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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do my lab test reports indicate?

Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1942 Questions

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Posted on Sat, 24 Mar 2018 in Digestion and Bowels
Question: Hello,

Just curious about something...

If I've been experiencing RUQ pain for two years now, in which it started after a meal and has not gone away. It is typically aggravated after eating or drinking anything that isn't just water. Sometimes it'll hurt with no eating at all. It has also recently started to hurt on the middle-left of my back/abdomen. I've had an MRI, endoscopy, and a few blood tests.

If these all came back normal (amylase, lipase, trypsin, MRI, etc), is there a chance of this still being cancer or just simply a digestive issue?
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Gastritis is not always apparent on endoscopy.

Detailed Answer:
Hello,
Thanks for query dear patient,
Have gone through your details and i appreciate your concerns.
As per your query answers are-
No it can't be cancer or a precancerous state if MRI and endoscopy are normal.
However yes it can be gastritis.As said by you pain is directly related to food intake so most likely it can be due to a inflammation along the gastric mucosa.Endoscopy is used to rule out possibility of peptic ulcers,However gastritis(inflammation) is not always apparent and is not necessary that we can appreciate inflamed area in every patient of gastritis.
A better way in your case is to see how your pain responds to acid inhibitors(clinical diagnosis).

I would suggest you take omeprazole 40 mg twice daily an hour before having heavy meals along with an antacid syrup for few days and see if pain responds to it.

Secondly get a 2d echo of heart done.Some times post parandrial pain in upper abdomen with normal gut investigations can be suggestive of angina.
A 2d echo would rule out possibilities of angina.

Hope i was helpful.
Warm regards and feel free to follow up.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
Thank you for the response doctor. I will say that i have taken pantoprazole before and it didnt have an effect. I also had a stress test done not too long ago (a few months ago) and the doctor noted mild thickness but nothing that would be causing this pain .
doctor
Answered by Dr. Ramesh Kumar 12 minutes later
Brief Answer:
Follow up answer.

Detailed Answer:
In that case i would suggest you to go for a stool test to see parasitic or helminthic infestation in intestines.
If that test also turns up to be normal i would suggest you to take probiotic and a antispasmodic like dicyclomine for a few days and to see if it helps.
As of now as tests are normal just on the basis of history its difficult to conclude things.
If there is some residual infection in gut then on taking food peristalsis increases pain starts,Antispasmodic could slow down contractions of peristalsis hence could help.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 47 hours later
I was actually wondering if parasites were the cause. If i may ask doctor, today a new sharp stomach ache has come on, in the center of my abdomen (please see picture); would this be in line with parasites or could it be stomach or pancreatic?
doctor
Answered by Dr. Ramesh Kumar 7 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Parasite can be a cause(less likely) easy way is take albendazole 400 mg one tablet for three days at night time.
Please attach the picture dear i can't find any attachments.
Waiting.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 13 hours later
Im waiting another day or two to see if it goes away on its own; does this area possibly linkk to somethink pancreatic or would it be something more like a viral gastroenteritis / parasite?
doctor
Answered by Dr. Ramesh Kumar 10 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again ,
Pancreatic condition are rarely related with of and on pain,Usually pain is very severe in most of the cases.
So I dont feel its pancreatic.Secondly MRI is a very sensitive test and would have reflected pancreatic pathology.

For parasite if you don't want to take albendazole go for a stool routine test most of the times parasites are reflected in it.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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