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Pain in RUQ and midepigastric radiating to the back, nausea. Prescribed Zofran ODT. Next steps?

Hello my name is Melissa, I am 30 yr old healthy female. 5'4" 130lbs. Exercise regularly. Very active. About 3 months ago started with RUQ pain, Mid Epigastric pain, which radiates to my back. Nausea which I had to be prescribed Zofran 4mg ODT for. I am taking at least once daily. I have had a normal abdominal ultrasound. What should be the next steps?
Asked On : Sat, 4 May 2013
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General Surgeon 's  Response

Thank you for the query.

Such symptoms can be caused by gallstones (what has been ruled out with an ultrasound), bile ducts stones, pancreas inflammation, urinary tract infection, peptic ulcers.

As you have had an ultrasound, next step should be blood work, liver tests (AST,ALT,GGTP,AP), bilirubin, amylase, urine amylase, urine analysis. If GGTP and AP will be elevated, ERCP should be done. If not, regular endoscopy seems advisable.

Hope this will help.
Answered: Sun, 5 May 2013
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