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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is pain in the upper right abdomen?

Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1958 Questions

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Posted on Thu, 7 Jun 2018 in Digestion and Bowels
Question: Wondering how concerned I should be- 35 year old male, non smoker, light to moderate alcohol consumption. I've been feeling under the weather the last month or two. A couple weeks ago I had full CBC with diff. and liver/kidney blood/urine tests all normal as part of my normal physical due to feeling lethargic. All results were normal. Then,ironically, a couple days later (after blood tests) I started experiencing severe abdominal pain after a large meal out at night. The pain lasted a few days (first night was really, really bad almost went to ER as I thought it could be acute pancreatitis) and it got better progressively over a day or two. No vomiting or fever, with the pain, but the upper quadrant (mostly right) felt stabbing and very uncomfortable. I am not a big drinker (socially moderate, don't do drugs), and did not drink that evening at dinner my symptoms started. I called my doctor the next day and he told me that it was probably gastritis or an ulcer (did not think acute pancreatitis) and prescribed an antacid which actually did help with the pain. The abdominal pain has pretty much gone away the last week. Stools are pretty normal, no real history gastro issues, family gallbladder or kidney issues. I saw my doctor again earlier this week just to touch base and he agreed to do Lipase, Amylase, and CRP blood draw on my insistence. He called today to tell me XXXXXXX and CRP were normal, but Lipase was slightly elevated at 76 U/I (the lab he uses says 60 U/I is normal cut off.) He did not seem very concerned at all, but is sending in my for abdominal ultrasound next week. Only meds I take are Tylenol and the antacid he prescribed me. Now I'm worried thinking there is something wrong with my pancreas or liver/kidneys, etc. Does this sound like a concerning situation? Thanks you.
doctor
Answered by Dr. Ramesh Kumar 10 hours later
Brief Answer:
Ultrasound has to be done.

Detailed Answer:
Hello,
Thanks for query,

pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back. The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen.I dont feel both of them fits into your history.
Right upper quadrant pain is a common complaint that typically stimulates a workup of the hepatobiliary system. In particular, evaluation of the gallbladder (GB) is important because cholelithiasis and its complications are a frequent cause of RUQ pain.
Your dictor have suggested you an ultrasound which should be done to rule out the above mentioned condition.

Regards!
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 57 minutes later
Thank you. Is a level of lipase at 74 U/L very concerning?
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
follow up.

Detailed Answer:
You welcome.
Not at all sir.Mild elevation of single enzyme has no clinical significance.

Thanks!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 4 hours later
Thank you doctor. Last question. If the cutoff was 60 u/l (US Lab) and my reading was 76 u/l that would be considered a mild elevation, correct?

Thanks!
doctor
Answered by Dr. Ramesh Kumar 14 hours later
Brief Answer:
follow up

Detailed Answer:
Hello again my dear patient,
20-30 u/l elevation is considered as mild only.

Regards!
Please feel free to follow up.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 10 hours later
Thank you doctor. Would you mind appeasing the hypochondriac in me? My GP in the US won’t order the ultrasound for another week or two. I made the mistake of googling “abnormal” lipase results. (Even slightly elevated). The internet is full of people terrified of medical abnormalities.
Can you reassure me the prospect of a tumor is highly unlikely? Thank you.
doctor
Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
follow up.

Detailed Answer:
My dear,
Please don’t panic.

It's not a tumor sir.

A tumor means uncontrolled growth of cells.So when growth is uncontrolled the level of elevation of various enzymes is massive 10-20 times the normal.

Please follow only reliable sites, sir.
In fact to have any clinical significance any enzyme should be elevated at least 3 times the normal limit.
Rest assured, try to get an Ultrasonography done.

It doesn't seem like pancreatitis nor cancer.

Wish you a good day ahead.
Fel free to follow up.

P.S. Please don't rely on threads written by others. Only follow the reliable sources.

Thank you!

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