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    What does this CT scan report indicate?

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Posted on Wed, 26 Jul 2017 in Liver and Gall Bladder
Question: Hello doctors,

So I've been having abdominal issues for years now. Had my gallbladder removed 12 years ago. I've been having RUQ pain (just under the ribs) for the past 2 years. Now I'm having it on both sides, but the right is more pronounced, as well as feeling it in the back. I've had two CT scans, an MRI, and tons of blood/urine work, all of which came back totally normal. The MRI rules out diverticulitis, and it seems to be inflamed more after eating, particularly heavier foods. I've had a heart ultrasound and stress test done to rule that out, normal with no risk.

When I was eating healthy and working out, the RUQ pain went away completely.

I'm just curious what this could be because my family doc and GI doc can't figure it out. I'm afraid that it's something like cancer but the tests would've shown that I assume...
doctor
Answered by Dr. Sunil 47 minutes later
Brief Answer:
Gastritis a diagnosis of exclusion.

Detailed Answer:
Hi There,
Thanks for choosing HealthcareMagic.
Have seen the reports.
See chest heaviness and pain of and on especially after eating heavy food can be due to-

1) Cardiac issue- But cardiac disease at a age of 30 is very rare unless you are a smoker or have strong family history of cardiac disease.
In your case 2d echo and Stress test are also normal. So its very unlikely that its cardiac.
2)Gastritis -As all investigations are absolutely normal its very likely that symptoms are due to gastritis and dyspepsia.In gastritis large amount of acid produced irritates the soft lining of gut causing severe pain and gastric irritation.
Its not cancer tests would have shown that.

Suggestions-

Take a proton pump inhibitor like Esomeprazole 40 mg twice daily along with a prokinetic drug (eg.Domperidone) for 5 days. This will provide you symptomatic relief from symptoms of dyspepsia (you may need to obtain prescription for this from your local physician).

Antacids can be taken for few days along with it.
Any over counter probiotic should be taken for few days to provide relief in symptoms of indigestion.

Apart from this, some dietary restrictions are to be followed-

- Avoid alcohol or smoking.
- No aerated beverages.
- Take light non spicy easily digestible food for few days.
- No Fast food like pizza or burger should be taken.
- Drink a cup of cold milk daily.
- Avoid fatty foods.

Follow up after 5 days if symptoms are relieved its gastritis.

Thank you!
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil 15 hours later
I has a stress test and heart ultrasound and the doc said that they all came back normal except for mild valve thickness (said losing weight would take care of it).

For this reoccuring stomach and ruq pain, no other docs can figure it out. CT and MRI came back normal except for a little fatty liver.

The only reason i thought cancer was because this pain is hardly ever relieved, except by exercise

I will start with the proton pump and probiotic. .
doctor
Answered by Dr. Sunil 1 hour later
Brief Answer:
Follow up answer!

Detailed Answer:
Hello again,

No, only proton pump inhibitor won't do.
You have to take a prokinetic drug(as adviced earlier) along with it.

Once you will take medicines properly pain would relieve.

So follow up after 5 days of taking medicines.
Cancer would have been reflected in imaging tests.Mild fatty liver is normal and has nothing to do with your problem.
Its Gastritis and only response to medical therapy can help us diagnose it.
Thanks!
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sunil 3 days later
Understood doctor. Its just bizarre i guess that theres a nagging upper quadrant pain caused by stomach inflammation. Is thag common for gastritis?
doctor
Answered by Dr. Sunil 9 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Gastritis can pesent as pain in upper quadrants of abdomen specially epigastric area.
Yes its very common.
At a age of 30 it can't be cardiac secondly your basic tests are normal.
Your symptoms are typical of gastritis.As gallbladder is already not there we have to rule out possibility of gastritis initially.
Ct,MRI etc all atre normal.If any of the abdominal organs were involved it would have been reflecte in scans.

So ruling out gastritis initially is the best policy.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sunil 8 days later
Ah that makes sense. Its so odd how randomly, such as today (all day), I'll get bouts of nausea, with almost no identifiable cause. Again, doctos cannot fogure this out either. They think it too might be gerd or something .
doctor
Answered by Dr. Sunil 16 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hi again,

Start following the suggestions I gave you earlier, and tell me how you feel after a week.

Thanks!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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