer: . Detailed Answer: It is not major surgery. But as every surgery it is serious and can give some complication (bile ducts injury is the most serious complication, but it happens very rarely). Gallstones surgery is done with laparoscopy (so called key-hole surgery). Through 3 or 4 small holes made in the abdominal wall gallbladder is removed. Usually, one day after the surgery patients are discharged home. After a week of surgery, you should get back to normal (so you can come back to work for example). 3 months of liver diet is necessary after this surgery. Stitches are removed about 10 days post surgery. So in conclusion, this is kind of standard surgery which usually does not cause any problems after it. Regards.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5795 Questions

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What Causes Discomfort In Right Side Of The Abdomen Below The Rib Cage?

Brief Answer: Gallstones. Detailed Answer: Hello! Thank you for the query. It sounds like gallstones pain indeed. Please note that alcohol does not have to trigger the pain. Gallstones cause pain when there is gallbladder contraction. Bile is used to digest fat mostly. So in case of fatty meals there is a strong gallbladder contraction what results with pain. And the pain is not always present. It also depends of the stones position (the pain is more intense if the stone obstructs the entrance to gallbladder). It is very characteristic for gallstones to cause upper middle or right abdominal pain/discomfort which radiates to the back. Other organ which can give similar symptom is pancreas. Pancreas pain is strongly associated with alcohol intake. Acid reflux does not give back radiation at all. It gives upper middle, dull pain, chest burning and nausea. So it is hardly possible that your symptoms are caused by acid reflux. In differential diagnostics, peptic ulcer should be considered. In my opinion you should: - have abdominal ultrasound and liver tests, bilirubin levels and amylase levels first - if this tests will be negative, gastroscopy should be second In a meanwhile you should avoid fatty foods, spicy foods, fried foods, coffee (very important). Hope this will help. Feel free to ask further questions. Regards.