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    What causes occasional abdominal pain with cramping in upper right quadrant?

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Posted on Fri, 3 Jun 2016 in Abdominal Pain
Question: Hello, I'm hoping you can help me. I'm a 33yr old woman & for the past 5 weeks I've been experiencing a range of symptoms. It started with occasional abdominal pain, crampy feelings on the right upper quadrant, which was very mild , so I didn't think much of it. Within the last 3 weeks I noticed that my bowel movements were paler than usual so my GP ran some liver function tests, everything came back normal. They are not constantly paler, but frequently & when I say paler I'm talking sort of a XXXXXXX , very light brown color. I also noticed a few times a little blood, which was a mid reddish color. As I have a few hemoroids from child birth the gp said it wasn't anything to worry about. However in the last two weeks I've had loose watery stools, not diahorrea I think as I'm not going to the toilet lots of times a day, but when I do it is fairly loose. The crampy pains are still there a little more frequently and mostly still on the right side. I also have had occasionally a little tenderness across the abdomen & I've noticed my stomach seems very noisy. Also a little more gas than usual and sometimes a feeling of hunger pangs, even straight after eating, but again not every time. I suffer from health anxiety so I'm always thinking the worst. Please could you give me your professional opinion as I'm starting to get extremely worried. Many thanks, XXXXXXX
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Enteritis

Detailed Answer:
Hi.
Thanks for your query and an elucidate self-explanatory history.
To recapitulate: Female/33 - problem started 5 weeks ago with occasional abdominal pain - cramping in right upper quadrant - 3 weeks - BM paler sort of a XXXXXXX very light brown color - mild reddish blood sometimes - normal liver function tests - 2 weeks loose watery stool - little tenderness - very noisy - more gas - hunger prangs even after food - health anxiety - wants professional opinion ...

With this history I would think this as a case of enteritis and would advise you the following:
Get the stool tests done for 3 consecutive days.
If there is evidence of an infection get a clinical evaluation, examination and further tests like ultrasonography and other blood and urine tests.
I feel a course of an antibiotic along with probiotic should solve your problem- needs a prescription of your Doctor.

I hope this answer helps you to get a proper an an early diagnosis and proper curative treatment, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 3 hours later
I just wondered because of the lighter bowel movements if pancreatitis or gallbladder issues could be a possibility? As I forgot to mention I usual get some pain within an hour of eating?
doctor
Answered by Dr. T Chandrakant 44 minutes later
Brief Answer:
Stool get a clay color.

Detailed Answer:
In obstructive jaundice the stool is clay/white colored.
Pain within an hour of eating needs to be investigated by Upper GI endoscopy and get EUS that is endoscopic ultrasound which has high resolution. Along with the routine ultrasound of the abdomen.
Further studies can be done if there is clinical and lab tests supporting the possible cause as you have mentioned. GGT and Alkaline phosphatase are very sensitive and raise up. If these are normal, there is less chance of obstruction to the bile flow.
In addition MRCP and CT scan of the whole abdomen helps in some cases to confirm or rule out some of the problems.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 37 minutes later
Thanks so much. With the pain after eating , do you still feel that it could be an infection of some kind. Very worried now about pancreatic cancer, is this something that could be causing these symptoms?
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Go for the tests as explained above.

Detailed Answer:
Thanks for an appreciation.
Considering the whole history together the feeling remains the same and as for the pain after one hour of food can be due to the factors as I explained above.
Pancreatic cancer is usually painless in the initial stage and once you have a suspicion, it is better to get the exact diagnosis by most appropriate tests either to confirm or to rule out a given cause.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 25 minutes later
Again, thank you for your prompt and informative response. Last question, in your professional opinion is pancreatic cancer likely? I know there is no definite way of knowing without tests etc but does it occur at my age often? Would there be any additional symptoms to look out for? Thankyou.
doctor
Answered by Dr. T Chandrakant 50 minutes later
Brief Answer:
Please go for the tests too.

Detailed Answer:
Can not say.
Since this is concerned with an elusive cancer and as we see in practice, it presents in various ways, hence the best option to get the thing out of mind is to get a proper clinical evaluation and investigations as discussed.
Does not occur at your age so often.
Back pain, loss of appetite and loss of weight any other symptoms that can not be really explained.
I hope this answers your queries
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

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